Written Ministerial Statement

The content of this written ministerial statement is as received at the time from the Minister. It has not been subject to the official reporting (Hansard) process.

Department of Health

Neurology Deceased Patients Review (DPR)

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 Published at 2.00pm on Wednesday 3 July 2024

Mr Nesbitt (Minister of Health): I wish to inform Members of the next steps and future approach to the Neurology Deceased Patients Review (DPR), including the rationale in respect of the approach to the DPR work moving forward and to outline the arrangements to support this work.

Firstly, I would like to acknowledge the exceptionally difficult circumstances which the families of deceased patients have experienced. I wish to apologise for the hurt caused to the neurology recall patients and the families affected by these matters, and I would like to reiterate my thanks and appreciation to them for their cooperation and patience.

It is important to explain the context of the DPR and the work undertaken to date, which has been challenging and extensive.

On 2 May 2018, a public statement by the Department was provided on the neurology patient recall. This statement also confirmed that the Department had directed the Regulation and Quality Improvement Authority (RQIA) to commission an Expert Review of the clinical case notes of the patients of Dr Michael Watt who died in the 10 years prior to the neurology recall (i.e. the “Deceased Patients Review” - DPR).

Given the potential scale and complexity of the work, a phased approach was agreed.  Significant work was involved in the completion of Phase One, which was a preparatory phase, concluding in November 2020, with the formal adoption of operational protocols and a legal framework to ensure access to the relevant records and the appropriate infrastructure to enable the robust, ethical and sensitive delivery of the review.

Phase Two of the DPR commenced in April 2021. This phase involved the RQIA commissioning the Royal College of Physicians (RCP) to establish an Expert Panel.  The RCP reviewed the clinical records of 44 deceased patients and, where available, considered the testimony of families, to report on the findings.

The RQIA published the RCP Phase Two overarching reports in November 2022 which are available on the RQIA website.

The Review’s findings included significant failures in the care and treatment of patients, and identified concerns over clinical decision-making, diagnostic approach, communications with other clinicians, and interactions with patients.

The RQIA has continued to support the families involved in the DPR Phase Two and has made a number of significant public commitments in respect of the DPR Phase Two findings and recommendations. The RQIA continues to progress this work and to deliver on these commitments, in order to support the necessary improvement across the healthcare system. Furthermore, I can confirm that I plan to offer to meet with a number of the DPR Phase Two families, with arrangements to be agreed in the weeks ahead.

Throughout this period the door has remained open for any other families to come forward and my Department and the RQIA have continued to work together to determine the appropriate approach to the DPR work moving forward.

The RQIA has completed an engagement exercise with the families who expressed an interest in participating in a further phase of the DPR. The purpose of this engagement was to ascertain the families’ expectations and to provide open and honest information about the Expert Review process, including its benefits and limitations based on learnings from Phase Two, alternative options available and to determine if they wished to proceed. 

The approach to DPR next steps and the future approach has been considered and is based firmly in line with the findings of the Independent Evaluation of the Family Experience of Phase Two, learnings from the work undertaken to date, the outcome of engagement with families who have come forward and against the consideration of resource implications within an extremely challenging budgetary outlook. A key factor in this process has been to ensure the complex ethical considerations associated with this work are given due cognisance.

DPR Phase Three

To date a further 18 families have approached the RQIA and confirmed that they wish to proceed with an Expert Review in relation to a deceased family member.  The 18 families will be included in a further DPR Phase (Phase Three), with the primary purpose being to provide the opportunity to impart answers, if possible, to the families in respect of the quality of care and treatment provided to their deceased relatives.

The RQIA will commission the undertaking of Phase Three and, in common with Phase Two, the process will include the opportunity for families to provide their testimony.

It is difficult to provide definitive timescales for the completion of Phase Three, although it is anticipated that completion may be possible before the end of the financial year 2024/25.

DPR Future Approach

Further to the 18 families within Phase Three, a six-month period will be provided for any additional families who are interested in having their deceased family member’s clinical records reviewed to contact the RQIA to explore involvement in the process.

Any family who wishes to come forward to explore involvement with the DPR should therefore contact the RQIA, no later than 31 December 2024.

The RQIA will engage with any affected family who makes contact by 31 December 2024. Following this process, the Department of Health and the RQIA will clarify next steps for this stage of the DPR.

Families can contact the RQIA by:

• Freephone number 0800 052 0012 between 10am and 5pm, Monday to Friday, to speak to a member of the Family Liaison Team; 
• Emailing an enquiry to: expert.review@rqia.org.uk; or
• Filling in an online form on the RQIA website and a member of staff will be in touch.

DPR Family Support and Engagement

The RQIA Family Liaison Team will engage with families to understand: their wishes, needs and concerns; whether their deceased relatives’ case is likely to fall within the scope of the Expert Review of Records of Deceased Patients; and to provide information on the Expert Review of Records of Deceased Patients to date. 

The Family Liaison Team will ensure that families interested in participating in a clinical record review process, are fully informed about the nature of the process, the potential benefits, and the potential for adverse impact.

The RQIA will identify families who wish to proceed with a clinical record review process, will remain in regular contact with families and will ensure families are aware of how to access counselling and advocacy support.