Patients need to know risks

Cancer sufferers should be explicitly made aware of care variation, according to treatment review

Cancer patients should be explicitly warned about the risks of variation in their care from generally accepted guidelines, according to an independent review into treatment at NHS Tayside.

A total of 19 recommendations have been made in response to the revelation breast cancer patients in Tayside were given lower chemotherapy doses than individuals in other areas of the country.

Around 200 patients were given the lower dose between December 2016 and April 2019 in a bid to reduce harmful side effects. The issue only came to light after a whistleblower raised the alarm.

A subsequent risk assessment advised the treatment may have increased the likelihood of cancer recurring. The health board has since changed its policy to align with the rest of Scotland.

The independent review group said risk created by variations in care should be discussed with patients and that this discussion should be recorded in their records.

Its recommendations, which have all been accepted and will be implemented in full by the Scottish Government, also include the introduction of a new “Once for Scotland” national approach to treatment.

Scotland’s chief medical officer Dr Catherine Calderwood said the move would “help ensure cancer patients across Scotland have access to the same high level of care and treatment, regardless of where they live”.

The review group heard evidence of the need for “cultural and organisational change” at NHS Tayside and across Scotland to ensure clinical governance processes are “not only explicit but adhered to in the future”.

It recommended the construction of a new longer life group to ensure all suggested changes are implemented correctly. A national clinical management guidelines oversight group will also be established to “ensure consistency across NHS Scotland”. The oversight team will hold an annual conference as part of work to establish the “Once for Scotland” approach.

The report recommends the offer of independent medical advice from outside NHS Tayside should continue to be available to both patients and their families, along with extended health monitoring.

Dr Calderwood said the recommendations had been welcomed by Health Secretary Jeane Freeman.

She said: “Delivering on recommendations on informed patient consent is essential so that all cancer patients have the same high level of informed involvement in decision making about their care.

“One of the first actions will be to establish an implementation group for these recommendations and I am pleased to announce that this will be led by Dr Hilary Dobson OBE.”

NHS Tayside medical director Professor Peter Stonebridge said: “Today’s report sets out clear recommendations for cancer networks and teams across Scotland and we welcome the recommended new approach, which will allow cancer networks across the country to work more closely together.”

“Delivering... on informed patient consent is essential. DR CATHERINE CALDERWOOD

Picture: Getty. Scottish Health Secretary Jeane Freeman.