NHS Tayside responds

“The level of the dose of chemotherapy treatment offered to some breast cancer patients in Tayside between December 2016 and April 2019 is a matter which has been the subject of intense public scrutiny.

“It has been comprehensively examined by independent panels of experts who have issued recommendations for action to NHS Tayside and it has been reviewed and monitored continuously by Scottish Government. It is also the subject of regular, ongoing examination in the public domain and analysis in the media.

“The matter has been managed with full openness and transparency by NHS Tayside and in line with the duty of candour to those patients affected.

“The concerns about chemotherapy prescribing and the subsequent reviews – and criticism that was levelled at the service – have been difficult for all those involved. However, the matter has been, without doubt, the most difficult of all for the 304 patients and their families who were directly affected.

“The primary outcome of all of the external reviews is that Tayside breast oncology patients are offered a chemotherapy dose regime which is the same as would be offered in other areas in Scotland – and this has been the case since April 1 2019.

“NHS Tayside remains absolutely committed to providing high-quality, local services for breast cancer which are safe for patients, safe for staff and sustainable for the people of Tayside.

“Concerns were first raised by a whistleblower who said there were variations in chemotherapy treatment for breast cancer patients in Tayside compared with other health boards in Scotland.

“This followed an internal review of patients by Tayside’s oncologists in December 2016, following which there were changes applied to the chemotherapy dose given to some breast cancer patients locally.

“This change meant that the dose some patients received was different to that which might have been prescribed in other hospitals in the rest of Scotland. The oncologists made a decision for Tayside patients based on this review to reduce the dose of chemotherapy with the sole aim of reducing some of the worst side effects.

“Following the whistleblower’s concerns, Scotland’s Chief Medical Officer (CMO) and Chief Pharmaceutical Officer (CPO) commissioned Healthcare Improvement Scotland (HIS) to review breast cancer treatment in Tayside and a report was published on April 1 2019.

“This independent HIS report stated that NHS Tayside prescribing relating to chemotherapy in breast cancer was different to the rest of Scotland and it made recommendations which all members of the board of NHS Tayside accepted in full.

“At the time of the publication of the HIS report, NHS Tayside contacted all patients affected directly to advise them of the HIS report and its findings and offered them a review consultation with an oncologist to discuss their chemotherapy dose and any other concerns they may have.

“An expert independent panel (Immediate Review Group) also reviewed the HIS report to understand any potential impact on Tayside patients arising from the different approach to chemotherapy treatment.

“The panel reported that the risk of any negative impact on the probability of breast cancer recurrence of anyone treated from December 1 2016 was very small. The expert panel also stated that the oncologists took the decision in the best interests of patients.

“Since the publication of these independent, external reviews in April 2019 Tayside breast oncology patients have been offered the same chemotherapy treatment as they would be offered in other areas in Scotland.

“There is absolutely no lack of transparency or openness in these matters. All independent and external reviews have been published, recommendations acted upon and the matter has been discussed and scrutinised in great detail.”