Statement - Professor Eljamel due diligence report
THURSDAY, 31 AUGUST, 2023
Immediate release
Professor Eljamel due diligence report
NHS Tayside Executive Medical Director Dr Pamela Johnston presented the findings and recommendations of the due diligence review into former neurosurgeon Professor Eljamel to Tayside NHS Board at its meeting today (Thursday, 31 August).
The review was undertaken as part of the NHS Tayside response to fully address recommendations in the ‘Scottish Government Review of Unresolved and Outstanding Concerns Regarding Professor Eljamel’. This external review made a number of recommendations, including the Board taking further action to investigate areas of ongoing concern of patients, and actions relating to the decision-making around the practical arrangements for the supervision of Professor Eljamel in 2013.
In taking steps to address these recommendations and understand more about the decision-making in 2013, Dr Johnston commissioned a due diligence review of all documentation NHS Tayside holds regarding Professor Eljamel.
The aim of the review was to enable Dr Johnston to provide a fresh assessment to Tayside NHS Board of the professional, clinical and corporate governance position relating to Professor Eljamel’s tenure with associated recommendations for the Board for assurance and ongoing monitoring.
What did the review cover?
The review covered the main areas of concern raised by former patients who have been in contact with NHS Tayside. This included:
• the appointment process to consultant – and qualifications – of Professor Eljamel
• the systems and processes which were in place at the time to identify clinical concerns
• any areas of concern which had been flagged in these systems
• the actions taken and decisions made relating to the supervision arrangements which had been placed on Professor Eljamel between 21 June 2013 and 10 December 2013.
It also sets out the current clinical and professional governance in place in NHS Tayside in 2023.
Executive Medical Director conclusions
The Executive Medical Director presented conclusions to a full meeting of Tayside NHS Board today. The key conclusions are:
• the recruitment and appointment of Professor Eljamel followed due process; he had the appropriate, verified qualifications and excellent references
• there were multiple systems and processes in place for identifying concerns, but some were in their infancy and others relied on self-reporting of clinical outcomes by doctors themselves
• the first Significant Clinical Event Analysis (SCEA) was triggered by a complaint at the end of December 2012, with the SCEA report completed in May 2013
• the outcome of the SCEA, alongside a number of concurrent complaints, led to the decision to commission an external Royal College of Surgeons (RCS) review in June 2013
• Professor Eljamel was placed under clinical supervision on 21 June 2013. This was indirect supervision which means he was not supervised directly in the operating theatre by another neurosurgeon
• The decision to supervise Professor Eljamel from 21 June 2013 was the right decision to take, however the arrangements for this supervision and the indirect nature of it were not adequate to ensure consistent, good quality, clinical care
• In the time Professor Eljamel was supervised between 21 June 2013 and 10 December 2013 when he was suspended following receipt of the RCS report, he operated on 111 patients
• The indirect nature of the supervision was inadequate when there was a known concern over some aspects of his clinical practice
• Therefore, the group of 111 patients were potentially exposed to possible harm
Dr Johnston made a number of recommendations to the Board relating to continuing strengthening of professional, clinical and corporate governance processes today which were approved (see background).
Speaking today, Dr Johnston said, “I have written to the patients who had their operation between 21 June 2013 and 10 December 2013 to inform them about the findings of the review and to sincerely apologise on behalf of the Board.
“We are offering support to them in a number of ways and there is a dedicated team to help them with any questions and concerns they may have going forward.
“The Scottish Government review, which reported in 2022, looked at the concerns of some patients of Professor Eljamel and gave recommendations to NHS Tayside which included taking further action to investigate areas of ongoing concern of patients and the decision-making around the practical arrangements for the supervision of Professor Eljamel in 2013.
“Today’s report is the conclusion of that further action, but we recognise that many former patients remain understandably very upset and unhappy with what has happened. NHS Tayside apologises to former patients of the surgeon and remains committed to do whatever is required to support the independent commission which is being set up by Scottish Government to respond to patients’ ongoing concerns.
“Over the past few months, we have been encouraging any former patients who have concerns to get in touch with our dedicated Patient Liaison Response Team at TAY.patientliaisonresponse@nhs.scot and we continue to ask anyone with concerns to please get in touch.”
Background
Recommendations
The Executive Medical Director’s recommendations to Tayside NHS Board have been themed under three key areas of governance:
• Professional Governance
• Clinical Governance
• Corporate Governance (routes for scrutiny, monitoring and assurance)
On publication and approval |
Lead |
a. Following consideration and approval by the Tayside NHS Board, this report should be shared with Scottish Government with the Action Plan to ensure all recommendations are completed. |
Executive Medical Director |
b. Report to be shared with consultants and wider clinical professionals to raise awareness and promote further learning sets. This will ensure the report outcomes and recommendations form the backdrop for continuous improvement plans in professional, clinical and corporate governance. |
Executive Medical Director |
Professional Governance | |
c. The Responsible Officer Assurance Group (ROAG) processes should continue to be promoted and strengthened within all medical management lines to support staff to be clear on when and how to raise a concern regarding a medical professional. d. |
Associate Medical Director Professional Governance |
e. Training for new clinicians taking on leadership roles should be further strengthened so that they have the knowledge and skills to create environments in their own areas which are person-centred, deliver safe care and have mechanisms for assurance. |
Associate Medical Director Workforce |
Clinical Governance | |
f. The patients who were operated on during Professor Eljamel’s period of supervision (June 21, 2013 to December 10, 2013) should receive a letter to explain the findings of the due diligence review, with an apology from the Board relating to the inadequacy of the supervision arrangements which were placed on Professor Eljamel. Patients will be further supported through the Patient Liaison Response Team for future and ongoing engagements with the Board. |
Executive Medical Director |
g. There should be an organisation-wide system for collecting and analysing patient reported outcome measures, and local and national clinical audit data, to provide assurance to the Board on the clinical effectiveness of patient care. |
Associate Medical Director Clinical Governance |
Corporate Governance | |
h. NHS Tayside should develop a clear and consistent Board level governance approach to all external reviews relating to clinical issues. This will ensure Board members are assured that action plans are completed and outcomes measured against agreed performance indicators and timescales to ensure improvements are made. i. |
Board Secretary |
j. Undertake a resource review of the Patient Liaison Response Team against its key objectives and deliverables to ensure it can deliver agreed performance measures on behalf of the Board. k. Those in leadership roles require skills and support to engage with patients with ongoing concerns so that their concerns are captured accurately, investigated and appropriate changes made and spread. Teams should be supported by the new Patient Liaison Response Team to learn from groups of service users as well as responding to individual complainants. |
Board Secretary Executive Medical Director Board Secretary |
These recommendations will now be addressed in an action plan with lead officers and timescales which will be reported to Tayside NHS Board for monitoring and assurance, through the Care Governance Committee.
Contact:
NHS Tayside Communications
(01382) 424138
