The treatment of 14 patients who died while receiving chemotherapy treatment at NHS Tayside is to be investigated by an independent expert in the wake of the health board’s dosage controversy.
Politicians have called for an “urgent” public inquiry into why Tayside patients received a lower dose of chemotherapy treatment than those elsewhere in Scotland.
The health board has apologised to patients and families affected.
A report by Healthcare Improvement Scotland (HIS) revealed nurses and pharmacists working for the board shared fears that patients were not being consulted about the lower dose.
The report also said NHS Tayside breast oncologists and their contemporaries at NHS Highland and Grampian could not agree on dosing levels, with Tayside doctors not willing to “endorse” using a higher dose, while Grampian and Highland doctors failed to sign off on the guidelines unless the higher dose was available.
As the guidelines were being drafted, the Tayside oncologists asked for two bullet points regarding dosing levels to be removed, without “providing the rationale” for doing so.
North East Labour MSP Jenny Marra said there were “serious questions” to be answered.
She said: “There should be a public inquiry established with urgency to clarify why this situation was allowed to happen and went unchallenged until a whistleblower had the courage to speak out.
“Serious questions need to be asked of the doctors and management at Ninewells.
“Staff said they were in ‘lockdown’ and had to continue to give low dosages of chemotherapy.
“This is a serious question for NHS management as patients were being treated with low dosages while an investigation was under way.”
Shona Robison, MSP for Dundee East, was cabinet secretary for health when the issue was first raised.
She said: “Families of those who have died need answers and reassurances. I welcome an independent review. This could be the quickest and best way to get the answers that people are looking for.
“I was deeply concerned when I discovered what had happened and that is why I got involved in having this issue reviewed.”
An NHS Tayside spokeswoman said: “As part of our response to the HIS report, NHS Tayside asked an independent expert to review the breast cancer chemotherapy treatment of 14 patients who have died.
“These patients received breast cancer chemotherapy during the time period December 1 2016 until March 31 2019. The findings will be shared with the families.”
Professor Peter Stonebridge, acting medical director at NHS Tayside, said: “We have written to all affected patients who received chemotherapy as part of their breast cancer care from December 1 2016 and will be offering them a clinic appointment with an oncologist.
“We understand that patients may be feeling worried at this time and we are really sorry for that.
“The independent expert panel which reviewed the HIS report to understand any potential impact on Tayside patients arising from the different approach to chemotherapy treatment said that the risk of any negative impact on the health of anyone treated for breast cancer from December 1 2016 was very small.
“We want patients to know we are taking this issue extremely seriously and putting in place all the changes to ensure we provide a high quality breast cancer service in Tayside.”
First Minister Nicola Sturgeon said today she expected the results of the review to be ready by June.
Cancer charity hits out at ‘unacceptable’ treatment of patients
One of the country’s leading breast cancer charities has said it is “disappointed” with the actions taken by NHS Tayside.
Breast Cancer Now said it was “extrememly concerned” that lower doses of chemotherapy were dispensed in Tayside and it was “completely unacceptable” that Oncotype DX testing was not “routinely” offered to patients.
NHS Tayside said it was now offering the test to eligible patients following recommendations made by Healthcare Improvement Scotland (HIS).
Breast Cancer Now policy manager Ashleigh Simpson said: “It’s extremely concerning a decision was taken to offer a lower dose of FEC-T chemotherapy to all patients and we now need to understand what clinical impact this may have.
“It’s vital that the same standard of care is in place no matter where patients live in Scotland, with best practice guidelines and patients’ individual circumstances being taken into account to enable patients to make informed decisions about their care.
“It’s also completely unacceptable Oncotype DX has not been routinely offered to eligible patients in NHS Tayside.
“Tests like this can be vital in guiding decisions about whether chemotherapy is necessary or whether early breast cancer patients can be safely spared its difficult side-effects, and we must ensure equal access across the country to enable all Scottish patients to receive the best treatment for them.
“These issues must now be addressed as soon as possible.
“We hope that NHS Tayside will act swiftly on the recommendations of this report.”