Evidence Some Patients ‘May Have Come To Direct Harm’

Specialist lawyers representing women affected by a review into gynaecologist’s work are calling for lessons to be learned after a report found concerns with nearly 120 cases. 

An interim report by NHS England into gynaecology and obstetrics procedures carried out by consultant Dr Daniel Hay has today been published. It found major concerns with the care received by 50 women and some concern with the care a further 69 patients received. There was evidence that some women may have come to “direct harm,” the report said.

All women were under the care of the University Hospitals of Derby and Burton NHS Foundation Trust, which runs Royal Derby Hospital. 

Dr Daniel Hay: 'Considerable concerns' about surgeon

The report also identified “considerable concerns about decision making and the choice of surgery that was undertaken.”

The rationale for surgery was “often absent” or unclear in medical notes. Treatment plans didn’t include whether non-surgical options were discussed with patients prior to surgery.

A total of 327 cases, were reviewed by NHS England. They included 181 gynaecology procedures such as hysterectomies and 36 obstetrics cases, covering surgery such as caesarean sections. The care of 110 women, who attended outpatient appointments at Ripley Hospital, was also investigated. 

Royal Derby Hospital patients ask medical negligence lawyers to investigate

A number of women who have been contacted as part of the review have instructed expert medical negligence lawyers at Irwin Mitchell to investigate and help secure answers for them. 

Expert Opinion

“The findings of the report, including the standard of care women received and how operations were apparently carried out without other less invasive options being fully considered first, mirrors the first-hand accounts women have told us as part of our investigations.

“Patient safety should be the fundamental priority. We’re particularly concerned that life-changing procedures appear to have been conducted without some women being able to make informed decisions about their care.

“Our clients continue to live with the physical and psychological effects of what happened to them and understandably continue to have concerns about their care.

“We’re determined to provide the care and support our clients need to get through this difficult time. It’s also vital that lessons are learned from the issues identified by the review to improve patient safety for others.” Tim Annett - Partner

Investigation launched into Dr Daniel Hay and gynaecology care  

University Hospitals of Derby and Burton NHS Foundation Trust launched an investigation into Mr Hay’s practice when colleagues raised concerns after he went off work ill, the report said.

A total of 58 cases were investigated. 

The Trust contacted NHS England to further investigate and the review was extended covering cases between 2015 and 2018. Mr Hay has not returned to work since the concerns were raised.

NHS England’s report classed cases using a traffic light system with red being serious concerns and green, no concerns. 

A total of 40 gynaecology operations were classed as red and 51 amber. 

Evidence alternatives not discussed with patients before gynaecology surgery

There was evidence that patients underwent operations without alternatives having been discussed, or a second opinion not sought.

Some may have come to harm or suffered complications. In one case reviewers were concerned that a patient’s fallopian tubes were injured. There was a delay in diagnosing a cancerous lesion in another patient, the report said.

One obstetrics case was marked as red and two classed as amber. 

Ten outpatient appointments were marked as red. These included five patients who were scheduled for surgery but had operations cancelled because the rationale for surgery was unclear.

A total of 15 cases were marked as amber, including because inadequate examinations were performed or because alternatives to planned surgery were not documented in medical notes. 

NHS England report recommendations

The interim report has made seven recommendations including women are invited to a review of their care, the Trust review its measures so information is shared and staff don’t work as individuals and so that other employees feel they are able to raise concerns about the standard of care.

Women are to also receive an apology from the Trust. 

The full report findings are due next year.