800 patients have X-rays reviewed in new concern over locum

THE X-rays and scans of almost 800 patients are being urgently reviewed after alleged mistakes were found in two cases dealt with by a locum radiologist, it was revealed yesterday.

The investigation into the vital scans was ordered by NHS Highland after problems with two chest X-rays were highlighted by medical staff at Raigmore Hospital in Inverness.

The latest locum controversy was revealed only a month after a senior Scottish physician warned that the heavy reliance on locum doctors by NHS hospitals in the UK was putting the safety of patients at risk

Professor Chris Isles, who is based at Dumfries and Galloway Royal Infirmary, said he was concerned about the quality of staff being sent to hospitals and the misleading information supplied about their experience.

And the British Medical Association has also recently issued a warning about the inadequate checks being made on foreign doctors' language and clinical skills when they come to work in the NHS in Britain.

NHS Highland has refused to disclose any details about the locum radiologist at the centre of the scan review and has stressed that he has full registration with the General Medical Council and had appropriate references for the work he carried out at Raigmore.

But a spokeswoman for the Highland health authority said: "He has not worked for NHS Highland before. He has worked in the UK before."

Rhoda Grant, the Highlands and Islands Labour MSP, called for a complete review of how the region's health services are delivered in the wake of the investigation.

She said: "I urge NHS Highland to provide all the affected patients with the information they need as soon as possible but I also think we need to review how health services are delivered in this part of the world.

"Too often we end up having to depend on locums and, as Audit Scotland has recently highlighted, they do not provide the level of service that patients expect."

Mrs Grant added: "We have to look at new ways of developing health services in the Highlands and Islands that attract the right sort of people rather than relying on locums."

Prof Isles said he did not wish to comment specifically on the Raigmore review. But he told The Scotsman: "My warning was reflecting the fact that all of us across Scotland and probably the UK are aware that a particular type of locum - overseas doctors who come to work in the UK, usually at the junior level but have never worked in the NHS before - don't have the experience or the competencies to do the job.

"The NHS is spending 47 million on locums each year in Scotland. As a health service we are heavily dependent on locums and more dependent than most doctors would think was reasonable."

The NHS Highland spokeswoman explained that they had set up a "critical incident team" to review the radiological investigations reported by a locum radiologist who had worked at Raigmore Hospital from 5 to 16 April.

She said: "Discrepancies in two cases were identified by our staff who raised their concerns through NHS Highland's clinical reporting structure. Following further investigation we have therefore decided that all investigations reported by this doctor should be reviewed, to ensure patients are receiving the appropriate care.

"The discrepancies were in chest x-rays. Other doctors have disagreed with the opinion of this locum radiologist. They did not think his opinion of the images were accurate."

She continued: "We have written to 786 patients whose investigations were reported by this doctor to let them know that the image from their tests will be reviewed and re-reported. We will contact them again with the results. We expect all the images to have been reviewed by the middle of July.

"Where there is a significant discrepancy in the reports the referring doctor will be informed immediately to ensure that the appropriate clinical care is being given. This action has already started for the cases already reviewed."

Dr Ian Bashford, NHS Highland's Medical Director, stressed that only a "very, very small" number of patents were likely to require a repeat examination as a result of the review.

As a health service we are heavily dependent on locums and more dependent than most doctors would think was reasonable."

The NHS Highland spokeswoman explained that they had set up a "critical incident team" to review the radiological investigations reported by a locum radiologist who had worked at Raigmore Hospital from 5 to 16 April.

She said: "Discrepancies in two cases were identified by our staff who raised their concerns through NHS Highland's clinical reporting structure. Following further investigation we have therefore decided that all investigations reported by this doctor should be reviewed, to ensure patients are receiving the appropriate care.

"The discrepancies were in chest x-rays. Other doctors have disagreed with the opinion of this locum radiologist. They did not think his opinion of the images were accurate."

She continued: "We have written to 786 patients whose investigations were reported by this doctor to let them know that the image from their tests will be reviewed and re-reported. We will contact them again with the results. We expect all the images to have been reviewed by the middle of July.

"Where there is a significant discrepancy in the reports the referring doctor will be informed immediately to ensure that the appropriate clinical care is being given. This action has already started for the cases already reviewed."

Dr Ian Bashford, NHS Highland's Medical Director, stressed that only a "very, very small" number of patents were likely to require a repeat examination as a result of the review. .