Letter: Mortality figure a guesstimate

RE: YOUR article "'Patients dying' because of staff shortages" (News, 3 October). I am delighted that your paper has taken an interest in the document "Interventional Radiology Out of Hours - Standards for haemorrhage-control services in Scotland".

The aim of the document is to inform the development of models of care which will improve access to emergency interventional radiology services for haemorrhage control.

The mortality figure which was quoted, "…senior doctors estimate around 30 patients every year… could be dying needlessly", is misleading and is unrepresentative of the information provided by me. The guideline document describes reasonable evidence indicating that approximately 60 patients per year might benefit from this service in currently unserved areas.

The mortality figure of 30 patients per year has been arrived at by your correspondent on the basis of this robust figure and my own "guesstimate" of a 50 per cent mortality for untreated patients.

It is very important that this figure is recognised for what it is: a personal estimate based on personal experience alone and lacking any robust evidence base to support it. Reliable data on which to base estimates of avoidable mortality are lacking. Further, many of the patients in areas which currently do not have access to out of hours interventional radiology services will be transferred to areas which do, or receive effective traditional treatment, or do well with non-invasive supportive treatment alone.

Also, the document does not constitute a "damning report" and no reference is made to "patients dying because of staff shortages" either in the document or by me in discussion with your correspondent.

Dr Ian Zealley FRCP FRCR, Consultant Radiologist, Department of Radiology

Ninewells Hospital, Dundee