AGGRESSIVE behaviour by radiologists towards junior doctors, ageing equipment and concerns about “the Jersey way” are among the findings of a damning report into the Hospital’s radiology department that has finally been made public by Health.
The report, which led to the review of over 2,700 mammograms and recall of 20 women for breast cancer screening after a possible misdiagnosis by a radiologist, was described as “sobering” by Health chief officer Chris Bown. Six months after receiving the report and two months after its existence was first discovered by the JEP – which agreed not to publish a story until all of the women had been notified – Health has published the Royal College of Radiologists document on its website. The sharing of the report comes after multiple attempts to have it released under the Freedom of Information Act were unsuccessful.
This newspaper revealed on 24 June that the Health Department recalled the 20 women, while a further 14 were notified that their breast cancer diagnosis was initially missed, in some cases delaying treatment for up to a year. It has since emerged that one woman was told she did not have breast cancer and has since been told that she does.
In a statement issued yesterday, the government apologised to the woman – as well as the 20 others who had been recalled – and confirmed that her treatment had now begun. It also sought to reassure Islanders that anyone who was potentially misdiagnosed would have already been contacted.
The RCR report discovered a “them and us” dynamic between radiologists and radiographers. The former are medical doctors that interpret scans and outline treatment and the latter are employees who carry out the scans but are not trained doctors.
It also found that junior doctors – and particularly female junior doctors – were spoken to inappropriately by some radiologists, who dealt with their colleagues “without due regard to professional courtesy and civility”. This poor treatment of junior doctors led them to avoid requesting scans when they were needed, the report claimed.
“Behaviour was sometimes so aggressive that [doctors] opt not to request a scan to avoid confrontation, and […] this subsequently leads to adverse outcomes for patients,” the report said.
Staff in the department also complained of a leadership deficit, a lack of civility, ageing equipment, and frustrations about “the Jersey way”, including an “[unwillingness] to take responsibility for [their] actions” and a “lack of transparency”.
Commenting on the report’s findings, Mr Bown said: “It is clear we need to reset the relationship between different professional groups in this area and engender a much stronger culture of collaboration and professional respect. I am determined we will do this.”
The RCR report – and a second report by the British Society of Breast Radiologists – were commissioned following complaints by a member of staff about a radiologist at the Hospital. He still works at the Hospital, but does not carry out mammograms or breast ultrasound diagnostic tests, with his work now restricted to CT scans, MRI scans and X-rays.
In the statement, HCS deputy medical director Simon West claimed that the radiology case demonstrated that the department’s “freedom to speak up” policy was working.
“It’s very important that healthcare staff feel free to speak up internally when they see something they think is not quite right. And when somebody raises questions about the practice of a colleague it is vitally important these matters are taken seriously by HCS, fully considered, and thoroughly investigated. That is exactly what has happened in this case.”
Health Minister Tom Binet said he was glad that the report was now in the public domain, adding that he was determined to achieve improvements.
“I’m setting a target to get Health out of the headlines within the next 12 months – sooner if I can – and will be emphasising that in a letter to all staff within the next week or so,” he explained.
The minister referred to “unnecessary controversy” caused by recent Scrutiny interviews of senior advisers to the department, and media coverage.
“One perverse consequence of this is that it’s brought some of the opposed factions [within Health] together to defend the service, and that’s something I hope we’ll build on,” Deputy Binet added.
“This has been an organisation that hadn’t kept pace with where it should have been, and now we’re going through a very major job of bringing everything up to date – and when you lift up stones, it will be uncomfortable.
“I’m much more comfortable than I was at the start of this process, and I genuinely believe I have better support from management than when it began.”
TIMELINE
Speaking in the States last month, Deputy Binet admitted that although a damning report into the Hospital’s radiology department by the Royal College of Radiologists had been given to his department in late January, it took him more than two months to sit down with Mr West.
Speaking in response to a question from Deputy Lucy Stevenson, of the Health and Social Security Scrutiny Panel, Deputy Binet also suggested that the problems at the Hospital may not be over.
“There are numerous problems to be overcome at the Health Department and there is no doubt that other issues will emerge before things settle down,” Deputy Binet said.
The radiology scandal came just months after a scathing report by the Royal College of Physicians into the Hospital’s rheumatology department was finally published by the government in January 2024, nearly two years after complaints were made about the department by a member of staff.
It found that the standard of care at the department was “well below what was […] acceptable”, and cited a number of specific failures, including incorrect diagnosis of patients, the inappropriate prescribing of medicine, and a lack of basic training.
It has not been an easy year for Health – or for the Health Minister, who was hit by the resignation in May of the clinical lead of the Hospital’s so-called “change team”, Professor Simon Mackenzie.
Prof Mackenzie was part of the five-person team of consultants brought in after a damning report in August 2022 revealed concerns about management and working culture within the department. In a stinging broadside against the Health Department and Deputy Binet in July, Prof Mackenzie told a Scrutiny panel that “assertive individualism” at the Hospital was preventing genuine change.
The JEP reported yesterday that the “change team” was expected to cost the taxpayer nearly £750,000 this year.
The price tag for the team of experts last year was £880,000.
If you work in radiology or in an other department at the Hospital and want to share your story, get in touch in confidence by emailing: ocrowcroft@jerseyeveningpost.com.
