MORE than 250 Islanders are being recalled for repeat bone scans after an independent review uncovered “potential concerns” over how some patients were diagnosed and treated.
The audit – which came out of a major review of the Island’s rheumatology department – raised questions about the reporting of ‘bone densitometry’ scans carried out between January 2017 and January 2022.
Health apologised to those affected, confirming the issue stems from the work of a single individual who no longer works for the service. It expressed full confidence in the current service.
Specialist independent consultants reviewed just over 1,000 patient notes and found that in 20 cases, the treatment and care a patient had following their bone scans “fell below the level that would have been expected”.
Medical director Simon West told the JEP that “all of these cases were only classed as ‘moderate’ harm’ because all involved fractures”.
For another 250 patients, the specialist consultants have advised that a re-scan should be undertaken, in order to monitor any changes to bone density.
Bone densitometry scans are sometimes referred to as Dual-Energy X-ray Absorptiometry, or DEXA, scans; they use low dose X-rays to see how dense or strong a patient’s bones are, which is important in assessing the risk of fractures.
The 20 highest priority patients have already received a letter inviting them in for a rescan; the other 250 will be notified this month.
It is anticipated, subject to patient availability, that all recall scans will be completed by the end of May.
Heath has said that anyone who has had a DEXA scan since January 2022 can be reassured that there are no issues with the reporting of their results.
Patients who have not been contacted and offered a recall appointment by the end of April can be reassured that this issue does not affect them.
Mr West explained that the concerns centre on the reporting of the scans, not the procedure itself.
“We were quite assured that post-2022, the reporting of the DEXA scans was robust,” he said. “However, we could not be assured pre-2022.”
Mr West confirmed that the uncertainty was down to the actions of a single individual who was responsible for interpreting the results of the DEXA scan.
He added that the person in question no longer worked for Health, the individual’s professional regulator was aware of this review, and it would be up to them if they wished to take any action.
The DEXA scan review came out of a review by the Royal College of Physicians, published in early 2024, which found the standard of care at the Hospital’s Rheumatology Department “to be well below what the review team would consider acceptable for a contemporary rheumatological service”.
It also revealed a “lack of governance, not just in rheumatology but across the healthcare organisation.”
Mr West said the College had not called for the DEXA review; rather it was the impetus of Health itself.
“Patients who were part of the rheumatology review specifically were asking if their DEXA scan – or any medication that they been given as part of rheumatology – had played a part in them either having a fracture, which some of them had had, or could be linked to their osteoporosis.
“The answer was no but some of the medication they had taken might have had a part to play.”
Those questions ultimately led to a wider review, extending beyond rheumatology patients to include referrals from GPs and other specialities such as orthopaedics.
“What we have learned from conducting this review is that, pre-2022, there were not enough checks and balances,” said Mr West.
The 250 patients recalled will not know which category they fall under – ‘mild’, ‘moderate’ or ‘severe’ – until they have been rescanned.
“This is because we either we do not have enough information about what has happened to them since their last scan; they should have been rescanned but have not; or they haven’t been given appropriate advice in their report for us to be assured that they don not require medication,” said Mr West.
“It could be that once we rescan all 270, none of them need any further action.”
To help with the review, Health has recruited an additional radiographer who is a specialist in the conduction of DEXA scans, who will be coming to the Island on weekdays to deliver scans at the Enid Quenault Health and Wellness Centre.
Two rheumatologists who are experts in the reporting of DEXA scans are also being taken on temporarily.
Mr West said: “I would like to sincerely apologise to any patients who have been affected and recalled for a scan as I understand receiving such news can be unsettling.
“As soon as it became apparent that there were potential issues with the accuracy of reporting of the results of DEXA scans, Health and Care Jersey took steps to commission an independent review. Following the findings of the review, we have worked as quickly as possible to contact affected patients and to recall them for another scan.
“I can assure Islanders that they can have confidence in our current DEXA service, and I hope that the swift action Health and Care Jersey has undertaken shows that, as a department, we continue to address issues that have been identified from previous years, we are open and transparent when these issues emerge and that the quality and safety of our services is of the utmost importance to us.”
Any patient who has concerns is asked to contact the Patient Advice and Liaison Service on 01534 443515 or PALS@health.gov.je.
Anyone who would like to share their story can contact news@jerseyeveningpost.com.
