Northern Health and Social Care Trust concludes radiology review

The Trust confirmed in June that it had commenced the "lookback review" into radiology image reporting completed by the radiologist, who had been engaged by the health body between July 2019 and February 2020.

The Trust wrote to 9,091 patients or their parents/guardians at the end of June to make them aware of the review concerning the images, which were taken in Antrim Area Hospital, Causeway Hospital, Whiteabbey Hospital, Mid Ulster Hospital and the Ballymena Health and Care Centre.

Dr Seamus O’Reilly, Medical Director at the Northern Trust and Chair of the Steering Group for the lookback review, said: “I can confirm that we have completed the review of all of the images and we have identified a total of 6 images with Level 1 discrepancies.

“In addition, we have identified a further 60 images with Level 2 discrepancies.

“Most of the images categorised as having Level 1 and Level 2 discrepancies are CT scans but some are MRI scans, chest x-rays and other x-rays.”

'Clinical assessment group' met each week

A clinical assessment group made up of senior clinicians met each week throughout the review to carefully consider the images of patients where Level 1 and Level 2 discrepancies were found, Dr O’Reilly added. "They also reviewed a number of images which were considered as Level 3 discrepancies. That detailed clinical assessment, which has resulted in 69 patients being called back, was to determine whether any clinical harm occurred as a result of the discrepancies found in the lookback review.

“I can confirm that following careful consideration, the clinical assessment group has determined that 17 patients should now be part of a Level 3 Serious Adverse Incident (SAI) review.

“We are currently in the process of appointing an independent SAI panel in line with regional guidance and have agreed draft terms of reference which will consider the methodology for the Lookback Review processes, provide individual case reports for each patient determined to be an SAI, explaining what happened, why it happened, and how this may have had an impact on the patient/relative and if the patient’s outcome would have been different had the discrepancy not occurred. This will involve the engagement of clinical experts in the specialties relevant to each individual case.

“The SAI review will also identify any learning of relevance across the HSC and the panel is expected to make recommendations on how radiology reporting processes may be strengthened to minimise the possibility of similar adverse events occurring in the future.”

The Trust will now contact affected patients and families to inform them of the pending SAI review and to seek their participation throughout the process.

Radiologists report on 300,000 images annually

Each year in the Trust, radiologists report on approximately 300,000 images.

Following concerns raised by the General Medical Council, the Trust reviewed a small sample of 30 CT scans that had been reported on by the locum radiologist in question.

A decision was then taken to undertake a full review of all radiology reports issued by the locum Consultant Radiologist during their time with the Trust.

The review has been carried out by a qualified and experienced external provider that is already contracted by HSC to do this sort of work and consultant radiologists in the Trust, with some assistance from consultant radiologists in other Trusts.

During the review, images have been categorised into one of five Levels as follows:

Level 1 - Major Discrepancy (immediate and significant clinical impact);

Level 2 - Major Discrepancy (probable clinical impact);

Level 3 - Minor Discrepancy (clinical impact unlikely);

Level 4 - Minor Discrepancy (either typographic or a discrepancy of very doubtful significance)

Level 5 - No Discrepancy.

Freephone helpline set up

A freephone helpline telephone number 0800 023 4377 was set up and operates from 9am – 5pm Monday to Friday and there is also a dedicated email address: [email protected].

The Trust is also providing psychological support services throughout the course of the review for any patients who might be particularly anxious.

Further details, including frequently asked questions and answers, can be accessed from the front page of the Northern Trust’s website www.northerntrust.hscni.net.

Breast services have not been impacted and are not part of the review.

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