Urology: Aidan O'Brien's patients 'missed out on essential care'

Aidan O'Brien worked at the Southern Health Trust from 1992

An inquiry into the clinical practice of a consultant urologist has heard how he refused to involve specialist cancer care nurses on his team.

A senior cancer specialist said patients under Mr Aidan O'Brien's care at Craigavon Area Hospital missed out due to the "luck of the draw".

All other patients received this care, the specialist said.

The inquiry is examining Mr O'Brien's work at the Southern Health trust between January 2019 and June 2020.

Earlier in November, the inquiry heard that almost 600 patients received "suboptimal care" as his patients.

Dr Dermot Hughes was involved in a review of nine serious incidents involving the urologist.

He told the inquiry he found it unusual that cancer care nurses were not involved in any of his cases.

Dr Hughes said that, in his experience, it was normal practice for care to be shared and that cancer care nurses were integral.

The inquiry focuses on the work of consultant urologist Aidan O'Brien at Craigavon Area Hospital

"That way, there is seamless care - so there is a clinical care nurse specialist either to support the patient or to be with the patient or to inform the patient of their illness," said Dr Hughes.

"In my experience, the professional giving the care should be the person referring the patient to the clinical care specialist.

"But the issue here in the Southern Trust is that, clearly, Mr O'Brien did not work with clinical work specialists in his oncology clinics.

"He did not involve them in the classic roles of cancer nurse specialists in terms of holistic assessment, informing patients of their disease and discussing their options."

Dr Hughes said his reviews found that this situation had been raised by nurses with the trust but that it had failed to act.

"The practice in the Southern Trust was that all other patients received this care in tandem with their consultant, but a separate cohort did not," he said.

"That issue was known but not dealt with."

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The inquiry, chaired by Christine Smith KC, also heard from urologist Mr Hugh Gilbert who worked in the review team with Dr Hughes.

He described the benefits of having a care nurse assigned for cancer patients undergoing treatment, saying "it continuously allows the patient access to information and support".

"It just so happens that the best-placed person for that is a cancer nurse specialist as they have not only knowledge of the medical aspects of care but also in the nursing aspects of care which are fundamental to a patient's wellbeing," said Mr Gilbert.

"At the time of discussion (of a patient's diagnosis), a key worker is appointed and that is usually, almost inevitably, a cancer nurse specialist.

"They are named and their name is put on all printed materials."

Dr Hughes said families were concerned to learn from the review team that their relatives were being treated differently and missed out on vital support.

"The role of the cancer nurse specialist really is essential.

"It is informative; patients receive better experience and the families found it difficult to know that the majority of patients received this and their cohort did not.

"The care that is delivered by those nurses in the Southern Trust was exemplary.

"But for these patients it was the luck of the draw because they were allocated a particular professional, they didn't get this service."

Mr O'Brien worked at the Southern Health Trust from 1992 until his retirement in July 2020.

He was temporarily excluded from the workplace in 2017 before returning under supervision.

The inquiry's role is to examine the clinical and corporate governance of the Southern Health Trust.