Jersey rheumatology service well below acceptable standards, review says

Rheumatology patients have been audited to ensure their diagnosis is correct

The standard of care of Jersey's rheumatology service is "well below" what would be considered acceptable, an independent review says.

The review, by the Royal College of Physicians' (RCP), noted cases with "no evidence of clinical examination" and incorrect diagnoses "on occasions".

Health and Community Services leaders, who published the review, apologised, saying people "deserve better".

They added that patients thought to have been harmed would be contacted.

'Not proud'

Health and Community Services (HCS) has published the RCP review after it was commissioned following concerns raised in January 2022 by a junior doctor.

In its review, the RCP team "found the standard of care to be well below what the review team would consider acceptable for a contemporary rheumatological service".

The RCP review also expanded on previous criticism of the prescribing of biologic drugs, saying that "in many cases" their use was "out with both UK and European guidance".

The RCP recommended that HCS undertook an audit of patients on such drugs to ensure their diagnosis was correct.

Chris Bown, chief HCS officer, said it was "a picture... that none of us at HCS could be proud of" and "the people of Jersey deserve better".

"I would like to say how sorry I am to those patients who have been impacted by this poor service," he said.

He said "the lack of recorded diagnoses", "the lack of diagnostics before reaching a diagnosis" and "the prescribing of very powerful drugs" that were not required in some cases were among the biggest concerns.

He added: "A number of patients have had changes to diagnoses or medications as a result of the work we have undertaken and it is inevitable that some of these patients will have been harmed clinically, emotionally and/or economically by their earlier diagnosis or treatment.

"We expect that, in most cases, the level of harm will be minor or negligible.

"But, of course, any level of harm is completely unacceptable and over the coming weeks we will be contacting any patient where we think harm may have been caused and we will be discussing with lawyers an appropriate approach to compensation."

'Let down'

Emma Hammond, a former patient, said she used the rheumatology service in 2021 to treat chronic pain and fatigue after the birth of her son.

She said she was diagnosed with an anti-depressant medication after a "a very quick appointment".

The medication was later found to be ineffective, she said.

"I don't feel like I was given enough support, I don't feel like enough investigation was made into what my actual issues were," she said.

"It makes me feel really let down."