Chief medical officer recommends 'once for Scotland' consistency in cancer treatment

The chief medical officer has recommended a “once for Scotland” approach to cancer treatment, after findings that women with breast cancer in NHS Tayside were given treatment inconsistent with the rest of the country.

The Scottish Government has accepted all 19 recommendations in a report, produced by an independent advisory group on how to implement changes to breast cancer management at the health board and to ensure consistency across NHS Scotland as a whole.

The group was set up following two official reports into healthcare practices that saw 304 women with breast cancer in Tayside given lower than normal doses of a chemotherapy drug.

Among the 19 recommendations made in the report by the independent advisory group is a "once for Scotland" approach to ensure consistency in cancer treatment across the country.

As part of this approach, the report recommends the setting up of a “properly resourced” oversight group to help monitor the implementation of treatment standards.

The oversight group should hold annual conferences to help maintain consensus across NHS Scottish cancer networks.

Additionally, the current upgrading to Chemocare – an electronic chemotherapy prescribing and monitoring service – should be delivered “as quickly as is safely possible” across NHS Scottish cancer networks, the report says.

The Scottish Government will set up an implementation group to make sure the reports recommendations are acted on.

The chief medical officer, Dr Catherine Calderwood, said: “The Health Secretary has welcomed these recommendations and in adopting them we will help ensure that cancer patients across Scotland have access to the same high level of care and treatment, regardless of where they live.

“Delivering on recommendations on informed patient consent is essential so that all cancer patients have the same high level of informed involvement in decision making about their care.

“One of the first actions will be to establish an implementation group for these recommendations and I am pleased to announce that this will be led by Dr Hilary Dobson OBE.”

The two previous reports from Healthcare Improvement Scotland and a government-created ‘immediate review group’ looked at why the women were given less than standard treatment and what the clinical impact of this variation in practice could have been.

In April it emerged that 304 patients treated after December 2016 were given a three quarters dose of a chemotherapy drug in the hope that it would reduce the side effects, a decision that had no clinical basis.

The Healthcare Improvement Scotland report published in April described a “dysfunctional team environment” at NHS Tayside that contributed to the treatment decisions.

The immediate review group report concluded that the decision may have had a “very small” impact on patient risk.

The practices at NHS Tayside has since been brought in line with national standards.

Commenting on the announcement, shadow health secretary Miles Briggs said: “There’s clearly a major problem within NHS Tayside, and these experts are fearful it may even be more widespread.

“The fact so many recommendations have been made show the extent of these failings.

“Health secretary Jeane Freeman must enact all of these, and I’ll be writing to her to ensure she does.

“Major errors like these simply should not occur in a modern NHS, and it’s critical they are not repeated.”