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Neurology: Frequently Asked Questions

What is the background to the Expert Review of Records of Deceased Patients of Dr Watt?

On 1 May 2018, Belfast Health and Social Care Trust (Belfast Trust) announced a recall of 2,500 patients in relation to concerns regarding the clinical practice of Dr Watt, a consultant neurologist employed by the Belfast Trust.

On 2 May 2018, the Permanent Secretary to the Department of Health announced the establishment of an Independent Neurology Inquiry, chaired by Brett Lockhart QC, to review the recall of neurology patients by the Belfast Trust. The Health Minister converted this inquiry to a Statutory Public Inquiry on 11 December 2020, under the Inquiries Act 2005.

The Permanent Secretary also directed the Regulation and Quality Improvement Authority (RQIA), Northern Ireland’s regulatory body, to:

• undertake a Review of governance arrangements of outpatient services in the Belfast HSC Trust, with a focus on Neurology and other high volume specialties (published in February 2020)
• review governance arrangements in independent hospitals and hospices in Northern Ireland (published in June 2021).
• commission an expert review of the records of all patients or former patients of the consultant neurologist, who had died over the previous ten years. This is known as The Expert Review of Records of Deceased Patients of Dr Watt (2008-2018) (Published in November 2022).

Is the Review different to the Independent Neurology Inquiry?

Yes, this Review is separate to the Independent Neurology Inquiry (INI) announced by the Permanent Secretary in 2018. The Health Minister changed the status of the INI to a Statutory Public Inquiry in December 2020. The Independent Neurology Inquiry published its findings on 21 June 2022. For further information, visit: www.neurologyinquiry.org.uk

How is the Review being carried out?

Given the significant scale of the work involved in reviewing the records of deceased patients who were at some point under the care of Dr Watt between 2008 and 2018, the Department of Health agreed that RQIA should take a phased approach to the Review. The outcome of Phase 2, which examined 44 patient records, was published in November 2022. During 2023 RQIA has worked with the Department of Health to agree next steps. We are currently commencing engagement with a further group of families who expressed an interest in having their relative's clinical records included in a future phase of the Review.

We are now engaging with these families to provide information on what a review of the clinical record of a deceased patient can potentially provide, and about its limitations.

Families of deceased patients of Dr Watt who wish to contact RQIA to explore involvement in the process are welcome to do so.

Please:

• phone on Freephone number 0800 052 0012 between 10am and 5pm, Monday to Friday, to speak to a member of our Family Liaison Team; or leave a voice message and our Family Liaison Team will get back to you

• email us at expert.review@rqia.org.uk;

• use our 'Contact Us' form to send us your contact details.

What phase is the Review at now?

Phase 2 of the Expert Review of Records of Deceased Patients of Dr Watt is complete. The report was published on RQIA website in November 2022.

Phase 2 comprised two groups of patients:
• Group 1 included 29 deceased patients whose relatives had approached RQIA with concerns about the care and treatment provided to their loved one

• Group 2 included 15 deceased patients who had sadly died during the course of the live recall before their assessment appointment could be commenced or completed

RQIA established a Family Liaison Team who reached out to the families of the deceased patients whose records were included in Phase 2. The Family Liaison Team explained the Review and offered the families an opportunity to become involved by sharing their experiences regarding the care and treatment provided to their relative by Dr Watt.

Royal College of Physicians established an Expert Panel which included three consultant neurologists from outside of Northern Ireland. The Expert Panel used Structured Judgement Methodology. This is well-tested and validated methodology for reviewing care and treatment.

Two expert reviewers examined each case. Where family stories were made available to the expert panel, these cases were reviewed, firstly without the family story and then again with the family story. The Expert Panel then discussed the findings for each case and agreed a judgement regarding the diagnosis, prescribing, treatment, follow-up, communication, multidisciplinary working, potential for harm and documented cause of death.

The Family Liaison Team met with families to share the individual case summary report and explain the findings prior to publication of the overarching RCP reports, which were published on the RQIA website. Individual case summary reports are confidential and are not published.

A further 15 families of deceased patients have approached RQIA expressing an interest in having their relative's clinical records included in a future phase of the Review. RQIA is engaging with these families to provide information on what the Review of the clinical records of the deceased patient can potentially provide, what are its limitations and to provide information from the feedback we received from many of the 44 families, as to the personal impact such a Review can have on family members.

Families of deceased patients of Dr Watt who wish to contact RQIA to explore involvement in the process are welcome to do so.

Please:

• phone on Freephone number 0800 052 0012 between 10am and 5pm, Monday to Friday, to speak to a member of our Family Liaison Team; or leave a voice message and our Family Liaison Team will get back to you

• email us at expert.review@rqia.org.uk;

• use our 'Contact Us' form to send us your contact details.

Hearing about the Review has caused me distress, is there anywhere I can get some support?

RQIA is aware that our contact with families may prove difficult and painful and may further impact on their grief and sorrow and we apologise for any potential distress this may cause. However, we aim to be transparent and open about the review, family members and next of kin have been offered the option to choose to be informed about the progress.

We have identified a number of organisations who can offer support to family members, should that be of benefit. The Family Liaison Team can assist with this and contact details are included on our website www.rqia.org.uk, and in our Family Information leaflet and Coping with Grief leaflet .

RQIA appreciates that some families may wish to have no further engagement with us in relation to this Review and respect decisions in this regard.

What can families expect if they decide to become involved with Phase 2 of the Review?

The Family Liaison Team has made contact with the families of 15 deceased patients whose relatives have made contact with RQIA, expressing an interest in having their loved one’s clinical records included in a further phase of the Review.

The Family Liaison Team is currently making arrangements to meet with families to provide information on what a review of clinical records entails, including the potential benefits and limitations, and to share feedback we received from several families involved in Phase 2 of the Review about their experience of the Review process and its outcomes.

Other families of deceased patients of Dr Watt are welcome to contact RQIA. You can do this in a number of ways:
Please:

• phone on Freephone number 0800 052 0012 between 10am and 5pm, Monday to Friday, to speak to a member of our Family Liaison Team; or leave a voice message and our Family Liaison Team will get back to you

• email us at expert.review@rqia.org.uk;

• use our 'Contact Us' form to send us your contact details.

What members of our family will the Family Liaison Team be speaking to with regards to our relative who died?

The Family Liaison Team have sought to identify one or two people who would have knowledge of their relative’s care and treatment. This could also be one family member accompanied by a friend or an advocate.

What will RQIA do with the information provided by families?

Prior to sharing any information with RQIA’s Review Team, our Family Liaison Team will discuss and agree this matter with families.

Will I receive feedback on the findings in relation to the care of my relative?

Throughout the next phase of this Review, RQIA Family Liaison Team will keep in regular contact with families to advise on progress.

My relative received care from Dr Watt on a private basis. Will private records be included in the review?

Yes, where required, RQIA will seek to obtain relevant records relating to those who received care from Dr Watt on a private basis.

If I do not wish to be involved in the Review can I still receive feedback on the findings relating to my family member?

Yes, bespoke arrangements will be put in place for the next-of-kin or family members of individual deceased patients involved in the next Phase of this Review.

Can my relative’s records be reviewed?

Families are welcome to contact RQIA by using any of the following methods:
• phone on Freephone number 0800 052 0012 between 10am and 5pm, Monday to Friday, to speak to a member of our Family Liaison Team; or leave a voice message and our Family Liaison Team will get back to you

• email us at expert.review@rqia.org.uk;

• use our 'Contact Us' form to send us your contact details.

Where can I read the overall findings of Phase 2?

You can read the findings of The Expert Review of Records of Deceased Patients of Dr Watt (2008-2018) here.

I'm a journalist, where do I make media queries in relation to this work?

Any media queries should be directed to RQIA’s Senior Communications Manager: malachy.finnegan@rqia.org.uk

How do I find out about the Neurology Recall Compensation Scheme?

The Neurology Recall Compensation Scheme is being managed through the Department of Health. Information in relation to this scheme is available on their website, here.

This includes a link to a series of frequently asked questions.