Single approach needed for Scottish cancer services

Government promising joined-up approach after Tayside chemo under-dosing

Monday 26th August 2019

An independent advisory group says, in a country the size of Scotland, ‘it should be feasible to take a more country wide approach to cancer service delivery’.

The group was set up by ministers to make recommendations to prevent a repeat of the systematic programme where a group of women with breast cancer in Tayside were given chemotherapy medicines at a lower dose than elsewhere in Scotland.

Their report follows investigations by Healthcare Improvement Scotland and an expert group of clinicians into what has been deemed a ‘failure in medicines governance’.

Nearly two hundred women treated in NHS Tayside were found to have received chemotherapy lower than standard doses. 14 of them have since died.

The three investigations centred on the administration of two oncology medicines during a type of chemotherapy treatment known as the FEC-T regime.

Now the independent group, chaired by former deputy chief medical officer for Scotland, Professor Aileen Keel, is concluding that a single national approach is the only way to prevent the same issue arising elsewhere in Scotland.

In their report, they say they found strong evidence that the core principles underpinning the establishment of multi-professional Managed Clinical Networks, which include Scotland’s three cancer networks, were not being adhered to in Tayside and, potentially, elsewhere in Scotland.

Scotland’s chief medical officer, Dr Catherine Calderwood, says the government accepts all 19 recommendations in the report.

“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.”

Welcoming the report, NHS Tayside medical director Professor Peter Stonebridge said:

“Following concerns raised about variations in treatment in Tayside earlier this year, I can reassure patients that the same chemotherapy dosage regimes are being offered to patients in Tayside as in the rest of Scotland and all patients are fully informed about the options available to them. We continue to offer support to patients and families affected.

“Today’s report sets out clear recommendations for cancer networks and teams across Scotland and we welcome the recommended new approach which will allow cancer networks across the country to work more closely together.”

Dr Hilary Dobson is currently chair of the national cancer quality subgroup of the Scottish Cancer Taskforce and was previously lead cancer clinician of the West of Scotland Cancer Network (WoSCAN).