Bristol waits with interest for the report of the Histopathology Inquiry into allegations of misdiagnosis at University Hospitals Bristol NHS Foundation Trust. Will whistleblowers be heroes or villains? Will the report say whether 26 specific allegations of misdiagnosis were upheld by external reviewing pathologists or not? Will any clinical and managerial failings have been fully investigated and reported? To quote a statement from the BRI Heart Inquiry,”the arguments will be lost if the story is focussed on personalities and not the issues”

Meanwhile the Primary Care Trusts of Bristol, North Somerset and South Gloucestershire are pressing ahead with a long overdue review of Bristol’s Pathology Services and have included Weston Super Mare as well.

Local patient groups support changes to Bristol’s Pathology services that will lead to safer, higher quality, more cost effective services. They were looking forward to involvement in a post-election style NHS Service Review – “no decision about me without me”.

But the PCTs don’t seem to have got the message. Without consulting any patient or public groups, they decided to recruit an Independent Lay Member, through an NHS recruitment process, to the Pathology Review Project Board. Although the role is to be “independent” of the NHS, the PCTs have indicated that former Non-Executive NHS Directors are especially welcome to apply.

The successful applicants have been shortlisted by an NHS panel and were to be interviewed by a panel made up entirely of NHS staff, until patients and members of the public objected.

The NHS has now unilaterally decided that two Lay Members of the Project Board will be appointed to be “independent” of the NHS by an interview Panel – where one interviewer is a representative of a Local Involvement Network (LINks) and the rest (three) are NHS staff. Patient and public members of the review will be permitted to elect two additional lay people to the Project Board.

The result of all this is that there will be four lay members of the Project Board – two appointed through an NHS appointments process (where the lay interviewer is outnumbered three to one by NHS staff), to be “independent” of the NHS, – and two elected by their peers.

The role of the NHS appointed Lay Members of the Project Board is to “ensure that the review is open and transparent”. Perhaps they could start with scrutinising the openness and transparency of their own appointment process?

It’s not clear what happens if the two NHS lay appointees disagree on any issue with the patient/public lay appointees.

NHS has the casting vote perhaps?