University Hospitals Bristol (UHB) NHS Trust draft Quality Account 2010/11:
Histopathology
“The exhaustive Inquiry found no evidence to suggest that the histopathology department at University Hospitals Bristol provides anything other than a safe service.”
pardon???
Extract from FOI request to UHB:
Q. Please describe the process used by the Source BioScience reviewers to reach their opinions. Did they have access at any time to the UBHT and NBT reports and the reports of any external reviewers who had been requested for opinion? If so, at what points in the process did they refer to these opinions before writing their final reports?
A. Copies of relevant UHBT and NBT reports were sent to Source BioScience together with the slides. We do not know the process used by Source BioScience reviewers.
Q. Please provide the names, specialist interests and qualifications of the 12 RCPath. reviewers who reviewed the 26 cases, correlating the name of the pathologist to the reviewer ID numbers shown in Annexe 4(i).
A. We do not have this information.
Q. Please describe the process used by the RCPath. reviewers to reach their opinions. Did they have access at any time to the UBHT and NBT reports and the reports of any external reviewers who had been requested for opinion, including the reports of the Source BioScience reviewers? If so, at what points in the process did they refer to these opinions before writing their final reports?
A. Copies of relevant UHBT and NBT reports were sent to the RCPath with the slides. Copies of the Source BioScience reports were not sent. We do not know the process used by RCPath reviewers.
Q. Please describe the details of any external quality assurance procedures that were implemented to provide evidence that all the relevant slides and reports, both internal to NBT and UHBT, and external, were sent
for review by Source BioScience and RCPath.
A. This was not externally assessed.
The Report of the “exhaustive” Inquiry contains a case where the opinion of six histopathologists, including two national experts, was that a patient had squamous carcinoma of the vulva.
Panel – “College reviewers’ opinions support the original benign diagnosis by the histopathologist at UHBT” (UHBT diagnosed keratoacanthoma, a condition that is associated with sun exposure!)
President of the College “Both (reviewers) consider the possibility that this could be a squamous cell carcinoma.”
“Both believe that a diagnosis of keratoacanthoma is unlikely to be correct.”
Six opinions that already existed, that confirmed a malignant diagnosis, including those of two national experts, were disregarded by the President of the Royal College and the Panel.