NHSE should intervene in trust safety investigation, says inquiry chair

Leaders in Salford have been resisting pressure to expand a review of patients treated by the former head of its spinal division, John Williamson, over his 23-year career at the hospital.

A review of his last five years established clear problems with his surgical techniques and found multiple cases of avoidable harm.

But the trust has refused calls from campaigners and some staff to contact all of Mr Williamson’s patients before this period, saying it was impractical and unlikely that new themes would emerge.

The Rt Revd Graham James, a former Bishop of Norwich who chaired the Paterson Inquiry, has been following media coverage of the Williamson case.

Mr Paterson was a breast surgeon who worked in the Birmingham area and was found to have carried out unnecessary and unapproved procedures on more than 1,000 cancer patients over 14 years.

Bishop Graham told HSJ: “I have read the rationale for not recalling the patients of the surgeon John Williamson outside a late five-year period of his 23-year career in Salford, and it concerns me in the light of what we learned in the Paterson Inquiry.

“There were limited recalls in relation to Paterson, mainly for reputational and resource reasons. Even after the report was published, a final tranche of well over a thousand patients were contacted for the first time, by then a decade on from Paterson’s initial suspension.

“The national patient recall framework, issued in June 2022, fulfilling the recommendation of the Paterson Inquiry, puts patient safety at the centre of all recall procedures.

“While I recognise I am an outside observer, it does not seem that the recall of Williamson’s patients is currently thorough enough, and I would hope there may be an independent review of this decision, perhaps by NHSE, to determine a way forward.

“It is not sufficient to think that publicity alone will lead to patients taking the initiative in recall, nor is it right to expect them to do so.”

The Northern Care Alliance, which runs Salford Royal, did include some individual cases from before the 2009- 2014 review period in its recall process, in cases with reported incidents, complaints or litigation attached to them.

HSJ understands trust bosses had initially agreed to fully review further five-year tranches of patients, going back to 1991. But after the first stage of the work, senior members of the review team decided to shelve the process, saying no additional themes were likely to be identified, and cited practical issues in looking back further, such as the availability of records and imaging, and the ability to contact patients.

Instead, the trust has issued general invitations via the media to anyone with concerns about the care they received, for their case to receive a desktop review. The trust said 31 patients had responded and the cases were being worked through.

However, Glyn Smurthwaite – a recently retired anaesthetist who worked with Mr Williamson and was part of the review team – said it was essential to contact as many patients as possible, saying some may continue to suffer problems with their spine due to surgery by Mr Williamson, yet be unaware of the problems now recognised about his practices.

He believes the issues around Mr Williamson’s probity make this especially important, as incidents may not have been recorded at the time, meaning concerning cases from pre-2009 may not have been picked up.

A barrister-led review, published in March, found serious duty of candour issues around Mr Williamson, including a coroner being misled over a teenager’s death.

The Northern Care Alliance declined to comment, and NHSE did not respond.

Royal Manchester Children’s Hospital and Spire Healthcare, where Mr Williamson also practised, conducted similar recall processes to Salford, with full recalls only relating to the most recent five years of practice.