Trust X-ray problem scaled at 18k; just 21% of urgent breast care patients seen in 14 days in July

The review was also critical of breast cancer services at the Trust.

It found that in July 2010 just one fifth of all urgent breast cancer referrals were seen within the standard 14 days.

As a consequence of the X-ray problem "a detailed weekly report was required to ensure the backlog was addressed" between August and October 2010.

The review found that the large backlog of unreported X-rays developed due to capacity in terms of radiologists, increasing workload, equipment issues and the Trust's focus on other radiological priorities.

The report states: "Immediate action rectified the position in regard to new patients and an exercise was undertaken to scale the extent of the problem.

"In August, this was sized at 18,500 of which around 3,400 were chest X-rays.

"Part of the process was to risk assess the implications and be clear as to which patients were involved."

It adds: "Specifically, this required an analysis of any patient who might need recalled.

"Four patients were recalled and had their individual circumstances discussed with clinicians.

"As part of this review, Professor Gishen of Imperial College London, at the behest of the Board, reviewed the Trust's radiology department and indicated that professional practice by those working there is fully acceptable."

The review - released to a meeting of the Health and Social Care Board (HSCB)in Armagh today (Thursday) was also critical of breast care at the Trust.

At a public Board meeting in September 2010, underperformance against a 14-day target in urgent breast care referrals - 21 per cent were seen within a fortnight in July - was reported.

The review states that immediate steps were required from the Trust to return to 100 per cent and that this was substantially achieved by November (99 per cent) and involved, among other things, providing extra clinics, and is now at 100 per cent.

Other issues investigated include the high-profile Milly Martin, McElhill and McDermott brothers' cases.

Regarding the Milly Martin case the review found: "that baby Milly was not known to social services at that time, protocol requires a multi agency case management review (CMR) to be undertaken when a child dies and abuse or neglect is known or suspected.

"The CMR will look at all relevant issues but cannot report until criminal proceedings are completed."

Concerning the McElhill tragedy it says a major review of the case was undertaken by Mr Henry Toner QC.

Consequently: "The Trust has taken forward the recommendations from Mr Toner's report and in December 2009 the Minister for Health and Social Services asked him to assess the progress made. This report is awaited."

And regarding the McDermott brothers' it states: "There was significant community, public, media and political interest and disquiet at the handling of the McDermott brothers' cases and in September 2010, the Health and Social Services Minister, Michael McGimpsey MLA, asked RQIA (Regulation, Quality and Improvement Authority) to undertake an external review of them.

"RQIA subsequently found that the Trust had met the requirements of relevant legislation and policy in its supervision, care and treatment of the McDermott brothers."

In a statement following the monthly public meeting held in Armagh today the Board said: "The Health and Social Care Board today received a performance report on aspects of services provided by the Western Trust.

"This had been triggered by under performance in reporting hospital x-ray at Altnagelvin Hospital, performance against breast care targets, and performance issues in respect of a number of high profile cases in child care and learning disability services.

"The Board can report that the performance standards the Trust is required to meet in respect of these issues are now fully restored. As part of the work undertaken, the Trust processes were reviewed to ensure their compliance in handling such issues.

"Again the Board can report that it is satisfied with the outcome, subject to the implementation of recommendations made to the Trust. At forthcoming regular performance meetings, which occur monthly, the Trust will be required to continue the maintenance of performance standards and advise on progress on its recommendations.

"Turning specifically to the matters examined, it is worth note that the majority had been fully in the public domain. The Board has always made it clear that this type of work will be appropriately made public and is doing so today.

"The Board is aware that the issues reviewed may, by their very nature, cause concern or anxiety with individuals or local communities. The purpose of performance management is to systematically identify problems and ensure their resolution, and it is in this context that the work was undertaken.

"This review demonstrates the importance of performance management within the HSC system, and reaffirms the ongoing commitment of the Board to ensure that the highest possible quality of care is available to the population."