Radiologist's 37% error rate leads to review of scans

Hundreds of scans are being reviewed at an Irish hospital after an internal investigation showed over a third of a locum radiologist's work contained errors, according to reports in the national media.

An article posted by the Irish Times on 31 October noted that the locum consultant's contract was terminated within 10 days because of concerns raised about the standard of the individual's work at Letterkenny University Hospital (LUH) in County Donegal.

"Letterkenny, and some other peripheral hospitals, are finding it virtually impossible to recruit permanent staff, and are highly dependent on any temporary staff they can attract," a source told "To get rid of somebody so quickly would suggest that there were serious problems."

The senior member of staff who identified issues with the locum's work after the individual's departure complained to management about its initial failure to review scans, the Irish Times said. Senior hospital staff and local GPs then called for an external inquiry into the hospital, claiming it was close to collapse.

A spokesman from Saolta University Health Care Group, which manages Letterkenny, told the Irish Times: "A full review of the relevant clinician's work is under way to provide assurance regarding patient safety." The consultant worked in the hospital for seven days, he pointed out.

The hospital quality and patient safety service has a "clear pathway" for addressing concerns about clinical care, which is currently being followed, the spokesman added. "In the event that any cases of misdiagnosis come to light patients will be contacted with full open disclosure and appropriate arrangements put in place for follow-up care, in accordance with national policy."

High error rate

After the locum's contract was terminated, a senior consultant at LUH asked the hospital and Saolta managers to review the person's work. The consultant claimed that he did not get a reply. He then reviewed the CT scans performed by the locum and found an error rate of 37%, the Irish Times said.

According to the consultant, he received no response when he brought this to the attention of hospital management. "To date, I have not received a reply from management regarding the review of 238 x-rays and 66 ultrasound scans performed by this radiologist," the letter sent to management in October said.

Having "lost all hope" of the department being fully led by consultants, he said an external review of management of the radiology department was now required. In separate letters to Irish Minister for Health Stephen Donnelly last month, 11 consultants at the hospital and almost 80 local GPs warned that the hospital is in crisis and patients attending it are at clinical risk, the report continued.

Debate continues

SAOLTA CEO Tony Canavan was to be quizzed about the issue at a meeting with Regional Health Forum members on 3 November, according to an article posted on 2 November by the Donegal News.

"Mr. Canavan called the meeting with members of the health forum and Oireachtas members after serious concerns were raised about patient safety," the article stated. "The male radiologist was employed on a locum basis in September and has now had their contract terminated."

InHealth, based in the U.K., previously provided cardiac services at Letterkenny, but this service ceased in 2022, and therefore the company will not be involved in the review of scans, a spokesperson told on 6 November.

"It's time to come home"

A new contract for consultants came into force in Ireland at the beginning of 2023. It led to a substantial improvement in salary packages and gave staff the freedom to engage in private practice outside their contracted hours -- a provision that represented a new development that was effectively an acknowledgment that the prohibition on this work for most contract holders under previous contracts was making jobs unattractive.

The Health Service Executive (HSE), which runs all public health services in Ireland, has been marketing this new contract quite aggressively. For example, a full-page advert appeared in the BMJ in June 2023.

The headline of the HSE's advert was "You went away to the UK. Now come home to Ireland," and it referred to consultant salaries of between 214,000 and 257,000 euros.

"We're improving the Irish health service," the advert read. "This year we will create over 400 new consultant posts, offering great salaries, on-call payments, fantastic teammates, nonstop training with education allowance, and constant investment. It's time to come home."

Dr. Simon Jones, a consultant obstetric anesthetist based in North-East England, posted on (formerly Twitter) on 9 June: "International adverts in the BMJ, trying to attract U.K. consultants, now include those from countries attached to our own. The headline number is striking."

The HSE is ramping up the advertising, Jones added. "Clearly aimed at pulling Irish grads back across rather than UK grads. And of course money isn't the whole deal but it's a very strong number. It'll be quite a pull for cross-border workers. I know two in the North considering it."

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