Improving treatments for mesh complications

Recommendations on how to improve care for women who have experienced complications from mesh procedures will be made in the autumn.

The expert group was announced by Health Secretary Jeane Freeman last month following a meeting with women who have suffered as a result of mesh implants. 

Ms Freeman has now written to campaigners, MSPs and the Scottish Parliament’s Health and Sport Committee to set out details of the work of the short-time working group. 

The group, made up of senior clinical managers, medical directors, and other key specialists, will hold its first meet today (Friday), and is expected to submit its findings to health board chief executives in the early autumn.

To ensure the work takes into account the views of patients, a clinician will be nominated to feed in their views. Further work is also taking place to determine how best their opinions and experiences can be represented.

Background:

A full copy of the letter follows:

Mr Lewis Macdonald MSP
Convener
Health and Sport Committee

4 April 2019

As you know, the Scottish Parliament debated transvaginal mesh removal on 5 March.  After the debate, I met with several women who had suffered complications following mesh surgery, and I listened carefully to the personal experiences they shared with me.

Having given consideration to the views of MSPs and the concerns of the women I met with, I would now like to take the opportunity to set out the action that the Scottish Government and Health Boards will take.  I can confirm that a short-time working group, including Health Board Accountable Officers (or nominated Deputies) and other key individuals, will examine the needs of patients and the course of care provided for those who suffer complications following vaginal mesh surgery.  It will consider what additional steps could be taken to offer choice to women who want – and are clinically suitable for – removal of mesh. The group will also review and identify areas of best practice in the United Kingdom and beyond, and if these are not already available, consider how these can be provided in Scotland.  In doing this, the group will:

• consider the physical and psychological needs of women who experience complications following vaginal mesh surgery;
• consider sharing experience, techniques and learning with colleagues in Europe, the USA and elsewhere. For this to be successful it is important that surgeons and clinical teams engage with counterparts of proven merit and who are regarded by the professionals as leaders and innovators in their field;
• review the course and organisation of care for patients suffering complications in Scotland with a broader UK perspective;
• examine the complex education and training requirements we must have to ensure a sustainable and resilient high quality service; and
• identify the resource requirements to provide the service our patients need.

It is vitally important that, as the group progresses this work, it takes account of patient views.  On that basis a nominated clinician will help feed in views from patients.  Additionally, however, officials are presently examining further avenues for patient feed-in, and are seeking the advice of both Healthcare Improvement Scotland’s Transvaginal Mesh Oversight Group and the Health and Social Care Alliance Scotland on how this could be achieved.

It is, of course, important that this work is progressed as quickly as possible.  As such, a meeting of the group will take place on 5 April, with further meetings being held as required over the coming months.  Further, the group aims to conclude this work in the early autumn, at which point it will report to Health Board Chief Executives, given their role as leaders for service change.

I hope this is helpful.

Jeane Freeman

Cabinet Secretary for Health and Sport