Mesh implant final report

Scotland’s Chief Medical Officer (CMO) has accepted the recommendations of the final independent report into the use of transvaginal mesh implant procedures.

The report, published today, sets out a number of conclusions to improve the safeguards available. These include:

• Mesh must not be offered routinely to women with pelvic organ prolapse.
• Reporting of all procedures and adverse events to be mandatory, in line with the guidance from the General Medical Council.
• Extra steps to ensure that patients have access to clear, understandable advice to help them make informed choices.
• In the case of surgical treatment for stress-urinary incontinence, all appropriate treatments should be available, subject to informed choice and assessment.
• Improved training for clinical teams involved in transvaginal mesh.
• Improved research into the safety and effectiveness of the products.

A new oversight group will be established to ensure the conclusions are implemented.

Dr Catherine Calderwood, Scotland’s CMO, said:

“I want to thank this independent review for their hard work over a lengthy period of time. This is a highly complex and technical subject area and they had a wide range of evidence to consider. The group included a wide range of people with differing views and all of their contributions have been very valuable.

“On behalf of the Scottish Government I am today accepting the conclusions of the review group. It is vital that women are given all the available information before they decide whether to go ahead with a mesh procedure. It is also right that all adverse events are properly reported so that we can continue to improve safety and positive outcomes.

“We must remember that this review came about because of the tireless campaigning of women who have been negatively impacted by mesh procedures. It is right that we recognise the courage of these women, which has brought us to this point today.

“I want patients to have the best and most up-to-date information on which to base their decisions – in discussion with their clinicians. I will be looking for the newly-formed Oversight Group to ensure this happens.”

The Chair of the independent review, Tracey Gillies, said:

“I am pleased to announce the publication of this wide ranging report which, after the publication of key scientific and safety studies awaited by the review, is now complete. 

“I have no doubt that the implementation of the conclusions in this report will provide benefit to women across Scotland, and will provide clinicians with additional tools to support their engagement with realising realistic medicine, allowing better decisions to be made jointly with patients.

“I want to give my sincere thanks to all Independent Review members for their expert knowledge and dedication to this work in the 18 months that have elapsed since publication of the Review’s Interim Report.  I also wish to extend my personal thanks to the previous Chair for her wisdom in guiding the initial work on this report.” 

Background:

The Scottish independent review group, chaired by Tracey Gillies, has considered all available evidence on the safety and effectiveness of the transvaginal mesh implants.