Eljamel independent clinical review: terms of reference (draft)
Draft terms of reference for the clinical review of former patients.
Status and leadership
1. The Independent Clinical Review of individual cases of former patients of Mr Eljamel ('ICR') will be independent of the Scottish Government and NHS Tayside. It will be person-centred and trauma-informed.
2. Independent clinical reviews of individual cases of former patients of Mr Eljamel (“the ICRs”) will be undertaken within the ICR process. The ICRs will review the medical records of former patients and other relevant documentation in so far as they relate to the treatment received by the former patients from Mr Eljamel (and medical colleagues under his supervision) during the time that he was employed by NHS Tayside or in private care.
3. The ICR will be led by a leading surgeon, Professor Stephen Wigmore. Reviews of the cases of any former patient who wishes, or (in the case of deceased patients) whose family wishes, the relevant former patient’s case to be reviewed will be conducted by expert neurosurgeons, who will be recruited by the ICR. The ICR will ensure there are no conflicts of interest between the expert neurosurgeons and Mr Eljamel, NHS Tayside or any relevant private facility.
Purpose
4. The purpose of the ICR is to review the care and treatment with each former patient to provide clarity to the patient or their family as to what happened in the case of the patient. In addition, the ICR will also provide information to the public inquiry which may be used by the public inquiry in the fulfilment of its terms of reference, as set out more fully below.
5. The ICR will not consider or determine any questions of civil or criminal liability.
6. Each of the ICRs will be provided in the form of a report to the former patient or the family (in the case of deceased former patients).
7. Each of the ICRs will seek to ascertain:
- The chronology of events relating to the neurosurgical care and treatment received by the patient, including the actions taken by Mr Eljamel and, where appropriate, medical colleagues who were under the supervision of Mr Eljamel and who played a part in such care or treatment;
- Whether and, if so, when, concerns or complaints were raised about the care or treatment received by or on behalf of the former patient;
- Whether the care and treatment provided by Mr Eljamel and, where appropriate, colleagues under the supervision of Mr Eljamel playing a part in such care or treatment, were reasonable based on clinical guidelines and practice at the time at which they were provided; and
- Where possible, what physical damage was caused to the patient and whether that physical damage resulted from the treatment (or lack of treatment) by Mr Eljamel or medical colleagues under his supervision, on the balance of probabilities.
- Analysis of the adequacy of follow up care and signposting of patients if appropriate.
Participation
8. All former patients, or families of deceased former patients, of Mr Eljamel during his employment with NHS Tayside or in private practice are able to participate in the ICR. This process will be an opt-in process whereby former patients or the families of deceased former patients are required to self-identify. Known patients who were under the care of Mr Eljamel will be communicated with to advise them how they can request a review.
9. All former patients, or families of deceased former patients, will be asked to provide written consent, in a form to be provided by the ICR, so that the patient’s medical records may be accessed by the ICR. In addition, consent will be sought to share a copy of each of the ICRs with the public inquiry and to share contact details of each applicant and each former patient with the public inquiry to assist the public inquiry and to enable the inquiry public to further investigate a specific case, should it wish to do so.
Methodology
10. Each of the ICRs will review the medical records (including the NHS Tayside Hospital and/or primary care records, and the records of any relevant private facility) of former patients and other relevant documentation, which will include any other documentation as appears relevant and for which consent for access has been provided. Some patient's secondary care clinical records have been destroyed by NHS Tayside as part of agreed records management procedures at the time.
11. In addition, participating former patients or their families in the case of deceased former patients will be invited to respond to a questionnaire to provide additional information relating to their case. The public inquiry is to provide reasonable support to the ICR for this part of the methodology. The applicant statement provided in response to the questionnaire will also be considered as part of the ICRs.
12. The methodology used in any individual case will be determined by the reviewer, but it will seek to meet the purposes of the ICRs as set out above and will respect patient confidentiality and information governance principles.
13. In any of the ICRs, the anticipated timeline for the completion of the review will be set out at the outset, with progress updates to be provided, and will take account of the need for the review to be undertaken as quickly as possible, but at the same time be sufficiently thorough to achieve its purpose.
14. Both in the compilation of any of the ICRs and in the production of collective reviews or the provision of information or assistance as may be requested by the public inquiry, the ICRs will develop and publish systems to ensure patient confidentiality.
The role of the ICR in the work of the public inquiry
15. The ICR will liaise with the public inquiry and will set out publicly how the ICR intends to work alongside and cooperate with the public inquiry so as to best discharge these terms of reference and to support the inquiry in its work discharging its own terms of reference.
16. The ICR will provide information or assistance to the public inquiry, insofar as it is reasonably able to do so, in response to requests made by the public inquiry for such information or assistance arising from or in connection with the ICRs.
17. In any event, the ICR will seek to identify and report on common themes and areas of concern arising from the review of individual cases. These common themes and areas of concern will be communicated to the public inquiry by means to be agreed between the two processes in due course.
Interpretation
18. References in the terms of reference to Mr Eljamel mean Mr Muftah Salem Eljamel (also known as Sam Eljamel), former head of neurosurgery at Ninewells Hospital, Dundee.
19. References to NHS Tayside should be construed as including Tayside Health Board, any predecessor of NHS Tayside, any part or agent thereof; and
20. References to the “public inquiry” are to the public inquiry into the actions of Mr Eljamel and NHS Tayside, set up or to be set up by the Scottish Government.
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