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Royal College of Surgeons statement on Northern Ireland hyponatraemia inquiry

31 May 2018

The Royal College of Surgeons was deeply saddened by the hyponatraemia-related deaths of five children in Northern Ireland’s hospitals: Adam Strain, Claire Roberts, Lucy Crawford, Raychel Ferguson, and Conor Mitchell. The sorrow of their families will only have been compounded by the length of time the inquiry took to complete its investigations. The catalogue of failings, detailed in the inquiry’s report, is distressing to read and we have highlighted the report to our membership throughout Northern Ireland, the UK, and Ireland.

The overwhelming majority of healthcare staff work with diligence and commitment, often under enormous pressure, with great compassion for their patients. Nevertheless this inquiry has detailed unacceptable failings in the care of young children and it is now vital that the whole health sector takes steps to prevent such tragedies from happening again – not just in managing fluids in children, but in how patients and their families are treated throughout our health and care services. We have worked with a number of royal colleges, led by the Royal College of Paediatrics and Child Health, to present a united and detailed response to the 96 recommendations of the inquiry which is published today.

The Royal College of Surgeons supports the broad thrust of the inquiry’s recommendations and will work closely with the Northern Ireland health service to implement them. In particular, our role is to continue to help raise standards in surgical care and to educate and train surgeons to give the best care for their patients. Our recent guidance on patient consent makes clear that the days of “doctor knows best” are over. Patients and their families must be fully supported in making decisions about their care. 

During the course of the inquiry it was also concerning that Mr Justice O’Hara had difficulty in obtaining candour and truth from some witnesses. It is completely unacceptable for any healthcare professional or managerial staff not to be completely transparent about any failures in the NHS. It is right that a number of doctors have referred themselves to the General Medical Council in order to provide proper scrutiny of their involvement in the children’s care.

One of the key recommendations of the inquiry, supported by the General Medical Council, is the need for a duty of candour. In 2014 the Royal College of Surgeons chaired a review of such a duty leading to its establishment in England. We believe that a similar approach in Northern Ireland would enable positive cultural change.
The Royal College of Surgeons remains absolutely committed to upholding the highest standards of care for patients in surgery and throughout the wider Northern Ireland health service.


Notes to editors

The Royal College of Surgeons of England is a professional membership organisation and registered charity, which exists to advance surgical standards and improve patient care.

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