RCSI President backs ‘invited review’ process

The President of the RCSI would like to see an “invited review” process in Irish healthcare whereby a College team would be asked to assess a surgeon or process that is performing poorly.

In an interview with the Medical Independent (MI), Mr Ken Mealy said the issue of surgeons who may be under-performing is usually dealt with at hospital and HSE level, without involvement from the RCSI.

“In general, we are not invited in by Hospital Groups; sometimes we are, but seldom. So the only way we get involved would be in terms of professional development issues, in terms of individuals coming to us of their own volition, saying ‘I am in trouble’ or ‘I need to be upskilled’,” said Mr Mealy, a Consultant General Surgeon at Wexford General Hospital.

“Sometimes Hospital Groups come to us and say, ‘will you help in the upskilling of somebody who has had an issue’ but that is at the discretion of the Hospital Groups. In many cases in Ireland, it is adversarial and ends up in the courts, which is problematic. So I would like to see a more structured, defined process.”

He said the invited review process run by the Royal College of Surgeons (RCS), London, “is worthy of note and I am aware that… one or two hospitals here have started to use that process”.

According to the RCS, invited reviews are a partnership between the college, the specialty associations and lay reviewers representing the patient and public interest. An invited review supports but does not replace existing procedures for managing surgical performance.

It says healthcare organisations “should be open and transparent with patients, their relatives and the public about the review”.