Precautionary patient notification exercise begins at three hospital trusts following safety checks co-ordinated by NHS England Midlands and East
A number of patients who have been treated at Chesterfield Royal Hospital NHS Foundation Trust, Nottingham University Hospitals NHS Trust and Royal Cornwall Hospitals NHS Trust have today (Tuesday 2 May) been sent letters inviting them to specially arranged clinics for precautionary blood tests.
The recall affects 400 patients who were treated by a locum doctor, whom has been diagnosed as HIV positive, and worked at the three hospitals at various dates between June 2010 and February 2015. Clinical evidence shows any risk of infection is extremely low and it is highly unlikely that any patient identified will have been infected with HIV. The doctor is no longer working for the NHS.
When a healthcare worker is diagnosed with HIV, it is normal practice for the NHS to undertake a review to identify any patient who has undergone procedures which may have placed them at risk of infection by the health care worker before their formal diagnosis. The notification exercise is being co-ordinated by NHS England Midlands and East and guided by the UK Advisory Panel for Healthcare Workers infected with Blood-borne Virus (UKAP) which recommended, as a precautionary measure, identification of patients who had undergone a category 3 exposure-prone procedure (EPP) between June 2010 and June 2016. Exposure-prone procedures are those where there is a risk that injury to the worker could result in exposure of the patient’s open tissues to the blood of the worker. UKAP has advised this time period because the first confirmed blood test which showed the doctor was HIV positive was in February 2016 and the last recorded HIV negative test was June 2010. Only those patients written to by the three trusts concerned are subject to this recall.
Whilst any risk to patients is extremely low, patients are being invited for testing as a precautionary measure at dedicated clinics that will be held over the weekend of Saturday and Sunday 6 and 7 May. Support and counselling will be available and each hospital has set up a helplines. The majority of patients will be told their results within 72 hours by phone and letter. Patients unable to attend the weekend clinics will be able to attend at other times in the week or may choose to go for testing at their GP.
The number of patients being asked to attend is:
- Chesterfield Royal Hospital NHS Foundation Trust – 120 patients
- Nottingham University Hospitals NHS Trust – 223 patients
- Royal Cornwall Hospitals NHS Trust – 57 patients
Dr David Levy, Regional Medical Director for NHS England Midlands and East, said: “We understand that this will be a worrying time for patients who are being invited for precautionary testing and their families. However, clinical evidence shows that the risk of infection is extremely low and it is highly unlikely that any of the patients being contacted will have been infected with HIV. “Advice and counselling is available for those affected by this recall, and we would encourage them to access this support. It is our first priority to identify and provide reassurance to the individuals being contacted at this time. We continue to work closely with Public Health England and other organisations involved to understand the details of what has been a complex incident.”
Healthcare workers and the reporting of HIV to employers
Established procedures are in place regarding health care workers infected with HIV. As long as a healthcare worker who is diagnosed with HIV takes and maintains a course of drugs which eradicate the virus in the bloodstream they may return to work, providing they follow all appropriate infection control procedures and any other restrictions on their practice that their professional body may order.
Health care workers are required to tell their employer if they have become infected – their details are then held on a confidential register and the health care worker is required to have three-monthly testing to ensure compliance with treatment that ensures there is no risk of them passing on the virus.
Tracing patient contacts in cases such as these can be complex and lengthy exercises. It is vital that health care workers carrying out exposure-prone procedures tell their employers, including if they are employed through a locum agency, that they are HIV positive.
Patient record checks have taken place at other hospitals where the locum doctor worked but no category-3 exposure-prone procedures (EPP) have been identified and so no patients are subject to recall.
The doctor at the heart of this precautionary patient notification exercise is no longer working for the NHS. They were referred to the General Medical Council (GMC), which placed conditions on their registration. Subsequently the GMC has served an interim suspension order on the doctor earlier this year because they failed to comply with the conditions placed upon them. NHS England can confirm that no patients were put at risk during that time as their records show no category 3 exposure-prone procedures were carried out.
NHS England will review the incident to learn lessons for the future.
The risk to patients
The current recall is a precautionary measure – the risk to patients is extremely low and it is highly unlikely that any patient will have been infected with HIV. Worldwide, there have only ever been four reports of possible transmissions of HIV from infected healthcare workers performing exposure prone procedures, neither of which were in the UK. These cases were some years ago and surgical infection control practices and checks have further improved over recent years.