The CervicalCheck screening programme’s clinical director last year “expressed regret for any misunderstanding” over its communication strategy around disclosing false smear tests, when she met doctors.
In a previously undisclosed email sent to HSE officials in September 2017, Gráinne Flannelly said she had met CervicalCheck’s lead colposcopists after a year-long dispute between the programme and the doctors over who was responsible for informing patients about missed cancer warnings arising from a review of cases.
The email was released to the Joint Oireachtas health committee after questioning from TDs and Senators about who within the HSE was aware of the failure to tell women with cancer about the false tests.
Prof Flannelly stepped down from CervicalCheck at the end of last month after it emerged that scores of women with cervical cancer had not been informed about incorrect smear tests arising from clinical audits.
In an email last September, she told Dr Colm Henry, then HSE national clinical adviser to acute hospitals, and Elaine Brown, a project manager in his office, that the cancer review process "has been evolving over the last number of years" and she had "endeavoured to provide support and communication to the colposcopy teams".
We have, following the meeting, taken on board that the programme should record the woman's wishes
She noted that Dr Kevin Hickey, the gynaecologist who treated terminally ill Limerick woman Vicky Phelan, asked that the cancer audit be discussed at the meeting. Dr Hickey had pushed the programme for more than a year to tell the women about the incorrect smear tests.
‘Expressed regret’
“We expressed regret for any misunderstanding and perceived lack of clarity in the process to date,” Prof Flannelly reported back to the HSE officials about the meeting.
“The key areas identified for improvement relate to communication – both of the process itself and regarding the outcome and interpretation of any findings.”
She said CervicalCheck was working on a “prospective process of notification and consent” and a new leaflet, entitled Reviewing your Screening History, would be given to women shortly after they are diagnosed with cancer.
This would tell the women “of the process and record her wishes to be informed about any findings”, she said.
“We have, following the meeting, taken on board that the programme should record the woman’s wishes, and where she wanted to be informed, would write directly to her advising her when her results are made available to her clinician.”
The clinician would provide the results and contact details if the woman wanted further clarification from the programme where required, she said.
Prof Flannelly added that she had also spoken to Prof Donal Brennan, a gynaecologist oncologist, about including the gynaecological community to get "a consensus agreement and further feedback".
“This should provide a way forward to reduce any such disharmony in the future,” she concluded.
Exposed scandal
Since Ms Phelan's High Court settlement exposed the scandal, a review by the HSE's serious incident management team found that among 1,462 women diagnosed with cervical cancer since 2008, 209 women had received false negative tests and they had not been disclosed to 162 women.
Dr Henry has said he regrets taking Prof Flannelly’s assurances that women would be told at face value and assuming that “people were following through on what they told me they were doing”.
The email was released by the HSE to the Oireachtas health committee in recent days after Dr Henry was questioned about why he did not escalate the issue to more senior individuals within the health service.
