Surgeon accuses NHS of misleading ministers over cardiac deaths

Professor Marjan Jahangiri - Alex Lentati/Evening Standard / eyevine
Professor Marjan Jahangiri - Alex Lentati/Evening Standard / eyevine

A surgeon wrongly blamed for the deaths of dozens of cardiac patients has accused NHS chiefs of misleading health ministers over a crucial report into the fatalities.

Professor Marjan Jahangiri told an inquest that NHS Improvement (NHSI) had given ministers inaccurate information about its Independent Mortality Review of deaths at St George’s Hospital.

The review, conducted by consultant surgeon Michael Lewis, concluded that cardiac surgeons at St George’s, in south London, had caused the deaths of 67 patients, leaving their reputations in tatters.

Professor Jahangiri said NHSI had wrongly told health ministers that the review was not about laying individual blame on clinicians and that it would not form the basis for any referral to the GMC or other professional bodies.

But following the publication of the Lewis Review, St George’s NHS Trust suspended Professor Jahangiri and her fellow surgeon, Dr Justin Nowell. The trust also paid hundreds of thousands of pounds in legal fees over claims of clinical malpractice and mistakes in care.

The two surgeons were subsequently referred to the General Medical Council (GMC) for a misconduct investigation by the medical director of St George’s.

Surgeon Justin Nowell
Surgeon Justin Nowell

However, following an 18-month process the GMC informed them last May that they had "no case to answer" and there was “no need for a formal investigation”.

By then, a High Court judge had ruled in August 2019 that no blame should be attached to the pair. Dr Nowell and Prof Jahangiri were reinstated and received apologies and compensation from the hospital.

Prof Jahangiri, an experienced cardiac specialist, said it took the intervention of her constituency MP, Conservative Felicity Buchan, to obtain a correction from James Morris, the health minister, about the remit of the Lewis review report.

Last week Prof Jahangiri told an inquest into the death of one of the patients, 84-year-old Maureen Brett, that: “NHSI gave inaccurate information about the Lewis review to ministers in advance of two debates in both Houses of Parliament.

“It was only due to the concerted efforts of my MP, Miss Felicity Buchan, that the health minister issued a written apology and retracted the errors.”

Ms Buchan, the Conservative MP for Kensington, Under-Secretary of State for Housing and Homelessness, has criticised the impact of the Lewis review on St George’s clinical staff.

The inquest into the death of Mrs Brett, from Folkestone, Kent, found that it contained "frankly unfair" criticism of the treatment the pensioner received at St George’s.

It was the latest in a series of inquests held in recent months by Prof Fiona Wilcox, senior coroner for inner west London, into the death of the 67 patients.

Over the course of more than 40 inquests so far Prof Wilcox has said that no blame should have been attached to St George’s medical staff and the two surgeons. She concluded in only one case so far that there had been failings in care.

Prof. Jahangiri told Mrs Brett’s inquest that the NHSI review had had a devastating impact on “many clinicians in our unit . . families of the deceased patients and past and future patients”.

She told Prof Wilcox she had spent 4,500 hours defending herself and her unit and incurred substantial legal costs “against the near unlimited legal resources” available to NHS England.

Paul Greaney, KC, appearing for NHS England disputed the claims of Professor Jahangiri and said that NHS England had welcomed the Prevention of Future Deaths report issued by the Coroner, which had criticised the Lewis Review.

During an earlier inquest, Prof Wilcox said: “There has been enormous damage and suffering as a result of the NHSI Review. The whole reputation of the cardiac surgery department and the hospital has been damaged with no evidence that this court has so far seen of deficiencies in care.”

NHS Improvement said the Lewis review, led by 12 senior clinical experts in cardiac surgery, was not undertaken to determine cause of death or attribute blame to individual clinicians, but to examine historic care failings in the Cardiac Surgery Unit at St George’s between 2013 and 2018.

NHS England said it had supported the health minister in providing a written update "to clarify a previous statement made in a ministerial briefing".

A spokesperson for the NHS in London said: "Cardiac surgery at the Trust has significantly improved following recommendations made by the Independent Mortality review. The review considered safety issues and was not critical of any individual employees."