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General Medical Council to probe conduct of Tayside doctors who prescribed low chemotherapy doses

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Doctors who prescribed lower than standard chemotherapy doses to breast cancer patients in Tayside will have their professional conduct reviewed as part of a probe by the General Medical Council (GMC).

More than 300 individuals, including 14 who have since died, were given reduced amounts of the treatment by doctors between December 2016 and March 2019 in an attempt to reduce serious side effects and long-lasting secondary conditions.

A Healthcare Improvement Scotland (HIS) report released earlier this month found the dosage given to individuals in Tayside was lower than in any other Scottish health board area, and that patients were not made aware of the variance.

The Courier has learned the GMC has now been in contact with senior figures at NHS Tayside in relation to the report, and the conduct of two consultants will be considered following a complaint from within the health board.

The watchdog was unable to comment on any specific investigations into individual doctors at this stage but confirmed it was “aware of the concerns described in Healthcare Improvement Scotland’s report”.

A spokesperson for the GMC said it would “carefully consider any issues raised against the professional standards we expect of doctors”.

The review will look at the conduct of the two consultants rather than the quality of treatment offered by the department as a whole. The GMC has not yet publicly identified any specific concerns.

Senior clinicians in Tayside have repeatedly reaffirmed their view that higher doses prescribed elsewhere were “unacceptably toxic” and insisted the treatment regime offered in Tayside was created in the best interests of patients.

The HIS report, including a dedicated risk assessment conducted by an independent review panel, agreed the decision was taken with patient wellbeing in mind but advised it may have inadvertently increased the risk of cancer returning.

It is understood the findings, which include criticisms over a reported lack of evidence to support the doctors’ decision, have been with met with questions of their own, in particular over a failure to provide methodology for the reported 1 to 2% increased risk.

A group of specialists from the Royal College of Physicians London will visit Tayside later this month to form their own opinions, while a review into the deaths of 14 patients since December 2016 has reportedly been brought forward.

Lee Dennis, who set up the NHS Tayside Cancer Care Support Group for individuals and families affected, highlighted the importance of trust being restored to the doctor-patient relationship following the revelations.

“Many patients and families feel as though they were deprived of fully informed choices about their treatment and this should give them confidence that all angles are being examined,” she said.

“We have reciewed the HIS report and the Scottish Government risk assessment; the Royal College of Physicians is releasing its own findings imminently, and now the GMC is involved.

“That is a significant amount of scrutiny, which will hopefully ensure any problems are detected and addressed expediently.”

An NHS Tayside spokeswoman said: “We are aware of this and are in regular contact with the GMC.”