Tag Archives: David Chang

Kevin McGee and Royal Blackburn Hospital falsifying HPB MDT attendance records – written proof!

In March 2015, at a face to face meeting at Royal Blackburn hospital, it was confirmed by Dr Mansoor (ward consultant of ward C1 at Royal Blackburn hospital) that the diagnosis of stage T4 cancer for dad was made during the 12th September 2014, HPB MDT meeting (on record in front of witnesses).

At this HPB MDT meeting, RBH radiologist’s inconclusive findings were over-ruled by the HPB MDT team.

Dr Mansoor stated (on record & in front of witnesses) that although he wasn’t present at any of dad’s HPB MDT meetings, staff present included “a more senior radiologist [needed before a scan can be over-ruled], an oncologist and an histopathologist, so they can look at the scans and confirm or refuse the diagnosis of him (Dr Mansoor)”

Dr Mansoor and the business manager for gastro are on record as saying “We can find out whom attended the HPB MDT meeting on the 12th September 2014, from the date”
It was agreed by Royal Blackburn hospital’s business manager for gastro, that it would be added to the “A4 action plan and can be sent out to you”

On April 29th 2015, the letter arrived with the names of the members of the HPB MDT team that were in attendance.

The actual attendance of Royal Blackburn hospitals HPB MDT meeting 12-09-2014

The actual attendance of Royal Blackburn hospitals HPB MDT meeting 12-09-2014

Mr Chang – surgeon
Dr Kaushik – GI physician
Joanne Green – Upper GI nurse specialist

For months, we asked for copies of attendance records from Royal Blackburn hospital’s HPB MDT clinical lead, David Chang, the names were blocked from release.
We asked Kevin McGee (Chairman of East Lancs Health Trust) the names were blocked from release.
We asked via our MP Graham Jones, whom wrote directly to the Health secretary at the Department of Health.
Finally (after months of waiting) we had a response!

Royal Blackburn hospital HPB MDT attendance according to East Lancs Health Trust chairman Kevin McGee

Royal Blackburn hospital HPB MDT attendance according to East Lancs Health Trust chairman Kevin McGee

As you can see, although all names have been blocked from release, Kevin McGee is claiming that Royal Blackburn hospital’s HPB MDT attendance for all three of dad’s HPB MDT meetings (12th September, 19th September and 3rd October 2014) had six senior medical professionals in attendance.
This is simply not true!
Kevin McGee via David Chang (clinical lead for the NSSG cancer network in the North West and clinical lead for Royal Blackburn’s HPB MDT team) is publishing false information as regards staff attendance, not only to the family, but to our MP Graham Jones, the Department of Health and in other letters, the Information Commissioners Office (after a freedom of information request).

Why is this important?
To over-rule scans and test results, more senior, qualified staff must be in attendance at HPB MDT meetings.
There was no oncologist, no histopathologist and no radiologist present at dad’s HPB MDT meeting on 12th September 2014, when diagnosis was made.
This same HPB MDT meeting was not quorate (in that the correct qualified staff were not present, as is a legal requirement and required by the cancer peer rules).
Royal Blackburn’s HPB MDT team failed to adhere to strict protocols in regards to over-ruling scans/test results by referring the decisions higher up the chain, to more experienced and qualified staff (both within Royal Blackburn and further afield using the NSSG cancer network)

Not to mention the failures under their Duty of Candour not to publish or state (knowingly or not) false and misleading information.

East Lancashire NHS Trust have been selected to pilot the national trial for “faster cancer diagnosis standards”
God help us all.

The business manager for gastro at Royal Blackburn hospital whom kindly provided us with the information we requested, to try and resolve the complaint, was subsequently moved off our case not long after it went to more senior HPB MDT staff.
We managed to contact her, she informed us that she had been told “the family have received all the information on the A4 action plan” when she asked about it.
This is not the case.

Dr Mansoor was promoted soon after, to the HPB MDT team at Royal Blackburn hospital (read of that what you will) under the clinical lead of, David Chang.

The “consultant histopathologist” quoted as being present at HPB MDT level by Kevin McGee, is none other than one Dr Richard Prescott, the same Dr Prescott that claimed to have “no contact with the living side of the hospital [ Royal Blackburn]” when insisting to the East Lancs deputy coroner’s office that he should carry out the post-mortem on dad.
This has now been confirmed as 100% accurate, in writing by Kevin McGee (Chairman of East Lancs Health Trust).

Royal Blackburn hospital’s magical changing MDT attendance records

It is a legal requirement for an hospital (such as Royal Blackburn) to hold and maintain actual attendance records for each and every one of their Multi disciplinary team (MDT) meetings.

We have been attempting to get a copy of three such meetings that took place, in our dad’s case.
Royal Blackburn hospital’s HPB MDT chairman (Mr David Chang – lead cancer surgeon for Royal Blackburn and NSSG north west England cancer team chairman) has blocked each and every attempt we have made to obtain a copy.
Kevin McGee (CEO of East Lancashire Hospital NHS Trust) on the direction of David Chang, has also blocked every attempt made to provide us with a copy of these attendance records.

Senior Royal Blackburn hospital complaint staff have claimed they, “Didn’t know that actual HPB MDT attendance records exist, but we’ll try and get them for you” – then failed to respond ever again.

We have tried to get a copy through our MP Graham Jones and he has written to the Department of Health, again without success.

We have made Freedom of Information requests, where the Information Commissioner’s Office (ICO) have requested copies, they too have been blocked.

We have tried to obtain the copies through the medical records office at Burnley General Hospital, where we were told, “They [HPB MDT attendance records] do exist and we can put in a request for them, but to date, Royal Blackburn hospital senior staff have never released them, in any case!”

So we changed tack, perhaps if Royal Blackburn hospital will not release them to our family, then the Care Quality Commission (CQC) could confirm if they had followed their strict protocols and had the attendance records presented to them when they carried out two hospital inspections at Royal Blackburn hospital (as is required by law)?
They refused to confirm or deny this.
Perhaps the CQC could view the HPB MDT attendance records for the meetings concerning dad on our behalf and confirm/deny that the reported staff to us, were actually in attendance, as we have written evidence of whom was and was not present and the written accounts of David Chang and Kevin McGee were conflicting, to three different official bodies?
After months of deliberation, they passed all our complaint information to them (without permission) straight to… Kevin McGee (CEO of East Lancs NHS trust) and then refused to confirm or deny that they had access to the HPB MDT attendance records.

East Lancashire “Patient voices group” were informed after asking to look over the aspects of our complaint, they did not respond to the family, they instead handed over the details to Kevin McGee and then blocked my account on twitter!

After over a year of asking, senior Royal Blackburn hospital information office staff responded by informing the family that they were refusing to release the HPB MDT attendance records, due to,

“Processing is unwarranted by reason of prejudice to the rights and freedoms or legitimate interests of the individuals who would be identified.
The Trust has considered whether disclosure of the information would be fair”

Fair to whom?
All the family are asking is for copies of the attendance records of senior staff that diagnosed dad’s condition.
It is not relevant whom WAS at the HPB MDT meetings, but whom WAS NOT present at the meetings.

Kevin McGee and David Chang have made three reports of which professions were represented at dad’s HPB MDT meetings, every single one of them has been different and does not tally. (They cannot even agree on when the meetings took place for dad!)
Is this not in the public interest to know that East Lancs Health Trust chairman Kevin McGee and Royal Blackburn hospital’s HPB MDT chairman David Chang (and NSSG cancer network chairman) are making false and misleading statements to members of the public (which is a criminal offence)?

Are the CQC not concerned that each account by staff at the very top of East Lancs NHS trust conflicts?
Does the ICO not see anything wrong with their conflicting accounts?
Why does no official body want to see the evidence?
Why do Lancashire police not want to pursue the case when a crime is reported?

Why are Royal Blackburn hospital and East Lancs NHS trust going to such lengths to block the release of the HPB MDT attendance records if they have nothing to hide?

It is in the public interest to find out that Royal Blackburn’s MDT teams are understaffed.
It is in the public interest to know that Royal Blackburn’s MDT teams have unqualified staff, deciding diagnosis’ on patients, without the clinical knowledge/experience they require to have by law.

Publishing HPB MDT attendance records to a patient’s family may not be seen as ideal to those at the top, but as regards duty of candour, they are legally required to be open, honest and show integrity.
In dad’s case, they have failed on all accounts.

Multi Disciplinary Team (MDT) vanishing?

Royal Blackburn hospital’s HPB MDT team are a magical entity, that changes more often than the weather (sarcasm mode on).

Dad had three HPB MDT meetings to assess his care/treatment, two while he was in Royal Blackburn (ward C1), one after he was discharged.
Every aspect of these meetings has changed according to every member of senior Royal Blackburn’s senior staff and East Lancs Health Trust chairman Kevin McGee.
The Care Quality Commission (CQC) and the General Medical Council (GMC) have been offered written and recorded evidence of failings, but do not want to see or consider it.

HPB MDT meeting 1:
This took place on September 12th 2014.
Hospital notes show that nothing was discussed and notes returned to the ward not filled in (Mr David Chang, clinical lead of HPB MDT meetings is on record claiming “all meetings are recorded live” and it is required for the MDT meeting to be deemed quorate)
Nurses recorded that the outcome of this MDT meeting “needs to be chased up”.

Senior surgeon and clinical lead Mr David Chang claims “this meeting simply never took place, so there is nothing to discuss” – Written evidence shows Mr David Chang is telling the family lies, deliberately misleading and publishing false information.

HPB MDT meeting notes from the following week (19th September 2014) shows clearly that the diagnosis of terminal T4 stage cancer was made at the 12th September 2014 HPB MDT meeting.
These notes also show that an EUS FNA (cytology biopsy) was to be taken from dad and sent away for testing to confirm this diagnosis.
MDT update notes from the ward also show that various staff also knew about the “care plan” decided at the 12th September HPB MDT meeting (that Mr David Chang claims “never took place”) – Dieticians, ward consultant Dr Mansoor, ward doctors, nurses all recorded that an EUS FNA was to be done, all before Mr David Chang claimed it was decided at the 19th September HPB MDT.
The final damning evidence against Mr Chang’s claims, is that the doctor carrying out the procedure, Dr Kaushik, sits on the same HPB MDT team. He has confirmed on record that he was present at all three of dad’s HPB MDT meetings.
Written evidence shows that the EUS FNA procedure was carried out on the 18th September 2014… 24 hours BEFORE it was decided to be done at the 19th September HPB MDT meeting!

If Mr David Chang is to be taken seriously with his claims, then surely Dr Kaushik, sitting next to him at the 19th September HPB MDT meeting, would have informed Mr Chang that he had already carried out the procedure on the 18th September?
The notes from that meeting show that he did not. We have a copy of the email sent by the Critical Nurse Specialist (CNS) on the 22nd of September, advising Dr Mansoor (ward consultant) that dad would need an EUS FNA done.
Both Dr Kaushik and the CNS have stated on record that they were present at the 19th September HPB MDT meeting, so how/why did they know it had already been done?

East Lancashire health Trust chairman Kevin McGee confirmed in writing in November 2015 (yes, a full year to establish that an HPB MDT meeting DID take place) that the meeting of the 12th September DID take place, but dad “wasn’t discussed at this meeting as all the information/tests/results weren’t available” – more false and misleading information from Mr David Chang, as the same information/tests/results weren’t available for the 19th September HPB MDT meeting either!
In fact there are no notes from the 19th September HPB MDT meeting, all that is recorded is on these notes is what was discussed at the 12th September HPB MDT meeting, written evidence confirms this is accurate, despite Mr David Chang’s claims.

So why, despite overwhelming written evidence, does Mr David Chang continue to publish false and misleading information about the 12th September HPB MDT meeting not taking place for dad?

Could it be that the meeting did not meet the MDT quorum?

East Lancashire Health Trust chairman Kevin McGee and Mr David Chang have blocked the attendance records of the HPB MDT meetings from being released to the family.
Care Quality Commission, that should have access to the HPB MDT attendance records when inspecting hospitals, refuse to confirm or deny if these were provided when they inspected Royal Blackburn hospital.

The 12th September 2014 HPB MDT meeting at Royal Blackburn hospital did not meet the MDT quorum – we have written evidence of this.

That it did not meet the quorum is not irregular, that a diagnosis was made on dad and claims that his CT scans (showing pancreatitis) were over-ruled by more “expert” MDT senior staff, is highly irregular.
For a non quorate MDT meeting to over-rule test findings is very serious.
An MDT expert can over-rule, but if the meeting does not have the senior “expert” present then no decision is to be taken, it has to be referred higher up the expert chain, to a medical professional in that field more specialised.

Dad’s CT scans showed a small blockage at the head of the pancreas, as the radiologist Dr Oliver Nicholson is a very competent radiologist, he then examined further to establish if the blockage was invasive.
Dr Nicholson found “No invasion of the portal vein, splenic vein, SMA or coeliac” Dr Nicholson suggested it could be pancreatitis.

Mr David Chang and Dr Mansoor (ward consultant) have both claimed on record, that these findings were “over-ruled at MDT level by a more senior expert radiologist”
This is why we have asked numerous times to see the attendance records of whom this radiologist was, sitting at MDT level.
At the time, Dr Oliver Nicholson was Royal Blackburn hospital’s most senior radiologist, he was not qualified to sit on the HPB MDT team.
IF (and it’s a huge IF) he was called in to the MDT to give his opinion, are we seriously to believe that he over-ruled his own findings?

Written evidence provided by Royal Blackburn’s own senior staff, shows that no radiologist was present at the 12 September HPB MDT meeting.
Mr David Chang and Dr Mansoor (ward consultant) have both been making false and misleading claims, that more “expert radiologist over-ruled these findings at MDT level”
It is a serious issue that needs to be addressed, as dad’s diagnosis, that shaped his care pathway, was decided at this HPB MDT meeting.

East Lancashire Health Trust chairman Kevin McGee’s ever changing account of staff present at Royal Blackburn hospital’s HPB MDT meeting:

I can’t work out which is more inept.
That East Lancs Health Trust chairman Kevin McGee and RBH clinical lead surgeon Mr David Chang keep changing their account and numbers of “expert” staff present at the same HPB MDT meetings (publishing false and misleading information) OR that ELHT chairman Kevin McGee and Mr David Chang can’t see any issues of patient safety being affected by running HPB MDT meetings on care pathways and diagnosing patients, without the correct quorum of “expert” qualified staff being present?

Either way it does not look good, nor is it acceptable under any circumstances.
Who are these mysterious “more expert” MDT staff whom are over-ruling qualified test/scan results?
Are they qualified to over-rule?
What if they are wrong when they over-rule?
This could lead to misdiagnosis, wrong care pathways and treatments, dangerous to the patient when drugs administered come into play. It’s nightmare waiting to happen.
On the other side of this, is if the top brass are deliberately blocking release of essential information, where is the accountability?
How many more patients has/is this happening to?

I’ll end this post with something to reflect upon.
East Lancs Health Trust chairman Kevin McGee has now put in writing several different accounts of the professions that were in attendance at Royal Blackburn’s HPB MDT meetings for dad.
In November 2015 Kevin McGee wrote to the family stating,

“In attendance at the HPB MDT meetings were two consultant surgeons, one consultant gastroenterologist, two consultant radiologists, one consultant histopathologist, three consultant oncologists, an upper gastro-intestinal tract clinical nurse specialist and a MDT co-ordinator”

That’s eleven essential “expert” MDT core members.

In reply to the Information Commissioner’s Office ruling against them, East Lancashire Health Trust’s account had changed to (at least) eighteen “expert” MDT staff,

“We are able to advise that the following classes of staff would have attended each of the meetings :

  • Consultant surgeons
  • Consultant physicians
  • Consultant radiologists
  • Consultant histopathologists
  • Consultant cytopathologists
  • Consultant oncologists
  • Specialist nurses
  • Research nurses
  • Dieticians and administrative staff”

In reply to our MP Graham Jones and the junior Health Minister at the Dept. of Health, East Lancs Health Trust chairman Kevin McGee wrote,

“All three HPB MDT meetings had in attendance the following essential members;

  • A consultant surgeon
  • A consultant GI physician
  • A consultant radiologist
  • A consultant histopathologist
  • An upper GI nurse specialist
  • A consultant oncologist

The specialist palliative care team (read: MacMillan nurses) were not in attendance.”

There was only ever one consultant surgeon present – Mr David Chang (Reply 1 and 2 state minimum of 2 consultant surgeons – false)
There was only ever one upper GI physician present – Dr Kaushik (Reply 2 states there were more one present – false)
Radiologists present – Reply 1 and 2 claim more than one were present, reply 3 claims just one was present (written evidence shows that NO radiologists were present – false)
Histopathologist present – Reply 1 claims just one present, reply 2 claims more than one were present (even though only one sits on the HPB MDT) reply 3 claims there was just one present (written evidence shows that NO histopathologist was present at the first HPB MDT meeting where diagnosis was made and results were over-ruled – false)
Oncologists present – Reply 1 and 2 claims there were three oncologists present, reply 3 claims only one oncologist was present (written evidence shows NO oncologist was present – false)
Upper GI Nurse was present – Reply 2 claims “specialist nurses” there was just one (written evidence shows that just one upper GI nurse was present, but copies of emails show that the nurse who “was present” did not know that the EUS FNA had already been done, even though she was at the MDT meeting with the upper GI physician whom carried out the procedure), very odd.
Specialist palliative care nurses (read: MacMillan) – Reply 1, no specialist nurses were present, reply 2 specialist nurses were present, reply 3 it’s changed again to the specialist nurses not being present (even though this is a requirement of the MDT quorum!)
Research nurses – There was never any attendance by research nurses, we have no idea where this comes from in reply 2 – false information again.
Dieticians – again, no idea where reply 2 answer comes from, they simply were not in attendance at any of the MDT meetings and are not a core member of the MDT.
MDT co-ordinator/administrative staff – MDT co-ordinators have to be present and record events in real time. Written evidence shows they were not present at the 12th September MDT meeting, despite claims in reply 1 and 2 that they were present, in reply 3 reference to them being present has disappeared.

It’s hard not to conclude from the fabrications, false and misleading information coming from East Lancs Health Trust chairman Kevin McGee via Royal Blackburn hospital senior staff, that they have not one clue about what they are doing!
Publishing false and misleading information – whether by accident or knowingly – by any senior management of a public body, is a criminal offence!