The HSE is to carry out a wider look back at the practice of an individual consultant at the centre of a review into paediatric orthopaedic procedures carried out by them at CHI Temple Street and the National Orthopaedic Hospital Cappagh in Dublin.
HSE Chief Clinical Officer Dr Colm Henry confirmed the look back at the individual consultant's practice, which will involve a review of the doctor's patient surgeries between 2016 and 2023.
This will include all spinal, limb reconstruction and surgical dislocation of the hip, but not surgeries in the area of trauma and general orthopaedics.
Details of how this look back will be implemented are still being considered.
"The assumption at the outset is we're not saying harm has been done," Dr Henry told RTÉ's News at One.
"We're not casting blame. What we're doing is seeing these children to ensure that there are no remaining unaddressed clinical issues to ensure that they're put in the correct clinical pathway."
Health Correspondent Fergal Bowers outlines details behind the widened review
We need your consent to load this rte-player contentWe use rte-player to manage extra content that can set cookies on your device and collect data about your activity. Please review their details and accept them to load the content.Manage Preferences
Meanwhile, letters are being issued to 62 families of children who underwent orthopaedic procedures at CHI Temple Street Hospital, inviting them to a clinical follow-up.
It follows the completion of the first phase of an independent review by a UK expert into paediatric orthopaedic procedures by one consultant, who has been on leave from CHI Temple Street for several years.
The review was set up in September 2023.
The HSE said the call-back is a precautionary measure because in some cases the intended outcome of surgery may not have been achieved.
In other cases, the HSE said patients are being called back because the intended outcome of surgery may have been achieved, but there may be complications.
For other families, the aim is to assess what the clinical outcome of a procedure has been, given the passage of time.
The letters to families will set out the status of the independent review and progress to date and provide telephone number contacts for hospitals.
The HSE said it hopes the recall of patients will be completed by mid-March and said it will provide every support for patients.
It added that there is no immediate risk to patients.
It follows a review of 91 patients in total, and for the remaining 29 patients it has been determined that no follow-up is needed.
We need your consent to load this rte-player contentWe use rte-player to manage extra content that can set cookies on your device and collect data about your activity. Please review their details and accept them to load the content.Manage Preferences
Dr Henry has said that the purpose of the independent review was to give assurances over services provided by Children's Health Ireland.
Speaking on RTÉ’s News at One, he said: "The reason it was commissioned was because it was in response to some safety concerns, specifically in spinal surgery at the outset, such as a high complication in surgery rates.
"And for this reason, it was felt that despite the number of investigations that had taken place, that the most appropriate measure was to put in place an independent review of paediatric orthopaedic surgery in CHI.
"In advance of this second phase, we're taking some precautionary actions in the interests of children and their families, and they include asking 62 of the 91 cases reviewed to come back for a clinical review just to ensure there's no outstanding clinical issues that have not been addressed.
"Many of these children will already be in pathways. I realise it's a huge concern to children and families.
"Many will already be in clinical pathways, but this is a precautionary exercise. It's important to say any cases that we were more greatly concerned about, the independent reviewer was concerned about, were escalated to us during the review.
"Letters have gone out to all those families today. The letters will be followed up by phone calls to all the families.
"So, we provide them with all the supports they need because it would be upsetting for families to receive such a letter.
"I want to assure them that any cases that were deemed to be more urgent were highlighted to us during the review.
"So, these are not clinically urgent, but nevertheless, in the interest of peace of mind and assuredness to families, this exercise needs to be carried out quickly in the coming weeks."
HSE: Legal issues preventing publication of first phase of independent review
The HSE also said the report of the independent review of paediatric orthopaedics at Children's Health Ireland and the National Orthopaedic Hospital Cappagh will not be published, until the second phase is completed.
The report may not be completed until the end of this year.
The first phase of the report into the work of one consultant is finished.
The second phase into governance systems is under way and this will also look at access to surgery and capacity issues.
The HSE confirmed that there have been protracted legal issues and said that the process has to be fair.
Campaign groups representing families are being briefed on the status of the review this morning.
CHI Chief Executive Lucy Nugent said: "I know that news like this will understandably cause worry and concern for families, and I want to acknowledge that sincerely.
"CHI and our current 16 consultant orthopaedic surgeons are fully committed to supporting every element of the look-back process and to being open and transparent with families throughout.
"I want to reassure parents and caregivers that safe orthopaedic care is delivered in CHI every day, by highly skilled and dedicated professionals whose priority is always the wellbeing of children."
Angela Lee, Chief Executive of National Orthopaedic Hospital Cappagh, said: "We acknowledge the understandable worry caused by today's correspondence and are in the process of scheduling follow-up review appointments for patients impacted by this review.
"The majority of the patients are already in a follow-up process, and we are committed to supporting patients and families in every way we can."
