Minister criticises ‘very disturbing’ behaviour in cardiac surgery unit

The behaviour of some heart surgeons at Northern Ireland’s cardiac surgery unit was “entirely unacceptable”, the Health Minister has said.

It comes after an inspection report raised concerns about the working culture and risks to patient safety within the cardiac surgery unit at the Royal Victoria Hospital (RVH).

The independent external review, which were first reported by UTV, found an intolerable working environment and a pattern of consistently poor behaviour within the unit.

Minister Mike Nesbitt said he expects to see meaningful improvements in the unit, while describing the findings of the report as “appalling” and “very disturbing”.

He said it involved a “catastrophic” breakdown in relationships relating to four people.

Responding to an urgent question from DUP MLA Diane Dodds on the matter in the Assembly on Tuesday, he said the strategic planning and performance group (SPPG) and the Public Health Agency (PHA) commissioned an independent, external expert team to carry out a review of the cardiac surgery service in the Belfast Trust in December 2024.

The review concluded in April of this year and presented to the board of Belfast Trust on May 15.

“It was appalling to read of the staff experiences in the cardiac surgery unit in the Royal Victoria Hospital,” said Mr Nesbitt.

“I want to thank every staff member who engaged in the important review process. I also want to thank the external review team for its work.

“The findings on the culture of the unit and the behaviours of some individuals within it are entirely unacceptable.

“I expect to see meaningful and lasting improvements in the unit, not least in building a culture of respect for all colleagues at all levels.”

Mr Nesbitt, who declared an interest as a cardiac patient himself, said he was concerned by the review’s findings that the cultural issues represent a risk to patient safety.

“I acknowledge that public confidence in our regional cardiac surgery service cannot be allowed to deteriorate, especially for our patients and their families when they are at their most vulnerable.

“The expert team has made a number of recommendations based on the findings, specifically around governance arrangements, communication processes and the review of current processes and support and encouragement for those who are raising concerns.

“Improved team working across the unit must be an absolute priority.”

Mr Nesbitt said the Belfast Trust has accepted the recommendations of the review and is now working swiftly to take those forward.”

Ms Dodds told the minister that the report is “shocking”.

She said: “There has been a litany of problems and a culture of bullying and poor behaviour. At one stage, an operation was cancelled because of ‘interpersonal differences in theatre’.

She added: “It reveals that four surgeons were working from home. What really concerns me is the report’s conclusion ‘the culture of the cardiac unit is very poor, exacerbated by management. The cultural issues in this unit represent a significant risk to patient safety’.”

Mr Nesbitt also told Ms Dodds that he intends to publish the report and lay it in the Assembly Library.

Asked how cardiac services would be impacted, by Alliance MLA Danny Donnelly, he said: “I believe that the number of cancelled procedures was very low: off the top of my head, I think that it was six.”

Asked by SDLP MLA Sinead McLaughlin if any disciplinary measures were ongoing, the minister said he was not aware of any.

“That is something that I will be asking the chair of the trust about when we meet.”

Sinn Fein MLA Linda Dillon asked if there was any opportunity to assure people that no one had died as a result of what was going on in the unit.

Mr Nesbitt said: “I do not think that we can draw any inference that anybody who lost their life in recent years because of a cardiac issue should not have lost their life.”