Quality in Primary Care Open Access

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Abstract

Women?¢????s experience of a look-back exercise following inadequate decontamination of vaginal specula

Paul Milne

Background Following the identification of inadequate  decontamination of vaginal specula at a general practitioner (GP) surgery, over 400 women were offered screening for chlamydia, hepatitis B  and hepatitis C.Aim To explore the women’s experience of being notified of the error and participating in the lookback exercise.Design of study Qualitative interviews.Setting Primary care.Method Semi-structured interviews were held with 17 women, two to four months after completion of the look-back exercise.Results All interviewees had negative screeningresults. Although complimentary about the way the recall had been conducted, many women had experienced significant  distress, and reported feeling shocked, anxious, frightened and angry. These emotions were mixed with a sense of disbelief thatfailures in basic decontamination could occur, and be unrecognised for so long in the NHS. Overall confidence in the cervical screening programme,however, had not been damaged. The women felt the media coverage increased anxiety and breachedpatient confidentiality. All interviewees strongly agreed with the primary care trust’s decision to inform women of the error and felt they had the right to be informed if they had been put at risk, no matter how small that risk.Conclusions Despite the significant anxiety caused,the interviewees strongly endorsed the decision to inform women of the poor clinical practice and conduct a look-back exercise. Issues are raised regarding the potential conflict between patients’rights and desires and the opportunity costs of undertaking look-back exercises when the estimated risks to health are low.