VULNERABLE adults and children are at risk from "extremely poor standards of clinical practice" in NHS Borders' audiology department, senior staff have claimed.

In a damning letter to the Herald, the head of service, Dawn Saunders, and two senior audiologist colleagues, reveal that a male patient's eardrum was perforated "as a direct result of poor clinical practice".

Ms Saunders told the Herald that despite raising the case with senior management no one was disciplined and no serious adverse event review was ever carried out.

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She added that herself and her colleagues have attempted to flag over 100 cases of poor clinical practice and the potential risks of harm to patients over the past 18 months, but claims these have been ignored.

She said: "As a result of the clinical issues MRI and CT scans have been ordered on patients unnecessarily, patients have been prescribed oral steroids and steroidal injections wrongly, and medical devices prescribed inappropriately and fitted to normal hearing patients including paediatrics."

In their letter, the audiologists state that "the culture within NHS Borders is accepting of extremely poor standards of clinical practice that put vulnerable adults and children at risk every day".

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Issues relating to clinical negligence "are not responded to appropriately with whistleblowers being subject to continuous victimisation and bullying by senior management in an attempt to silence concerns", they add.

As whistleblowers themselves, they say that they have "all been subject to bullying and intimidation by senior management including the inappropriate use of suspension and investigation".

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Ms Saunders is currently suspended and is due to appear at a disciplinary hearing this week, but refutes allegations against her including "laughable" complaints about the way she puts her handbag down in the morning.

NHS Borders says it has already taken external advice from experts who it said found "no immediate patient safety concerns". It also refutes the allegations of poor clinical competency among staff and victimisation of whistleblowers.

Christine Grahame, the SNP MSP for South Scotland who has been involved in Ms Saunders case, said it "gives great cause for concern".

Ms Grahame said: “The alleged failure at Borders Audiology to maintain professional standards is worrying to say the least with the possible consequences of misdiagnosis.

“This is compounded by allegedly punishing the whistle-blowers, one of whom has already been suspended for nine months pending a conduct investigation, only being referred to the Disciplinary Panel last week with vague details as to the nature of the allegations against her.

“All of this gives great cause for concern that people are being singled out simply for doing their professional job.”

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Teri Devine, Director of Action on Hearing Loss Scotland, added: “We would expect senior management at every health board to consider the views of their senior audiology staff when concerns are raised about clinical competence or potential risks to patients and, following appropriate investigations, for measures to be implemented to resolve any issues that have been identified.

“Since launching our 'Time to raise the standards report' [in 2016], we have been calling for NHS audiology departments to have their performances against Scotland’s national audiology standards independently monitored and published, so that patients can be confident about using quality services which are person-centred and meet their individual hearing needs.”

The claims echo those which rocked NHS Highland in September last year when a group of senior clinicians went public for the first time to expose what they described as a culture of fear and intimidation which they said was jeopardising patient care.

The fallout has led trade union, BMA Scotland, to launch its own inquiry into bullying and harassment in the wider NHS.

BMA Scotland chair, Dr Lewis Morrison, said: “This is clearly a worrying letter alleging serious issues. It reflects our belief that bullying and harassment are a problem across our health service affecting all staff groups.

"These are not isolated cases in one or two health boards. The widespread concerns across NHS Scotland, including this case, emphasise the potential impact bullying and harassment has on not just the staff involved, but also the quality of care the NHS provides.

“We must have more effective systems in place to ensure workers feel able to speak out without fear.”

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Nicky Berry, director of Nursing, Midwifery and Allied Health Professionals at NHS Borders, said: “We can confirm that there have been anonymous whistleblowing concerns raised about patient safety in the audiology department.

"It is important that we honour the request for anonymity from the Whistleblowers as reassurance to all of our staff that it is safe and acceptable to speak up in the event that they wish to raise concerns.

“We can confirm that in this case we immediately took external expert advice from senior audiologists who raised no immediate patient safety concerns.

"They did however highlight some areas where practice could be improved and that is moving forward.

“An investigation into the concerns was instigated which has been completed with the recommendations agreed with the Whistleblowers.

“We are not putting our patients at risk. The external advice about the clinical competency of our staff has been given, and we have had confirmation that our audiology staff are competent clinicians capable of the work assigned to them.

“Any ongoing matters that are being dealt with through our internal employment policies are confidential between the employer and employee. However we would say that in all cases suspension is a neutral act, not a disciplinary action, and alternatives are always considered.”