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London Trust reverses decision to shut LUTS clinic

Trust reverses decision to close specialist clinic after legal challenge launched in High Court

Posted on 20 November 2015

A London NHS Trust has reversed its decision to close a specialist clinic, described as ‘life saving’ by its patients, following a High Court legal challenge.

Patients arrived at London's High Court from across the UK for the launch of the legal action challenging the decision by Whittington Hospital NHS Trust to close the clinic which treats chronic urinary tract infections.

The lower urinary tract service (LUTS) clinic based in Highgate, North London, has been run by Professor James Malone-Lee for the past 16 years.

It has pioneered treatment through the long-term use of antibiotics for patients with chronic urinary tract infections which have not responded to standard treatment.

An online petition has been signed by nearly 4,000 people in support of the Clinic.

Richard Stein from the human rights team at Leigh Day, the lawyer representing the patients, said after today's court hearing:

"We welcome the decision by the trust to put arrangements in place which allow Professor Malone-Lee to re-open the clinic on Monday.

"We hope that the trust will take a close look at the evidence showing the benefits his clinic delivers to hundreds of patients before making any decision in the future to close it again.

"We have adjourned our legal action to mediate issues concerning the trust's failure to involve patients in their decision making about the LUTS clinic."

There are over 900 patients currently treated at the clinic who have been referred by doctors from all over the country.

On 21 October 2015, Dr Richard Jennings, the Executive Medical Director of the Whittington Hospital NHS Trust, issued Professor Malone-Lee with a formal instruction preventing him from providing the specialist treatment. According to the Trust, the decision was made after a patient became unwell and suffered long-term organ damage which:

“…appears to have been caused by an antibiotic that was prescribed at a higher dose than is recommended, for a much longer duration than is recommended”.

However, lawyers argued the decision by the Trust to close the clinic, without involving patients in the decision making process, was unlawful. The patients launched an application for judicial review, challenging the legality of the trust's decision to close the clinic without involving patients.

The trust was accused of breaching a duty of care it owed to the patients by closing the clinic without first putting in place alternative arrangements for their treatment and properly balancing the risks and disadvantages of longer term care.

A spokeswoman for the Trust said:

"In advance of the case today, we agreed with Professor Malone-Lee a new framework for treating patients at the lower urinary tract service (LUTS) and are working to reinstate the clinic as soon as possible.

"Following an alert about a safety incident, and in order to protect patient safety the outpatient clinic that was being held at Hornsey Central Neighbourhood Health Centre was suspended. The clinic provided the LUTS.

"This change was necessary because of concerns about possible risks to the health of patients associated with some of the antibiotic prescriptions and potential long-term severe organ damage.

"We recognise that this has been a particularly difficult time for patients and their families and would like to apologise for any distress this suspension has caused.

"We would like to reassure patients and their families that delivering good, safe care remains our first priority and we will continue to work closely with Professor Malone-Lee to deliver the service."

Vivienne Bullock, from Leicestershire, who was at the High Court said: "I was in such pain, I could not work or do anything. Professor Malone-Lee finds a regime that suits you and works for you.

"I have been with him 14 months and I have really recovered. Some of the ladies have been with him 9-10 years. This clinic is so important because it tests fresh urine samples.

"We have all been to our local urologists and been left in horrible pain.

"We are a group of patients who have come from all over the country - and from all over the world - to see Professor Malone-Lee and been helped when others couldn't find an answer."