Sacked surgeon did not have 'necessary' competencies

A doctor who carried out hundreds of complex surgeries on shoulders and elbows did not have the "necessary" competencies to carry out the treatment, a review has found. 

The report was commissioned by Walsall Healthcare NHS Trust following concerns about the work of Mian Munawar Shah, who harmed 91 people who underwent shoulder and wrist operations.

It concluded that concerns were identified in 24% of the 382 cases reviewed, where the care offered was considered to have been "sufficiently suboptimal to have caused moderate or severe harm to patients."

The report said concerns were first passed on to Walsall Healthcare NHS Trust in early 2020. It commissioned an external review of 17 cases of complex upper limb surgery, which found concerns regarding Mr Shah's work, prompting a second review, which extended to 99 cases.

Concerns were raised in the second review’s report and the recall of nearly 400 patients who had undergone a "procedure of concern" at the hands of Mr Shah was launched in 2022.

The review of those treatments found that concerns about Mr Shah's "technical competence" to complete operations was the "most significant area of concern" relating to his practice. 

The report said: "It was the area of concern that was by far most likely to be assessed as having contributed to causing direct patient harm." 

The surgeries took place while Mian Munawar Shah was practising with Walsall Healthcare NHS Trust

Among those harmed was Angela Glover, who worked at Walsall Healthcare NHS Trust and was operated on three times by Mr Shah at Walsall Manor Hospital.

She was eventually awarded a six-figure settlement, but still has not got full movement of her arm.

She told the BBC "I'm quite restricted in a lot of ways. It's life-changing for me, there's no justice, they just throw a load of money at you and think 'crack on'." 

Her partner, Simon Roberts, added: "It's difficult and it has completely changed both of our lives."  He said she had endured many appointments and revision surgeries adding that further surgery might be necessary.

Martin Crowley from Pelsall was operated on twice by Mr Shah and had two further procedures to try and put things right. But he still cannot lift his arm fully.

The report found Mr Shah was originally undertaking the duties of a more "general" trauma and orthopaedic consultant but moved into more specialist and complex upper limb surgery without having developed the necessary abilities.

A recurring pattern of errors was recognised within the report, including the misplacement of prostheses, using the wrong-sized prosthesis, misplaced screws, or the wrong length of screws.

It also found the highest volume of cases and the highest rate of harm arose during and after the Covid pandemic.

Mr Shah was sacked from his role at the trust in November 2022.

Concluding the report, authors said a number of internal actions had already taken place due to the concerns but they advised some areas of practice still needed further development to "ensure ongoing quality and safety."

Chief Executive for The Royal Wolverhampton and Walsall Healthcare NHS Trusts, Joe Chadwick-Bell, said: "I want to absolutely unreservedly apologise for any harm that we have caused patients."

The trust said more stringent or robust practices had been put in place and the report findings would be shared with both the General Medical Council and West Midlands Police.