Tuesday, May 17, 2022

Surgical mesh restorative process report published

The Ministry of Health has published an evaluation of a restorative process designed to understand and address the harms New Zealanders suffered as result of surgical mesh.

The evaluation report, ‘Healing after Harm: An evaluation of a restorative approach for addressing harm from surgical mesh, Kia ora te tangata: He arotakenga i te whakahaumanu’ was commissioned from a team of researchers at Victoria University’s Te Ngāpara Centre for Restorative Practice who evaluated information provided by 230 people who took part in the restorative process.

The restorative process was co-designed by the Ministry of Health, advocacy group Mesh Down Under and Te Ngāpara Centre for Restorative Practice, Te Herenga Waka Victoria University of Wellington and delivered in three phases from July to December 2019 – Listening and Understanding, Planning and Acting, and Reporting and Evaluating. It’s thought to be the first time a restorative approach has been applied to a national healthcare issue in New Zealand or around the world.

“Surgical mesh is a medical device used when repairing weakened structures with the aim of providing additional support. While some people who have mesh inserted experience no harm, many do, including people who have undergone pelvic floor, hernia or other procedures. Some people experience harm immediately after their operation, while for others, harm is experienced years later,” the Ministry of Health said in a statement today.

“Through the restorative process, more than 600 mesh-harmed people shared their stories of mesh-harm, bringing to light the severity of physical and psychosocial harms. Many people described these as ‘life changing’. For many, harm was compounded by the professional and agency responses that followed, resulting in loss of trust in healthcare providers and public institutions.”

The evaluation report finds that mesh-harmed people who shared their stories were able to effectively communicate the massive extent of harm and injury after surgical mesh procedures, which helped the Ministry of Health, ACC and Health and Disability Commission in their work with other agencies to minimise further harm from surgical mesh.

“Most people who took part in the evaluation said the experience made them feel validated and provided them the opportunity to communicate their experience, preserve dignity. However, many evaluation participants were largely unaware of progress on the 19 actions that resulted from the Planning and Acting phase of the project and were unsure if their needs would be met in the future,” the Ministry said.

Of the 19 actions, six have been completed, nine have been completed and require ongoing attention and four are in progress, it confirmed

The Ministry has established a collaborative approach to harm from surgical mesh and set national standards.

“The Ministry is working on establishing specialist service centres for mesh complications, developing education resources for health professionals and consumers, and will soon release a New Zealand Credentialing Framework, which will be used in the future as the basis of a process to credential surgeons carrying out pelvic floor procedures, to give confidence that they are appropriately qualified and skilled to do so. This will replace the current use of the Australian credentialing framework.”

ACC has also committed to reassess previously declined injury claims for mesh harmed people, which is still open. Anyone who has had a surgical mesh claim declined prior to 28 October 2020 can have their claim reassessed (more information at ACC’s website).

The Ministry of Health has provided a summary of progress on its website (Hearing and Responding to the Stories of Survivors of Surgical Mesh: Updates).

“The release of this evaluation completes the three phases of the project – a restorative approach to surgical mesh harm. However, it does not signal the end of the restorative process which aims to restore wellbeing, relationships and trust in so far as this is possible. Whilst the evaluation found that some degree of trust was regained in the Listening and Understanding phase – it also told us that we need to deliver on our promised actions in order to maintain that trust. The Ministry is committed to supporting those affected by surgical mesh, and to use the learnings of this experience to prevent future harm,” said Robyn Carey, the Ministry of Health’s Chief Medical Officer.

“We have updated the summary of action taken in response to the process, on our website.”  

“We are grateful to everyone who made the decision to share their story with us and to health organisations that took part in the process. As one participant said, ‘despite everything that people had lost, people came along to talk to us in a very clear-minded and often fair-minded way, and for everything that had been destroyed, people’s humanity was still intact’. We are grateful to our co-design partners – advocacy group Mesh Down Under and Victoria University – for their work to create a space that most people found to be safe to share their story,” she said.

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