A final report into the care provided by neurologist Michael Watt finds some patients were misdiagnosed and received inappropriate treatment. 

Northern Ireland health minister Robbie Butler has apologised for failings in the care of patients treated by consultant neurologist Michael Watt. A final report into the cases has now been published by the Regulation and Quality Improvement Authority (RQIA). 

It found that patients were harmed in some cases by delayed or incorrect diagnoses, inappropriate treatment and failures in communication and support.

The report reinforces significant failings identified in an earlier review published in 2022.

The RQIA said poor diagnostic practice, inadequate communication, isolated clinical decision-making and weak multidisciplinary oversight meant standards of care “frequently fell below expectations”.

The RQIA review began in 2018 after the Belfast Health and Social Care Trust recalled around 2,500 patients amid concerns about Watt, who worked at the Royal Victoria Hospital in Belfast. The watchdog was subsequently asked to review the records of patients under Watt’s care who had died between 2008 and 2018.

The first report, published in November 2022, examined 44 patient records and identified concerns about clinical investigation, diagnoses, prescribing, record-keeping and communication.

Watt was struck off the medical register in 2023 after it was upheld that he put patients at risk and his fitness to practise was considered “impaired”. 

The latest report examined a further 25 records, including 18 patients whose families came forward following a ministerial statement in July 2024 and seven whose families contacted the RQIA later that year.

Fully or partially upheld 

The majority of concerns raised by families were fully or partially upheld by the independent expert panel, which reviewed clinical records and family testimony.

Relatives of those treated by Watt have argued the review should have gone further, and only looked at a fraction of those under his care. 

RQIA chair Christine Collins said the review showed the importance of patients and families speaking out.

She said the “strong and clear focus” now being placed on patient safety was due to the “courage and determination” they demonstrated. 

Butler said the findings were “deeply concerning” and provided an opportunity to reflect on past failings and strengthen patient safety.

He said: “On behalf of the wider health and social care system, I sincerely apologise for the failings in care that have been identified.”

The review has also led to the development of Being Human, a patient safety culture framework intended to embed lessons from the review and support a culture of safety, openness and learning.