Ebola nurse hits out at ‘blame culture’ at Public Health England

Pauline Cafferkey, the Scottish nurse who nearly died twice from Ebola, has called on Public Health England to “recognise their own failings” in a botched Heathrow airport screening process that led to one of her colleagues being suspended for two months.

She said she was “extremely disappointed” that PHE had employed a “blame culture” that highlighted the possible mistakes made by volunteers who risked their own lives to help Ebola patients but did not acknowledge its own.

Cafferkey made her remarks as Donna Wood, a nurse who was part of the same volunteer group who travelled to Sierra Leone in November 2014, was suspended by the Nursing and Midwifery Council (NMC) after it found she had concealed the nurse’s temperature during the screening process in Heathrow on 28 December 2014.

Najrul Khasru, the chair of the NMC panel, told Wood: “The seriousness of your misconduct … could have contributed to the risk of Ebola, a very serious and dangerous illness, spreading in this country.” The panel described Wood’s “dishonesty” as extremely serious and called it “a momentary lapse of judgment”.

Cafferkey said: “I am very sorry to hear the outcome of Donna Wood’s hearing. I still feel extremely disappointed that in making complaints against volunteers who willingly put themselves in danger for the benefit of others, Public Health England employed a blame culture and failed to recognise their own failings, which were many, on the day the volunteers arrived at Heathrow.

“I hope that Public Health England will now acknowledge their mistakes and accept that as a result of these, they took the decision to allow me to fly on to Glasgow, rather than transferring me to hospital in London. I look forward to this continuing ordeal eventually being concluded.”

During the eight-day disciplinary hearing, it emerged that PHE had run out of screening forms and monitoring kits and had only four cubicles for about 50 passengers.

It emerged during the hearing that Wood and Cafferkey were among five volunteers who decided to take their own temperatures to get out of the “uncomfortable” and “chaotic” screening area more quickly.

Donna Wood

Donna Wood was cleared of falsification but the panel found she was aware of Cafferkey’s higher temperature and had failed to escalate the situation. Photograph: Yui Mok/PA

Wood denied falsifying Cafferkey’s temperature, which a fellow volunteer recorded as over 38C, a degree higher than average body temperature and a potential early warning sign of Ebola. The panel cleared her of falsification, but found she was aware of Cafferkey’s higher temperature and had failed to escalate the situation.

Later, the doctor who took Cafferkey’s temperature raised the issue with an infectious diseases expert in their group and they agreed that Cafferkey should return to the screening area.

Her temperature was taken three more times by the lead clinician on the PHE team, Deepti Kumar, but she told the disciplinary hearing that she had not been told Cafferkey had taken paracetamol, which can mask a high temperature. Kumar then cleared Cafferkey to make her connecting flight to Glasgow.

The manager of the screening team, David Carruthers, a former police officer, told the panel that Cafferkey had told him she had taken paracetamol and that he had passed this information on to Kumar. However, he was not sure if the doctor had picked up that information.

It also emerged that the PHE manager had mistakenly phoned a hospital switchboard rather than an infectious disease team that was mandated to deal with any referrals from the screening team. Carruthers told the panel he had passed on enough information to those he spoke to get help but he never heard back.

All five of the volunteers were referred to their regulatory bodies by PHE following an early investigation into the screening on that day. The volunteer doctor who took Cafferkey’s temperature will go before a medical disciplinary tribunal in March.

Cafferkey faced being struck off but was cleared of any misconduct in a disciplinary hearing in September after an NMC panel found no evidence that she had set out to mislead PHE. Her solicitor at the time said she had found the proceedings stressful and upsetting.

Paul Cosford, medical director at PHE, defended the organisation, saying it was its duty to pass on information about the screening to the NMC and it was up to the nursing regulatory authority to decide whether to take action.

“It was for the NMC to decide if this information needed to be investigated further, which they subsequently did. The outcome confirms the referrals were appropriate,” he said.

He added: “The Ebola outbreak was unprecedented, with many lessons learned across the global healthcare system, including at Public Health England, and we made a number of changes to our processes as the situation developed. We screened thousands of returners from countries most at risk of Ebola and did so with efficiency and courtesy throughout.

“The Ebola outbreak in west Africa was unprecedented and we are hugely grateful to all the volunteers who contributed at great personal risk, including our own staff.”