"Risk-taking” former Derbyshire doctor who harmed dozens of women by performing unconsented surgeries went virtually unchecked by hospital bosses

An NHS report into Daniel Hay, aged 60, from near Alfreton, a former obstetrician and gynaecologist at Royal Derby Hospital from 2005 to 2020, has today been published three years after it was completed. A criminal investigation into his conduct continues.

The report has found “major” concerns of harm to 48 women and “some” concerns of harm to 68 women, although it has not provided a definition of “concerns of harm”.

It also identified potential “issues of care” to 13 women, while two women suffered “severe physical harm” and three women suffered “moderate” physical harm.

A total of 383 of Mr Hay’s cases from 2015 to 2018 at Royal Derby Hospital and Ripley Hospital were assessed as part of the review.

It has now been recommended that the investigation is expanded to between 2012 and 2015, focusing on major and intermediate gynaecology surgery cases.

These issues include women having hysterectomies who either did not want them, did not know they were having them or did not know alternative, less-invasive options were available.

This led to women who wanted to start families and who were still able to do so having that opportunity taken away from them unnecessarily and without consent, leading to ongoing mental health issues, which have seen them lose relationships and jobs.

The reviews assessed whether the medical procedures carried out by Mr Hay were carried out properly or directly caused physical harm, despite an apparent frequent lack of informed consent. It did not assess the impact patients suffered from having procedures they did not want.

It details: “Many patients were often subjected to inadequate or late consent processes. This poor practice did not point out the benefits and risks and whilst it rarely resulted in adverse clinical outcomes, it undoubtedly unsettled and disturbed some patients”.

Patients taking part in the review shared their regrets about the procedures. They said they felt pressured into getting them and still dwelled on what could have been and the families they may have had, saying Mr Hay’s actions “destroyed” their lives.

The review puts much of the avoidance of direct harm down to “good fortune”. It states Mr Hay was “well-known” for his “inadequate” consent process.

It details: “Daniel Hay lacked clinical judgement. He took shortcuts in his clinical assessment of patients, and over time he showed an increased willingness to take risks.

“The support of colleagues and good fortune prevented further harm being caused.”

These shortcuts included not requesting pre-operation scans, not examining patients before operations and not asking for their full family histories, the reviews detail.

The University Hospitals of Derby and Burton NHS Foundation Trust, Mr Hay’s former employer until his retirement in July 2020, has reiterated its “unreserved apologies” to the women who received care from Mr Hay “that was far below the standards expected”, along with how it communicated with affected patients.

A “phase 2” expansion of the review looking at patients “before 2015” has been approved and will start “in the autumn”, the hospital trust said, and patients who are affected will be contacted in due course, with no current detail on how far back this will assess.

The NHS review into Mr Hay’s clinical practices was highly critical of not just the former gynaecologist, but his former employer.

However, Gavin Boyle, the trust’s chief executive at the time, was not interviewed as part of the reviews.

Mr Boyle left the trust in December 2021 to lead the South Yorkshire Integrated Care Board, and earlier this month announced he will retire from that role in mid-October.

The South Yorkshire ICB said Mr Boyle is not named in the report and has not received a copy, so it was for UHDB to respond to.

The NHS review concludes: “This review examined a consultant obstetrician and gynaecologist, Daniel Hay, who suffered from deteriorating health and who lacked insight, demonstrated poor clinical practice, and failed to recognise the possible risks that could result from his behaviour.

“Individual error is found in all healthcare systems; however, Daniel Hay worked in a trust that somehow allowed this to continue until he eventually retired due to ill-health.

“The delayed trust management response to his clinical complications created extreme anxiety over a prolonged period amongst many women.

“This was after missed opportunities for detailed and comprehensive analysis of patients and a lack of assessment of potential harm.”

The review found that Mr Hay, who relinquished his medical licence in July 2021, had numerous periods of extended sickness absence as far back as 2012, citing psychological health issues, including anxiety and responses to “trivial” complaints.

It found there was no routine monitoring of his quality or conduct despite recurring issues, including “little evidence of competent decision making or adequate consent”.

The review found a lack of HR intervention over his sickness absence and said that “any other member of staff, other than a doctor, would have had their sickness level challenged more overtly”.

This included 17 days of sickness absence in 2012, 116 days in 2016 and 199 days in 2018, along with further stints in 2019 and 2020, before his retirement.

The review found that theatre staff who had worked with Mr Hay all raised concerns that should have led to further and earlier enquiries, but that they had “never” been asked by the trust.

It found there was “plenty” of intelligence about “problems” with Mr Hay “but too many trails went cold”.

This included a three-month assessment of his work in 2016, after which he “soon returned to his former modus operandi”.

It details: “This included poor note keeping, high conversion rates from outpatient consultation to surgical intervention and issues over appropriate consenting practice for his patients.”

The review details: “It took too long to recognise how ill Daniel Hay was and this meant that some of his patients were impacted unnecessarily.”

It says that many of the issues in terms of lack of trust intervention could be directed at the then ongoing merger between the Derby and Burton hospitals trusts – completed in July 2018 – which “took up considerable senior manager bandwidth”.

The review found the trust’s approach to notifying affected patients from April 2020 – via letters from the then CEO, Mr Boyle – “created unjustified levels of anxiety and fear”.

Dr Gis Robinson, the trust’s executive chief medical officer, said: “We want to reiterate our unreserved apologies to the women who received care from Mr Hay that was far below the standards expected.

“We also accept that our initial communication and approach about the review was not as compassionate or supportive as it should have been, for which we are truly sorry.

“Following the report we made important changes, with clearer consent procedures and enhanced clinical oversight so any issues with care can be identified more quickly, and improved post-procedure reviews for women.

“We will continue to closely monitor and review these to ensure they are effective and fully integrated, and use our learning to support and inform the next stage of the review.”

A Derbyshire police spokesperson said: “No arrests have been made – Daniel Hay has been interviewed under caution as part of the enquiries.

“Due to the complex nature of the case enquiries have taken time, however, throughout the investigation we have remained in close contact with those affected and will continue to do so as the investigation continues.”

The Medical Defence Union, which represents Mr Hay, said it had no further comment to make.

Mr Hay has not provided a statement through the MDU since July 2021, when he said: “I apologise to the women affected by the NHS investigation. I am co-operating with the investigation, however, due to my ongoing mental health issues, I ask that you please respect my privacy at this time.”