An independent review into the treatment of patients at St Helier Hospital in London has uncovered significant failures in clinical care, concluding that outdated medical practices and incorrect treatment decisions by a consultant physician may have resulted in premature deaths, permanent patient harm, and missed opportunities to provide life-extending therapies.
The investigation, conducted by the Royal College of Physicians (RCP), examined the care delivered by consultant respiratory physician Dr Veronica Varney to patients diagnosed with Interstitial Lung Disease (ILD), a group of chronic lung conditions that progressively damage lung tissue and severely impair breathing. The review found that several patients were prescribed treatments lacking scientific evidence while proven medications recommended under national clinical guidelines were either delayed or withheld altogether.
The findings have prompted Epsom and St Helier University Hospitals NHS Trust to issue a formal apology, launch an extensive review of more than 200 additional patient cases, and implement wide-ranging reforms aimed at strengthening patient safety and clinical oversight.
Review Identifies Serious Harm and Possible Premature Deaths
According to the Royal College of Physicians’ report, three patients may have died earlier than they otherwise would have due to deficiencies in their medical management. In addition, 12 patients experienced severe harm, while several others suffered lasting health consequences linked to delays in receiving appropriate treatment.
Investigators found that in at least three cases, patients were not offered therapies that could have slowed disease progression and potentially extended their lives.
The review examined randomly selected patient records and concluded that significant departures from accepted standards of care had occurred over several years.
Interstitial Lung Disease encompasses a range of conditions that cause irreversible scarring of lung tissue. Many of the patients included in the review were diagnosed with idiopathic pulmonary fibrosis, one of the most aggressive forms of the disease. Current clinical guidelines recommend antifibrotic medications, which have been shown through extensive research to slow disease progression and improve patient outcomes.
However, investigators found that these approved medications were frequently not actively recommended.
Outdated and Unproven Treatments Replaced Evidence-Based Care
Instead of prescribing recognised antifibrotic therapies, the consultant reportedly advised or prescribed alternative treatments that lacked established scientific evidence for managing Interstitial Lung Disease.
Among the medications identified were antibiotics and drugs licensed for treating severe chronic obstructive pulmonary disease rather than ILD.
The review concluded that patients were not informed that these treatments lacked evidence supporting their effectiveness for their condition.
Investigators also found several examples of medical advice that conflicted with nationally accepted clinical guidance. Some patients were reportedly advised to avoid rapeseed oil and to decline influenza and COVID-19 vaccinations, despite national recommendations encouraging vaccination for people living with chronic lung diseases.
Multiple Clinical Failures Identified
Beyond inappropriate prescribing practices, the Royal College of Physicians documented a series of broader clinical shortcomings affecting patient care.
The investigation found that treatment was frequently delayed or never initiated, while referrals for oxygen therapy, pulmonary rehabilitation programmes, specialist centres, and palliative care services were often absent even after patients’ conditions had significantly deteriorated.
The consultant was also found to have misinterpreted lung function test results, potentially influencing treatment decisions.
Patients were not consistently discussed during multidisciplinary team meetings, which play a critical role in confirming diagnoses and determining appropriate treatment strategies for complex respiratory illnesses.
The review further identified delays in referring patients to specialist centres capable of delivering advanced care.
One particularly concerning case involved a patient whose worsening respiratory symptoms were attributed to poor physical fitness. Rather than receiving appropriate medical treatment, the patient was reportedly provided with dietary advice.
Concerns Raised Over Clinical Trial and Communication
The investigation also examined concerns surrounding a clinical trial led by the consultant.
According to the report, investigators identified issues involving patient selection, consent procedures, and the use of treatments that had not been adequately validated.
Communication with patients was also found to be inadequate.
Very few patients received copies of clinic correspondence explaining diagnoses, treatment decisions, or future care plans, limiting opportunities for patients to understand and participate fully in decisions regarding their own healthcare.
The consultant was additionally found to have missed meetings she was expected to attend as part of multidisciplinary clinical governance arrangements.
Organisational Weaknesses Contributed to Failures
While much of the review focused on individual clinical decisions, investigators also identified wider organisational shortcomings within the hospital.
The report cited strained working relationships between senior clinical leaders, limited collaboration between respiratory departments operating across separate hospital sites, weak systems for escalating professional concerns, and operational disruption caused by the COVID-19 pandemic.
These systemic issues were found to have reduced opportunities for earlier intervention despite repeated concerns being raised by healthcare professionals.
Whistleblower Concerns Were Not Addressed Promptly
One of the most significant findings involved repeated warnings raised by junior doctors and hospital staff between 2019 and 2022.
According to the report, concerns regarding the consultant’s clinical practice were submitted through both supervisory channels and the Trust’s whistleblowing system.
However, investigators concluded that these warnings were not addressed adequately or promptly.
The consultant stopped seeing patients in January 2023 before retiring several months later in April.
Hospital leaders acknowledged that, with hindsight, stronger action should have been taken sooner and recognised that some staff members who raised concerns were not adequately supported during the process.
Consultant Defended Treatment Decisions
During the investigation, Dr Veronica Varney defended aspects of her clinical approach.
She stated that she had concerns regarding potential complications and side effects associated with antifibrotic medications and therefore preferred to consider alternative treatments before recommending them.
She also argued that some delays in prescribing approved therapies resulted from patient choice, staffing shortages, and heavy clinical workloads.
Following publication of the review, her representative stated that she would not comment further on the findings.
Meanwhile, the General Medical Council continues to investigate the consultant’s professional conduct, and restrictions remain in place on her medical practice while regulatory proceedings continue.
Hospital Launches Wider Patient Review
Following publication of the findings, Epsom and St Helier University Hospitals NHS Trust confirmed it had accepted all 19 recommendations made by the Royal College of Physicians, stating that the majority have already been implemented.
The Trust has contacted the families of the 22 patients identified as having suffered serious harm or whose care requires formal disclosure under NHS patient safety obligations.
In addition, letters have been sent to another 203 patients who received treatment for Interstitial Lung Disease under the consultant between 2019 and 2023.
Their medical records will undergo detailed review, a process expected to take approximately one year.
Hospital leaders also confirmed they had received independent assurance in late 2024 that all current patients receiving treatment for Interstitial Lung Disease are now following appropriate evidence-based treatment pathways.
Trust Pledges Stronger Clinical Governance and Patient Safety
Dr Richard Jennings, Group Chief Medical Officer for Epsom and St Helier University Hospitals NHS Trust, issued a public apology to affected patients and their families.
He acknowledged that the standard of care provided had fallen significantly below what patients were entitled to expect and recognised the serious impact the failures had caused.
The Trust stated that while no corrective action can undo the harm already experienced, comprehensive reforms have been introduced to strengthen governance, improve multidisciplinary oversight, enhance patient communication, and ensure similar failures cannot occur again.
The Royal College of Physicians’ report has also been forwarded to the relevant coroners, the Care Quality Commission, NHS England, and the General Medical Council as further regulatory reviews continue.
