Doctors conducting mesh removal surgery could be required to complete a specially-created training programme to show they have the necessary skills and address patient safety concerns.

Health Secretary Jeane Freeman has written to the General Medical Council (GMC) backing the introduction of a ‘credential’ in mesh removal.

Royal medical colleges are involved in drawing up a proposal for the regulator to consider but this is not likely to be submitted until later in 2021.

This follows the news that women suffering from complications could be offered care privately or outside of Scotland, including in England or even abroad.

In a parliamentary answer Jeane Freeman said ‘credentialing’ would define the skills needed to carry out mesh removal surgery.

‘By formally recognising the skills of our surgeons, credentialing will provide assurance for patients and the service, will reduce the risk of harm and will help improve public confidence.’

Care for mesh-related complications has been mired in controversy, with patient groups saying they will have little confidence in new specialist mesh removal centres being developed in Scotland if they are staffed by the same surgeons that carried out the initial implants.

Mesh was often used to treat incontinence following childbirth but its use in Scotland has been banned after it was linked to painful, often permanent and debilitating complications after the implant disintegrated or shifted.

However, some patients who underwent a procedure to have the mesh taken out, later learnt this had been only a partial removal.

An offer from leading American surgeon Dr Dionysios Veronikis to come to Scotland to train doctors in full mesh removal procedures he had pioneered fell through after discussions with NHS Scotland broke down.

The Royal College of Obstetrics and Gynaecology is in favour of the move.

Vice President Dr Jo Mountfield told healthandcare.scot:

“The RCOG supports the introduction of a credential for mesh removal surgeons.

“We’re currently working with the Royal Colleges of Surgeons to develop a credential in mesh removal surgery as part of a multidisciplinary team, with the intention that the GMC and UK Medical Education Reference Group will approve mesh removal as a priority area for credentialing later in 2021.

“If this is agreed as a priority, we will then be able to develop these proposals further, including producing a curriculum for a training programme that leads to a GMC-regulated credential in mesh removal surgery for doctors.

“The RCOG takes each and every complication caused by mesh very seriously, some of which can have a devastating effect on women’s lives. It’s crucial that doctors and surgeons who work in specialist units are trained to the highest standard and have the necessary skills required to provide the best quality of care to women with mesh related complications.”

Membership of a review panel that will go through records with women to discuss their concerns was announced this week.

Chair Professor Alison Britton will be joined by Professor Anthony Smith, Professor of Urogynaecology, Manchester Academic Health Sciences Centre; Ian Currie, former Vice President, Royal College of Obstetricians and Gynaecologists; and Dr Carey Lunan, Chair of Royal College of GPs Scotland until 2020.

Proposals to introduce a mesh removal credential will not be considered until a first wave of qualifications in four other areas has been developed, but work and engagement on this initial tranche was delayed due to the pandemic.

A GMC spokesperson said: “We are currently piloting select credentials and hope to complete this work later this year. Stakeholders and patient groups have already made a strong case for a credential in mesh removal, which we will assess as we move to the next phase.

“Our thoughts remain with all patients suffering the debilitating side-effects of transvaginal mesh. Patients deserve the highest standard of care and we’re using what we’ve learnt from their stories to develop our work in this area.”