Current status: Answered by Jenni Minto on 10 November 2025
To ask the Scottish Government, regarding the 21 listed recommendations in the report, Transvaginal Mesh Case Record Review, which of the recommendations it (a) accepted and (b) rejected.
The Scottish Government did not reject any of the recommendations from the Transvaginal Mesh Case Record Review.
Recommendations 1, 2 and 5 were about how similar case record reviews might be conducted, and in particular how they might be conducted in a more cost-effective fashion. The Government has no plans to conduct further case record reviews.
Recommendations 3 and 16 were about training of General Practitioners and surgeons. Training about transvaginal mesh and possible complications has been made available to GPs in Scotland, and we continue to support the introduction of a GMC credential in mesh removal surgery.
Recommendation 4 was about a registry. It is being implemented by the establishment of a Scottish Pelvic Floor Registry and Audit Programme by Public Health Scotland. It will collect, understand, and measure data to improve pelvic floor services for women in Scotland, and contribute Scottish data to the UK-wide registry being progressed by NHS England. The SPFRAP will begin collecting data in 2026, with the first report expected in 2027.
Recommendations 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 17 and 18 were about communication to and decision making with patients. NHS Scotland seeks to exemplify the implementation of these recommendations through the operation of the NHS Scotland Complex Mesh Surgical Service (CMSS). The CMSS forms part of a national, published patient pathway and its services are explained on a dedicated website and through other information resources. It places patient-centred decision-making at its core, ensuring that patients have access to high-quality decision aids, sufficient time to consider their options, and support in reaching a final decision about their treatment. Patients are contacted in advance of attending the service, encouraged to bring a companion, and invited to record consultations. All decisions are documented to ensure clarity between patient and clinician, and patients are offered postoperative photographs showing the mesh that has been removed. The service is committed to continuous improvement and regularly surveys patient experience. More generally, the Chief Medical Officer wrote, on October 2023, to Health Boards highlighting the report and emphasising the importance of fully informed consent in all circumstances. With respect to patients returning from the independent sector surgeons, these individuals will receive two follow-up telephone or video calls from their surgeon or specialist nurse post-operation. Any further aftercare will be provided by the patient’s local Health Board.
Recommendation 19 was about guidance on significant adverse events. Healthcare Improvement Scotland continues to improve guidance on significant adverse events.
Recommendations 20 and 21 were about collaboration between mesh centres in the UK. The CMSS in Glasgow continues to collaborate with other UK mesh centres to share and disseminate best practice.