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Found 218 results
  1. News Article
    A prolific surgeon accused of poor care — some with a ‘catastrophic outcome’ — and altering patient notes has been found guilty of misconduct following a tribunal hearing. Jeremy Parker, who performed hundreds of operations at Colchester Hospital and the private Oaks Hospital until his suspension in 2019, faced a misconduct hearing in December and January. The medical practitioners tribunal investigated allegations that between August 2015 and November 2018, Mr Parker failed to provide good clinical care to six patients. It was also alleged he performed surgery in breach of restrictions on his clinical practice between October 2018 and January 2019 and that his actions were dishonest. Richard Holland, opening the tribunal case for the General Medical Council, said Mr Parker’s care of six patients – referred to as patients A-F – was “deficient” in a number of ways, with that provided to patient A leading to a “catastrophic outcome” where their leg was amputated below the right knee following “catastrophic blood loss” caused by severing of an artery during surgery. Read full story (paywalled) Source: HSJ, 1 February 2022
  2. News Article
    A further 1,500 patients of convicted breast surgeon Ian Paterson are to be recalled and their treatment investigated. Spire Healthcare, which runs private hospitals, said patients were being contacted after a trawl of IT systems. Paterson was jailed for 20 years in 2017 for 17 counts of wounding people with intent. The healthcare provider said it remained committed to tracking down all "outstanding patients". The former surgeon subjected hundreds of patients to needless and damaging surgery over 14 years. A 2020 independent inquiry ruled "a culture of avoidance and denial" left him free to perform botched operations in NHS and private hospitals in Birmingham and Solihull. The inquiry recommended all 11,000 patients Paterson treated should be recalled for review. Read full story Source: BBC News, 1 February 2023
  3. News Article
    An NHS surgeon has admitted to botching patients’ surgeries which left them with life-changing injuries, a tribunal has heard. Dr Camillo Valero, who works at Norfolk and Norwich NHS trust and is facing allegations over his conduct towards three patients, has been admitted to severing a patient’s gallbladder during an operation. Dr Valero is facing a medical practitioner’s tribunal where he already admitted to failures during two patients’ procedures. Allegations against him include a failure to obtain a “critical view of safety” for his patients during surgeries. He is also accused of shouting at patients during an altercation in an allegedly “aggressive” manner. According to a tribunal document he was accused of asking the patient “are you a doctor?” when discussing his medication. During surgery, Dr Valero is alleged to have misinterpreted the patient’s anatomy or sought assistance from an experienced surgeon following mistakes. In the case of the third patient, allegations which have not been admitted or proven, Dr Valero is reported to have inappropriately discharged a patient with learning disabilities and did not adequately assess their mental capacity. Read full story Source: The Independent, 25 January 2023
  4. News Article
    John Watkinson was one of the country's top ear, nose and throat surgeons. But Mr Watkinson's life and career were turned upside down when he was accused of shortening the lives of three patients, suspended and investigated. General Medical Council investigators would eventually close his case, taking no further action, and Mr Watkinson would receive an apology for what he had experienced from his employer University Hospitals Birmingham (UHB) NHS Trust. But that was six years after he was first suspended - six years that would see him pushed to the brink. "As doctors, we're trained in communication skills, we have appraisals, mandatory training," he says. "But the one thing we're not trained to cope with is when somebody declares war on you." The hospital trust stands by its decision to suspend Mr Watkinson and says its referral to the General Medical Council was "appropriately made following a clinical colleague raising significant concerns" about patient care. UHB has been in the spotlight in recent weeks, with reviews launched into its culture, leadership, and allegations of poor patient care aired in a Newsnight investigation late last year. It says a review into patient care is now well under way. Mr Watkinson says he was at the sharp end of this culture when he was suspended and suddenly went "from hero to zero". He accepts mistakes were made, but not just by him and not ones that would have affected the patients' outcomes. Read full story Source: BBC News, 13 January 2023
  5. News Article
    A new survey of more than 1,000 surgeons across the USA reiterates concerns that impending cuts to surgical care, set to take effect on 1 January 1 2023, will lead to a decrease in Medicare patient intake, increased delays to care, and longer wait times for patients in surgical practices. These survey results support the efforts of the over one million physician and non-physician healthcare providers joining together in urging congressional leadership to stop the full cut to Medicare payments through a Week of Action. "Our survey results confirm that the impending cuts to Medicare payments will be disastrous for patients and their access to life-saving and life-altering care," said Patricia L. Turner, American College of Surgeons Executive Director and Chief Executive Officer. "As our population continues to age, more and more seniors depend on Medicare to receive the care they need. Congressional leadership must protect patients by stopping the full cut to Medicare payments so healthcare providers can focus on delivering high-quality care to patients." The survey, conducted for the American College of Surgeons, a founding member of the Surgical Care Coalition, found: Around two-thirds of members expect patients will be faced with delays to care (68%) or longer wait times (65%). These are up from 56% and 57%, respectively, in 2021. One-in-three (33%) members say there will be a change in their Medicare patient intake if the cuts were to go into effect, up from 25% in 2021. 20% say they expect to take on fewer new Medicare patients, but that they will keep all existing Medicare patients. While members report feeling the impact from supply chain issues and inflation, surgeons are also sounding the siren around healthcare worker shortages. Over nine-in-ten (93%) report healthcare worker shortages impacting their ability to provide high quality care over the last year. Over three-quarters (77%) report "a great deal of impact" from these shortages. Read full story Source: CISION PR Newswire, 9 December 2022
  6. News Article
    A consultant orthopaedic surgeon who carried out double the average number of knee and hip operations over a three year-period is facing a tribunal over alleged misconduct and more than 100 legal cases lodged by former patients, HSJ has been told. Jeremy Parker, who performed hundreds of operations at Colchester Hospital and the private Oaks Hospital until his suspension in 2019, is currently appearing before a misconduct hearing. The tribunal is investigating allegations that between August 2015 and November 2018, Mr Parker failed to provide good clinical care to six patients. It has also been alleged that Mr Parker performed surgery in breach of restrictions on his clinical practice between October 2018 and January 2019 and that his actions were dishonest. The trauma and orthopaedic surgeon is also facing allegations that he added pre-typed operation notes to approximately 14 patients’ records ahead of an invited review into his clinical practice by the Royal College of Surgeons, without indicating they had been made retrospectively. Read full story (paywalled) Source: HSJ, 5 December 2022
  7. News Article
    A consultant surgeon refused to attend hospital to carry out urgent surgery at a trust which later had upper gastrointestinal surgery suspended after an unannounced Care Quality Commission visit. The CQC report into upper GI surgery at the Royal Sussex County Hospital in Brighton – based on an inspection in August – said incident reports revealed occasions when upper GI surgeons could not be contacted or refused to come into hospital to treat patients. In one case, a consultant would not come in to carry out urgent surgery, it added. Low numbers of surgeons meant the on-call rota for upper GI was shared with the lower GI surgeons. This meant an upper GI specialist was not always available immediately, despite guidance from a professional body that 24/7 subspecialty cover was needed at centres which carry out major resectional surgery. This surgery was suspended at the RSCH after the August inspection and has yet to be reinstated. Mortality at both 30 and 90 days for patients with oesophago-gastric cancer was twice the national average between 2017 and 2020 – though the trust was not an outlier – and there was an increasing number of emergency readmissions for patients who had undergone upper GI surgery, the report said. Read full story (paywalled) Source: HSJ, 1 December 2022
  8. Content Article
    This study in the Annals of Surgery aimed to characterise errors, events and distractions in the operating theatre, and measure the technical skills of surgeons in minimally invasive surgery practice. The authors of the study implemented the use of an operating room (OR) Black Box, a multiport data capture system that identifies intraoperative errors, events and distractions. The study found that the OR Black Box identified frequent intraoperative errors and events, variation in surgeons’ technical skills and a high number of environmental distractions during elective laparoscopic operations.
  9. Content Article
    This tool was developed collaboratively between the Association for Perioperative Practice (AfPP), NHS England (NHSE) and BD to guide perioperative staff in selecting the most appropriate skin preparation solution for respective surgical procedures. By providing a combination of cues pre-defined and selected by the user, this tool recommends the most appropriate surgical skin antiseptic solution, method of use, technique, and precautions. The development of this clinical interactive decision-making tool provides healthcare professionals with evidence-based information at their fingertips to manage surgical site skin preparation effectively. This facilitates clinical decisions in practice, saving time and reducing harm.
  10. News Article
    A damning report has highlighted failures in how NHS Tayside oversaw a surgeon who harmed patients for years. Prof Eljamel, the former head of neurosurgery at NHS Tayside in Dundee, harmed dozens of patients before he was suspended in 2013. The internal Scottish government report into Prof Sam Eljamel, which has been leaked to the BBC, said the health board repeatedly let patients down. It outlined failures in the way Prof Eljamel was supervised and the board's communication with patients. The report was commissioned last year over unanswered questions and concerns from patients Jules Rose and Pat Kelly. Mr Kelly has been left housebound and Ms Rose has PTSD after the neurosurgeon removed the wrong part of her body. After her operation in 2013, Ms Rose discovered that Prof Eljamel had taken out the wrong part of her body. He removed her tear gland instead of a tumour on her brain. She still has not been told exactly when health bosses knew he was a risk to patients. The latest Scottish government report said she should receive an apology. The written apology she received from the board last month said it was sorry she "feels" there has been a breakdown in trust. "I actually rejected the apology," she said. Ms Rose said she wanted the chairwoman of the health board to explain why it will not offer a "whole-hearted apology" for its failures. Scottish Conservative MSP Liz Smith called for a public inquiry, saying there had been a lack of accountability and the investigation had still not got to the truth. Read full story Source: BBC News, 3 November 2022
  11. News Article
    A consultant oncologist who ignored a hospital instruction and attended patients’ cancer surgery on two days when he knew he was still testing positive for Covid-19 has been suspended from the UK medical register for three months. Andrew Gaya admitted knowingly breaking the rules but told the medical practitioners tribunal he had feared that the patients’ treatments would be postponed if he could not attend the private London Gamma Knife Centre, part of HCA Healthcare UK. The two incidents occurred in the early weeks of the pandemic, at a time of high covid death rates. “I did not take the decision to attend the centre on 3 April 2020 lightly and was aware it was not in accordance with the instructions I had been given,” Gaya told the tribunal. “At the time I thought that I wasn’t going to do any harm and that I was acting in the best interests of the patient as the case was urgent. “I know I should have telephoned [the relevant manager] and asked if she would allow me to undertake the treatment, but I was afraid her answer would be ‘no’ and that the patient’s treatment would be cancelled,” he told the tribunal in a witness statement. Both patients have since died, but after the tribunal concluded Gaya told the Daily Telegraph, “One lived for 6 months with good quality of life.” Gaya, who was present as part of a multidisciplinary team, wore protective gear and observed social distancing. There is no evidence that he had infected anyone. Read full story Source: BMJ, 1 November 2022
  12. Content Article
    In this blog, Luke Yamaguchi describes his experience of hernia mesh surgery and the impact the procedure had on his health. He tells his story of having laparoscopic hernia repair using polypropylene (PP) mesh, which left him with severe chronic pain. After nine years, he underwent mesh removal surgery. Alongside his story, he describes the risks associated with surgical mesh and the use of PP as a material, highlights the lack of research about its side-effects and draws attention to the role of industry in promoting the use of mesh.
  13. News Article
    Surgeons in a London hospital have performed a week’s worth of operations in a single day, pioneering a technique that could be used to help reduce the NHS backlog. The team at Guy’s and St Thomas’ hospital performed eight robot assisted radical prostatectomy operations in under ten hours, the highest number performed in a single day in the UK in one hospital. High Intensity Theatre lists (HIT) focus on one procedure at a time and seek to minimise the turnaround time between operations. Using two theatres, the surgeon can go between cases without having to wait for a patient to come in. This helps to cut the significant amount of time it takes for medics to anaesthetise a patient, set up equipment in the theatre and help them to recover – a process which sometimes takes longer than the operation itself. The team at Guy’s assembled a large team for the HIT list, which took place on 8 October. Each theatre had a team of around 1.5 times its usual size and staff were given very specific roles. By the time the list had reached the third patient, the turnaround time between operations had dropped as low as 32 seconds. Behind the scenes, staff in the control room used Proximie software to monitor activity in the theatre in real time. Dr Ben Challacombe, a consultant urological surgeon who performed the operations with his surgical consultant colleagues Paul Cathcart, Christian Brown, and Prokar Dasgupta, told the Standard that the success of the HIT list had given staff a “huge” morale boost. “Everyone pulled together to do the job, it really helped to energise the team. Morale has been hit by Covid and other issues, but people feel galvanised by doing something different.” Read full story Source: Evening Standard, 29 October 2022
  14. News Article
    Up to 600 patients are to be recalled by a hospital after concerns were raised about shoulder operations. Some patients have lost the use of their arm after surgery by Mian Munawar Shah at Walsall Manor Hospital. Angela Glover had two operations by Mr Shah - the first, it later emerged after a review, was unnecessary and a screw had been placed inappropriately. Her partner Simon Roberts said she was in "constant pain" and was unable to raise her arm or grip things in her right hand. It has affected her mental health to the point she had to be sectioned after a suicide attempt, Mr Roberts added. Mr Martin Crowley had an operation in 2019 after dislocating his shoulder - Mr Shah then replaced the joint when the first operation was unsuccessful. Since then, he said he struggled with basic tasks such as buttoning up a shirt or holding a cup of tea. "It's affecting me quite bad, there's a lot of stuff I want to do that I can't do," he said. Between 2010 and 2018 there were 21 medical negligence claims relating to Mr Shah's surgery. In 2020, Walsall Healthcare Trust contacted the Royal College of Surgeons (RCS) which carried out a general review of surgery and then a further review into Mr Shah's individual work. A recall of his patients was recommended by the RCS. The surgeon has been given an interim order by the Medical Practitioners Tribunal Service (MPTS), stopping him from doing laterjet procedures or shoulder joint replacements without supervision. Medical director at the Walsall trust Dr Manjeet Shehmar told the BBC there had been a failure to carry out multi-disciplinary team meetings and some of the procedures should have been performed in a specialist orthopaedic hospital rather than at Walsall Manor. Read full story Source: BBC News, 26 September 2022
  15. News Article
    Watchdogs have been asked to investigate a Scottish government overhaul of NHS waiting times information after surgeons said that some of the figures were “grossly misleading”. A complaint has been made to the Office for Statistics Regulation, which ensures that important public data is trustworthy, about a new guide for patients on the NHS Inform website. Concerns have also been raised with Audit Scotland, which monitors public spending and NHS performance. Last month Humza Yousaf, Scottish health secretary, unveiled the platform claiming that it would reassure patients about waiting times. But the times given reflect only the experience of patients treated over a three-month period. In orthopaedics, surgeons say, only the most urgent cases are being prioritised while some patients face languishing on waiting lists for years due to lack of capacity. NHS Inform says that people waited a median of 26 weeks between April and June for orthopaedic care, but surgeons argue that this gives a false impression. Dr Iain Kennedy, new chairman of the British Medical Association in Scotland, said the way the figures have been compiled would suggest that people are still not getting a realistic picture of delays. Read full story (paywalled) Source: The Times, 16 September 2022
  16. Event
    Future Surgery, brings together surgeons, anaesthetists and the whole perioperative team. Designed specifically to meet the training needs, promote networking and develop a stronger voice for all surgical professionals and their multidisciplinary teams in perioperative care. Our CPD accredited speaker programme explores disruptive technology, connectivity, human factors, training and research to support the transformation of the profession and the improved care and safety of patients. Future Surgery is the biggest gathering of surgical and operating theatre teams with over 110 expert speakers – in keynote sessions, panel discussions and workshop sessions, covering all that is new in the field of surgery. Register
  17. News Article
    A major acute site has issued a ‘full capacity’ alert to staff, just days before the services are due to move into a replacement hospital with fewer beds. In an email seen by HSJ, medical leaders at the Royal Liverpool Hospital alerted staff to extreme pressures on the site, with ambulances being held outside and “no space” in resuscitation areas. The RLH currently has around 685 beds, but at the end of this month the services are due to start transferring to the long-awaited new Royal Liverpool, on an adjacent site. The new hospital has 640 beds, and several frontline staff have told HSJ this is causing significant concern, with the current services under so much pressure. One senior source at the trust said there has been a push since 2017 to reduce inpatients beds at the current hospital, to try and match the capacity of the new build, but this hasn’t been achieved. They added: “Surgeons are concerned that their beds will get filled with medical outliers. The whole issue is all the patients who are waiting for social care. It was supposed to have been sorted by now.” Read full story (paywalled) Source: HSJ, 13 September 2022
  18. News Article
    There was a fair bit of press coverage last week about an employment tribunal case against the Care Quality Commission – in which the regulator was found to have sacked an inspector for making a series of whistleblowing disclosures. However, many of the key details were either skirted over, or missed altogether, in the coverage. The disclosures made by Shyam Kumar related not just to his role as a special adviser for the CQC, but also to his full-time employer, University Hospitals of Morecambe Bay FT, and to understand the case fully, they need to be separated out. The important context (also skirted over) was that Dr Kumar had raised a series of legitimate concerns about another orthopaedic surgeon at UHMB, both internally within the trust, and externally with the CQC, in 2018. This caused major tensions within UHMB, to the extent that Dr Kumar started to be targeted for criticism by a different surgeon, being labelled a ‘traitor’ to Indian doctors in a group email. When challenged by Dr Kumar, the colleague complained to the CQC that Dr Kumar had sought to threaten and intimidate him, along with other accusations. Read full story (paywalled) Source: HSJ, 12 September 2022
  19. Content Article
    Everybody makes mistakes at work but what if you're a doctor and you ruin a patient's life - or even end it? Doctor-turned-writer Jed Mercurio recalls a catalogue of errors from his years as a medical student.
  20. Content Article
    Clinicians at Guy's & St Thomas' Foundation Trust in London are preparing to publish the results of 15 one-day HIT lists between February 2021 and August 2022, involving 300 patients across eight different specialties, in which they claim they have been able to carry out four times as many operations as they would normally expect to complete in a month using conventional lists.
  21. Content Article
    Proven patient safety solutions such as the World Health Organization’s Surgical Safety Checklist can be difficult to implement at scale. This article looks at a voluntary initiative launched in South Carolina hospitals in 2010 to encourage use of the checklist in all operating rooms. Hospitals that implemented the checklist by 2017 had higher levels of CEO and physician participation than comparison hospitals, and engaged more in activities such as in-person meetings and teamwork skills trainings. The authors suggest three considerations for hospital, state and national policy makers: Successful programs must be designed to engage all stakeholders (CEOs, physicians, nurses, surgical technologists, and others) Offering a variety of program activities—both lower-touch and higher-touch—over the duration of the program allows more hospital and individual participation Change takes time and resources
  22. News Article
    A leading colorectal surgeon whose former employer, North Bristol NHS Trust, faces negligence claims from dozens of his ex-patients has failed in his bid to keep legal action he is taking against the trust a secret. A review by the trust found that 203 women on whom the surgeon Tony Dixon performed pelvic mesh procedures between 2007 and 2017 came to harm. The trust faces legal claims from many of them. Trust board members were told in May that the trust had notified the 203 women that “although their laparoscopic ventral mesh rectopexy operation was carried out satisfactorily, they should have been offered alternative treatments before proceeding to surgery,” and that those patients were defined as suffering “harm.” Dixon sued the trust in the High Court to try to stop it releasing two documents to solicitors acting for ex-patients, as part of the disclosure process in litigation. Read full story (paywalled) Source: BMJ, 27 July 2022
  23. News Article
    Catherine O’Connor, who was born with spina bifida and used a wheelchair all her life, was looking forward to the surgery to fix her twisted spine. Tragically, after a catastrophic loss of blood, she died on the operating table at Salford Royal Hospital in Manchester. She died in February 2007 but only now has an NHS-commissioned report concluded the “unacceptable and unjustifiable” actions of her surgeon, John Bradley Williamson, “directly contributed” to her death. Williamson pressed on with the surgery despite being explicitly told he needed a second consultant surgeon. Her case is one of more than a hundred of Williamson’s being reviewed by Salford Royal Hospital amid allegations by whistleblowers of a cover-up by managers and a “toxic culture” within his surgery team. An internal list produced by concerned clinicians as long ago as 2014 describes some of Williamson’s patients being left paralysed or in severe pain as a result of misplaced spinal screws and others being rushed back to theatre for life-saving surgery. Separately, leaked minutes of a meeting between staff and the hospital’s new chief executive in December 2021 described a “snapshot” of five of Williamson’s patients which “clearly identified significant areas of clinical care, avoidable harm and avoidable death”. They added: “Concerns around Mr Williamson continue to be raised and remain unaddressed.” Read full story (paywalled) Source: The Times, 17 July 2022
  24. Content Article
    This Quality Improvement Programme for Surgical Site Infections document was developed as an output of an advisory board meeting, convened by Mölnlycke. The meeting focused on developing a resource to aid healthcare professionals to deliver successful infection prevention programmes in their organisations. 
  25. Content Article
    Surgeons are affected negatively when things go wrong. They may experience guilt, anxiety and reduced confidence following adverse events, which may lead to formal investigation and sanction. Medical errors have been linked with burnout, depression, suicidal ideation and reduced quality of life. This research from Turner et al. explores the impact of adverse events on UK surgeons’ health and wellbeing. Surgeons completed an online survey that involved recalling an error-based or complication-based event and answering questions regarding health, wellbeing and support seeking.
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