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Found 216 results
  1. News Article
    A leading surgeon says a major drop-out rate of trainee doctors is "an accident waiting to happen" for the NHS. Nigel Mercer was tasked with prioritising surgery across the NHS during the pandemic when services were under intense pressure. His biggest fear with what he sees as an up to 40% drop-out rate is whether there will be enough doctors to replace his generation of medics. The government said the majority of trainees go on to work in the NHS. "[But] at the moment everyone is so fed up with the system," Mr Mercer said Concerns over pay and conditions are leading many trainees to consider moving to other countries, he said. "You can get much more pay over in Australia and New Zealand and we reckon it's now 40% of medical graduates who are going to leave after their training and that's criminal," he continued. "That's an accident waiting to happen, but if we don't produce high-quality paramedical staff there won't be the ability to train anybody. Read full story Source: BBC News, 12 April 2023
  2. News Article
    A former adviser for the Care Quality Commission (CQC) has called on the regulator to explain what action it has taken against the officials responsible for wrongly dismissing him after he raised whistleblowing concerns. Shyam Kumar, a surgeon who was part of inspection teams in the North West, told HSJ that he had to live with question marks over his reputation for several years. He is furious that a senior CQC official sought to question his honesty and integrity in evidence submitted to the employment tribunal examing his dismisal. The tribunal heard Mr Kumar had raised a number of whistleblowing disclosures to the CQC, including concerns about the lack of appropriate expertise on inspection teams. After a wide-ranging review around its handling of whistleblowing concerns, CQC chief executive Ian Trenholm last week apologised to Mr Kumar for “unacceptably poor treatment” by his organisation, and thanked him for contributing to the review. However, Mr Kumar told HSJ: “I’m glad the CQC has looked at this and finally acknowledged what they did to me was wrong. But I want to know what has happened to the individuals that were responsible.” Read full story (paywalled) Source: HSJ, 6 April 2023
  3. News Article
    The high-profile Australian neurosurgeon Charlie Teo admits making an error by going “too far” and damaging a patient, but maintains she was told of the risks. The doctor on Monday appeared at a medical disciplinary hearing to explain how two women patients ended up with catastrophic brain injuries. Teo also defended allegations that he acted inappropriately by slapping a patient in an attempt to rouse her after surgery, contrasting it with Will Smith’s notorious slap of Chris Rock at the Academy Awards last year. “It wakes them up and it wakes them up pretty quickly. And I will continue to do it.” Charlie Teo tells inquiry he ‘did the wrong thing’ in surgery that left patient in vegetative state One of the issues the panel of legal and medical experts is considering is whether the women and their families were adequately informed of the risks of surgery. Both women had terminal brain tumours and had been given from weeks to months to live. They were left in essentially vegetative states after the surgeries and died soon after. “We were told he could give us more time,” one of the husbands said, according to court documents. “There was never any information about not coming out of it". Read full story Source: The Guardian, 27 March 2023
  4. Content Article
    In this BMJ opinion piece, Scarlett McNally discusses the revised National Safety Standards for Invasive Procedures (NatSSIP2). The original NatSSIPs were designed to prevent “never events”—yet more than 300 occurrences of wrong site surgery, retained objects after procedure, or wrong implant insertion still occur yearly in the UK.  NatSSIP2 brings in safety science and human factors, with expectations for organisations including standardisation, harmonisation, training, and audit. "The biggest danger is if the new standards sit on the shelf. With their benefits for patient safety and teamworking, we must accept the repetitive elements and consistently apply these new standards, every time, in every department", writes Scarlett.
  5. Content Article
    Tayo Oke talks to Kathy Oxtoby about why her chosen specialty of colorectal surgery is her “natural home” and the rewards of developing strong bonds with patients.
  6. Content Article
    Dr Freya Smith, a Specialty Trainee in General Practice, reflects on the sinister and toxic side of medicine, using the recent Paterson and vaginal mesh scandals to demonstrate how patients have been let down by the system. In an honest and personal account, she shares with us the horror and sadness she felt at learning of these scandals and how she aspires to keep her future patients safe.
  7. 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.
  8. 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
  9. 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
  10. News Article
    The United States Surgeon General Dr. Vivek Murthy issued a new Surgeon General’s Advisory highlighting the urgent need to address the health worker burnout crisis across the country. Health workers, including physicians, nurses, community and public health workers, nurse aides, among others, have long faced systemic challenges in the health care system even before the COVID-19 pandemic, leading to crisis levels of burnout. The pandemic further exacerbated burnout for health workers, with many risking and sacrificing their own lives in the service of others while responding to a public health crisis. Promoting the mental health and well-being of our nation’s frontline health workers is a priority for the Biden-Harris Administration and a core objective of President Biden’s national mental health strategy, within his Unity Agenda. The Surgeon General’s Advisory Addressing Health Worker Burnout lays out recommendations that the whole-of-society can take to address the factors underpinning burnout, improve health worker well-being, and strengthen the nation’s public health infrastructure. “At the height of the COVID-19 pandemic, and time and time again since, we’ve turned to our health workers to keep us safe, to comfort us, and to help us heal,” said Secretary of Health and Human Services Xavier Becerra. “We owe all health workers – from doctors to hospital custodial staff – an enormous debt. And as we can clearly see and hear throughout this Surgeon General’s Advisory, they’re telling us what our gratitude needs to look like: real support and systemic change that allows them to continue serving to the best of their abilities. I’m grateful to Surgeon General Murthy for amplifying their voices today. As the Secretary of Health and Human Services, I am working across the department and the U.S. government at-large to use available authorities and resources to provide direct help to alleviate this crisis.” “The nation’s health depends on the well-being of our health workforce. Confronting the long-standing drivers of burnout among our health workers must be a top national priority,” said Surgeon General Vivek Murthy. “COVID-19 has been a uniquely traumatic experience for the health workforce and for their families, pushing them past their breaking point. Now, we owe them a debt of gratitude and action. And if we fail to act, we will place our nation’s health at risk. This Surgeon General’s Advisory outlines how we can all help heal those who have sacrificed so much to help us heal.” Read full story Source: HHS, 23 May 2022
  11. 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
  12. 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
  13. Content Article
    The Operating Room Black Box (OR Black Box) is a system that collects, stores and analyses a large amount of data from the operating room beyond just surgical video, such as video and audio of the operating room and patient physiology data. In this episode of the Behind the Knife podcast, Dr. Teodor Grantcharov, one of the creators of the OR Black Box, talks about how the technology can be used to enhance surgical training. Using the system for feedback through self-directed review, coaching and integrated AI analysis has changed the way we can learn and teach in surgery, and may have implications for the future of evaluation and assessing credentials.
  14. Content Article
    Surgeons' News is a magazine for surgical, dental and allied healthcare professionals. Published quarterly by the Royal College of Surgeons of Edinburgh, it features comment and opinion from leading professionals, plus reviews and reports on subjects relevant to all career levels. Two articles in this month's issue we want to highlight are the Surgical safety update (p.10) on cases from the Confidential Reporting System for Surgery (CORESS) and Safe passage (p.18) discussing the National Patient Safety Syllabus.
  15. Content Article
    On 24 August 2022, the Employment Tribunal found that Mr Shyam Kumar, a consultant orthopaedic surgeon employed at University Hospitals of Morecambe Bay NHS Foundation Trust (UHMB), had been disengaged from his role as a Specialist Advisor within the Care Quality Commission (CQC) on account of having made “protected disclosures” to the CQC. This means he had raised concerns with CQC about the health of patients and other important issues and had done so in the public interest. The Employment Tribunal found that the fact that he had raised these various concerns with CQC had materially influenced its decision to disengage him. It awarded him £23,000 in damages for injury to feelings, on account of what it described as “the inevitable impact” of CQC’s actions upon Mr Kumar’s reputation among his peers and the shock, confusion and concern it caused to him. The CQC has accepted these findings and apologised to Mr Kumar. CQC’s Chief Executive, Ian Trenholm, issued a public statement on 6 September 2022 about what occurred, including a recognition of the importance of the concerns Mr Kumar raised, the importance of the information raised by staff and the public generally, and the “vital role” played by Specialist Advisors in CQC’s inspections. Following this, Zoe Leventhal KC was appointed by CQC’s Executive Board to carry out an independent review into whether CQC took appropriate action as a regulator in response to the protected disclosures that Mr Kumar made, and whether it dealt appropriately with a sample of other instances where concerns have been raised with CQC.
  16. Content Article
    The Operating Room Black Box, a system of sensors and software, is being used in operating rooms in 24 hospitals in the US, Canada and Western Europe. The device captures video, audio, patient vital signs and data from surgical devices in an effort to improve patient safety. This article in the Wall Street Journal looks at how Black Box technology at Duke University Hospital has identified several areas for improvement, including that the hospital needed a better system for sending and tracking specimens. The article also highlights some concerns raised by healthcare professionals about the use of Black Boxes, including fear that data collected might be used to punish staff, or that it may be used as evidence in medicolegal cases outside of hospitals' control.
  17. Content Article
    Published 10 times a year by the Association for Perioperative Practice, the IPP covers a variety of topics relevant for perioperative practitioners. Ranging from news and information, special focus pieces, industry interviews and profiles of company leaders in an easy-to-read format.
  18. 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
  19. 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
  20. 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
  21. News Article
    Dozens of surgeons have reported being told by the NHS employer to stop discussing shortages of personal protective equipment (PPE) during the coronavirus crisis. The Confederation of British Surgery (CBS) said almost 70 surgeons working in major hospitals around the country had been warned off discussing a lack of PPE by their trust. A third of surgeons said the supply of PPE was inadequate at their hospital, with many complaining of inconsistent guidance, rationing of supplies and poor quality PPE when it was available. When asked if their concerns were dealt with satisfactorily, nearly a third said they were not addressed, or not effectively. A survey of 650 surgeons by the union found many were now considering changes to the way they worked as a result of the crisis – with more than half, 380, saying they would be avoiding face-to-face meetings with patients in the future. More than 40 surgeons, around 7%, said they were now considering leaving surgery altogether. Read full story Source: The Independent, 10 August 2020
  22. News Article
    Former patients of rogue breast surgeon Ian Paterson may have died of “unnatural deaths” two senior coroners have said. Senior coroner for Birmingham and Solihull, Louise Hunt, and area coroner Emma Brown have said they believe there is evidence to suspect victims of Ian Paterson, who was jailed for 17 counts of wounding with intent in 2017, died unnaturally as a result of his actions. They now plan to open four inquests into the deaths of patients who died from breast cancer after being treated by Paterson. “Following preliminary investigations, the senior and area Coroner believe there is evidence to have reason to suspect that some of those deaths may be unnatural. In accordance with the Coroners and Justice Act 2009, inquests will now be opened in relation to four former patients of Mr Paterson.” Deborah Douglas, a victim of Paterson who leads a support group in Solihull, told The Independent: "I have spoken to so many women over the years who have since died. This is what I have always known and fought for. "Paterson lied about pathology reports and people did develop secondary cancers." Read full story Source: The Independent, 4 July 2020
  23. News Article
    Surgeons have invented a new device to make it safer to diagnose some cancers during the coronavirus pandemic. Most nose and throat investigations have been cancelled due to increased risks of medics contracting COVID-19 via patients' coughs and sneezes. Two consultants have developed a device that clips over patients' masks and protects front-line workers. The West Midlands-based doctors want to raise £50,000 they say is enough to make devices for use across the NHS. Chris Coulson, a consultant ear, nose and throat surgeon at University Hospitals Birmingham NHS Foundation Trust, said procedures involving an endoscope to examine the nose or throat were known to put clinicians at a significantly increased risk of contracting coronavirus. "When clinicians carry out a nasendoscopy it can make patients cough, sneeze, and splutter - which risks spreading the virus to doctors, nurses and therapists," he said. His company endoscope-i Ltd, co-founded with Ajith George, a consultant head and neck surgeon at University Hospitals North Midlands, has now developed the SNAP. It clicks on to a conventional surgical mask, creating a hole through which the clinician can pass an endoscope directly into a patient's nose. A valve means, despite there being a hole, any coughs, sneezes or splutters are caught within the mask. Mr George said: "If we can raise the money needed to produce the devices, we can keep looking after patients and ensure that diagnosis and treatment is not delayed." Read full story Source: BBC News, 11 May 2020
  24. News Article
    The Independent Inquiry into the issues raised by Paterson is yet another missed opportunity to tackle the systemic patient safety risks which lie at the heart of the private hospital business model, says David Rowland from the Centre for Health and the Public Interest in a recent BMJ Opinion article. Although the Inquiry provided an important opportunity for the hundreds of patients affected to bear witness to the pain and harm inflicted upon them it fundamentally failed as an exercise in root cause analysis. None of the “learning points” in the final report touch on the financial incentives which may have led Paterson to deliberately over treat patients. Nor do they cover the business reasons which might encourage a private hospital’s management not to look too closely. He suggests that the Inquiry report threw the responsibility for managing patient safety risks back to the patients themselves in two of its main recommendations but that it should be for the healthcare provider first and foremost to ensure that the professions that they employ are safe, competent and properly supervised, and for this form of assurance to be underpinned by a well-functioning system of licensing and revalidation by national regulatory bodies. Read full story Source: BMJ Opinion, 20 February 2020
  25. News Article
    Shipman, Mid Staffordshire, Morecambe Bay, and now Ian Paterson, the breast surgeon that performed botched and unnecessary operations on hundreds of women. The list of NHS-related scandals has got longer. It's tempting to say the health service has not learned lessons even after a string of revelations and reviews. But is that fair? asks BBC Health Editor Hugh Pym. The inquiry, chaired by Bishop Graham James, makes clear there were failings at every level of a dysfunctional health system when it came to patient safety. The public and private health systems did not compare notes about suspicious behaviour by a consultant. Staff working with Paterson thought that his surgical methods were unusual but, perhaps cowed by being ignored after raising concerns, kept their heads down. Add to that the power and status of a surgeon in the medical world and, in the words of the report, Paterson was "hiding in plain sight". So could it happen again? James says it's clearly impossible to eliminate the activities of determined criminals in any profession. He acknowledges that some improvements have been made on policing. But he says that a decade on from the Paterson scandal, he is not convinced that medical regulators, with a combined budget of half a billion pounds a year, are doing enough collectively or collaboratively to make the system safe for patients. The review chair notes tellingly that while regulators spoke of major improvements which should identify another Paterson, some doctors and nurses had told the inquiry that it was "entirely possible that something similar could happen now". Read full story Source: BBC News, 4 February 2020
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