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Found 217 results
  1. 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
  2. News Article
    A culture of "avoidance and denial" allowed a breast surgeon to perform botched and unnecessary operations on hundreds of women, an independent inquiry has found. The independent inquiry into Ian Paterson's malpractice has recommended the recall of his 11,000 patients for their surgery to be assessed. Paterson is serving a 20-year jail term for 17 counts of wounding with intent. One of Paterson's colleagues has been referred to police and five more to health watchdogs by the inquiry. The disgraced breast surgeon worked with cancer patients at NHS and private hospitals in the West Midlands over 14 years. His unregulated "cleavage-sparing" mastectomies, in which breast tissue was left behind, meant the disease returned in many of his patients. Others had surgery they did not need - some even finding out years later they did not have cancer. Patients were let down by the healthcare system "at every level" said the inquiry chair, Bishop of Norwich the Rt Revd Graham James, who identified "multiple individual and organisational failures". One of the key recommendations from the report is that the Government should make patient safety a the top priority, given the ineffectiveness of the system identified in this Inquiry. Read full story Source: BBC News, 4 February 2020
  3. News Article
    An independent inquiry is expected to call for major changes in the way private hospitals supervise doctors after hundreds of women were put through unnecessary operations by a rogue breast surgeon. Ian Paterson was jailed for 20 years in 2017 after being convicted of 13 counts of wounding with intent and three counts of unlawful wounding. But his surgical malpractice may have harmed more than 750 women over more than a decade. He carried out unnecessary surgery for breast cancer on women who did not have the disease, and put other women who did at risk by using his own unofficial technique, which left behind partial breast tissue. On Tuesday an inquiry chaired by the Bishop of Norwich, the Right Reverend Graham James, will be published and is expected to make recommendations about how doctors are allowed to work across both the NHS and private sector with minimal supervision and oversight. One key area of focus is expected to be a process known as “practising privileges”, where private hospitals allow clinicians to carry out their own activities within the hospital, similar to self-employed contractors. They effectively rent the hospital space for their work. Read full story Source: The Independent, 2 February 2020
  4. News Article
    A surgeon has been accused of carrying out “unnecessary” shoulder operations on several NHS patients at a private hospital linked to the Ian Paterson scandal, with 217 patients recalled. HSJ has been told at least five patients, all commissioned by the NHS, have instructed solicitors to take legal action against Habib Rahman, a consultant orthopaedic surgeon at Spire Parkway Hospital in Solihull. Mr Rahman is accused of undertaking “unnecessary or inappropriate surgical procedures at Spire Healthcare hospitals” . Spire has confirmed it has recalled 217 patients over the concerns. The allegations come weeks before the findings are due from an independent inquiry into disgraced surgeon Ian Paterson – who was found guilty of wounding with intent after giving hundreds of patients unnecessary breast surgeries in Spire hospitals across the Midlands. Read full story (paywalled) Source: HSJ, 24 January 2020
  5. News Article
    Warring between two surgeons at Great Ormond Street Hospital could put patients at risk, a review suggests. A board paper released by the leading children's hospital said a "fractured" relationship between two consultants in the paediatric surgical urology team was affecting the service last year. The London hospital said steps were being taken to resolve the problems. This has included mediation, mentoring and away days. The board paper from a meeting in November set out the findings of a two-day inspection by the Royal College of Surgeons last May. The college was invited in by the trust itself after reports of problems. The summary of the report said there were "significant difficulties" between two surgeons in the team. It described a "lack of trust and respect" which meant they did not work collaboratively and led to significant competition for work. If this continued it would have the "potential to affect patient care and safety" as well as longer waits for surgery, it said. The "dysfunction" between the two senior doctors caused problems for the wider team with evidence support staff had also been treated inappropriately. Great Ormond Street said it took the issue "extremely seriously" and good progress was being made. Read full story Source: BBC News, 15 January 2020
  6. News Article
    Artificial intelligence can diagnose brain tumours more accurately than a pathologist in a tenth of the time, a study has shown. The machine-learning technology was marginally more accurate than a traditional diagnosis made by a pathologist, by just 1%, but the results were available in less than 2 minutes and 30 seconds, compared with 20 to 30 minutes by a pathologist. The study, published in Nature Medicine, demonstrates the speed and accuracy of AI diagnosis for brain surgery, allowing surgeons to detect and remove otherwise undetectable tumour tissue. Daniel Orringer, an Associate Professor of Neurosurgery at New York University's Grossman School of Medicine and a senior author, said: “As surgeons, we’re limited to acting on what we can see; this technology allows us to see what would otherwise be invisible to improve speed and accuracy in the [operating theatre] and reduce the risk of misdiagnosis." “With this imaging technology, cancer operations are safer and more effective than ever before.” Read full story Source: The Independent, 6 January 2020
  7. News Article
    How would you feel about a robot performing major surgery on you? 2019 has seen a boom in the use of cutting edge robotic technology and there is more to come. Evidence suggests robotic surgery can be less invasive and improve recovery time for patients. That could be good news with ever growing demand on health services. But how do patients feel? BBC News speaks to a patient as he prepares to put his trust in robotic assisted surgery, hoping it would mean he could get back to work more quickly. Read full story Source: BBC News, 12 December 2019
  8. News Article
    Women are having their appendixes removed wrongly in nearly a third of cases, British research suggests. Researchers said too many female patients were being put under the knife when they should have undergone investigations for period pain, ovarian cysts or urinary tract infections. They said the study, which compared practices in 154 UK hospitals with those of 120 in Europe, suggests that Britain may have the highest rate of needless appendectomies in the world. Surgeons said they were particularly concerned by the high rates among women, with 28% of operations found to be unnecessary. They said the NHS was too quick to book patients in for surgery, when further scans and investigations should have been ordered. Researchers warned that such operations put patients at risk of complications, as well as fuelling NHS costs. Read full story Source: The Telegraph, 4 December 2019
  9. News Article
    Royal Cornwall Hospital has deployed an artificial intelligence (AI) tool that allows clinicians to view case videos safely and securely. Touch Surgery Enterprise enables automatic processing and viewing of surgical videos for clinicians and their teams without compromising sensitive patient data. These videos can be accessed via mobile app or web shortly after the operation to encourage self-reflection, peer review and improve preoperative preparation. James Clark, consultant upper gastrointestinal and bariatric surgeon at the trust, said: “Having seamless access to my surgical videos has had an immense impact on my practice both in terms of promoting patient safety and for educating the next generation of surgeons." Read full story Source: Digital Health, 28 November 2019
  10. News Article
    Suspended Belfast neurologist Michael Watt has offered his "sincere sympathy" to those affected by Northern Ireland's biggest patient recall. Dr Michael Watt worked at the Royal Victoria Hospital as a neurologist diagnosing conditions like epilepsy and Parkinson's Disease. He was suspended after 3,000 patients were given recall appointments last year. Dr Watt said he recognised the "distress these events have caused". On Tuesday, a BBC Spotlight investigation found that he had carried out hundreds of unnecessary procedures on patients. The programme also obtained details of a Department of Health report, as yet unpublished, that said one-in-five patients of the consultant neurologist were misdiagnosed. Read full story Source: BBC News, 22 November 2019
  11. News Article
    A transplant patient died after a surgeon failed to disclose he had spilt stomach contents on organs which went on to be used in NHS operations. The 36-year-old died of an aneurysm caused directly by infection from a donated liver, while two other patients became ill from transplants. The incident took place in 2015 but only came to light when one of the sick patients attended a hospital in Wales. It had involved a surgeon from Oxford University NHS Foundation Trust. Several organs became infected with Candida albicans, a fungal infection, after the surgeon cut the stomach in a donor while retrieving organs, spilling the contents over other organs. The surgeon did not tell anyone as he should have done and the organs were transplanted into three patients. The patient, who did not want to be named, said: "What angers me to this day is that fact that the surgeon who removed the organs from the donor wasn't honest. It was only when people who received the organs became unwell that the truth was told." Read full story Source: BBC News, 21 November 2019
  12. Content Article
    In this blog, a woman who has suffered from severe pain and complications for 17 years due to transvaginal mesh shares her experience. She talks about how the device has changed her life, how her symptoms have been repeatedly dismissed by surgeons, and the variation she has witnessed between different specialist mesh centres.
  13. Content Article
    Mr David O’Regan, Director of the Faculty of Surgical Trainers, offers this new video series exploring topics that are pertinent to surgical training and trainers. He looks beyond the field of surgery and interviews internationally recognised professionals in their own fields. He also features conversations with a select group of esteemed surgeons who are recognised for their impact on effective training – both giving and receiving – has had on their career and their legacies. Role modelling, situation awareness and team playing are key to reading any training scenario and David will discuss with his guests how a variety of skills required across a huge range of industries can benefit discussions and offer best practice in Surgical Training.
  14. Content Article
    In this opinion piece, Kath Sansom, founder of the Sling the Mesh campaign, highlights the many issues that women face when trying to get pelvic mesh slings surgically removed. She calls for the NHS to give patients a voice and to develop a robust and consistent plan to tackle the issues faced by patients harmed by surgical mesh.
  15. Content Article
    Surgical fires are a serious a patient safety issue. In this blog, Patient Safety Learning analyses a recent response from Maria Caulfield MP, Minister for Patient Safety and Primary Care, to several questions tabled in the House of Commons about surgical fires in the NHS, and outlines the need for further action to prevent these incidents.
  16. Content Article
    High Reliability Organisations (HRO), including healthcare and aviation, have a common focus on risk management. The human element is a ‘weak link’ which may result in accidents or adverse events taking place. Surgeons and other healthcare professionals can learn from aviation's rigorous approach to the role of human factors (HF) in such events, and how we can minimise them. Air Accident Investigation Branch (AAIB) reports show that fatal accidents are frequently caused by pilots flying outside their own personal limits, those of the aircraft or environment. Similarly, patient morbidity or mortality may occur if surgeons work outside personal their capability, with poor procedure selection and patient optimisation, or with a team or theatre environment not suited to the procedure. The authors of this study introduce the personal limitations checklist – a tool adapted from aviation that allows surgeons to define their limits in advance of any decision to operate, and develop critical self-reflection. It also allows management of patient expectations, shared decision making, and flattening of team hierarchy. The minimum skills, patient characteristics, team and theatre resources for any given procedure to proceed are defined. If the surgeon is ‘out of limits’, redressing these factors, seeking additional assistance, or thorough patient consenting may be required for the safe conduct of the procedure. The authors explore external pressures that could cause a surgeon to exceed both personal and organisational limits.
  17. Content Article
    This week Nadine Dorries MP, Minister for Patient Safety, Suicide Prevention and Mental Health, provided an update on the Government’s response to the Independent Inquiry into the Issues raised by Paterson.[1] Here, Patient Safety Learning reflects on this statement and the need for the Government to urgently prioritise providing a full response to the Inquiry’s findings.
  18. Content Article
    In April 2017, Ian Paterson, a surgeon in the West Midlands, was convicted of wounding with intent, and imprisoned. He had harmed patients in his care. The scale of his malpractice shocked the country. There was outrage too that the healthcare system had not prevented this and kept patients safe. At the time of his trial, Paterson was described as having breached his patients’ trust and abused his power. In December 2017, the Government commissioned an independent Inquiry to investigate Paterson’s malpractice and to make recommendations to improve patient safety. The report, outlining a series of recommendations to avoid future harm, was published in February 2020. On 23 March 2021 Nadine Dorries, Minister for Patient Safety, Suicide Prevention and Mental Health, provided an update on the Government’s response to the Independent Inquiry into the Issues raised by Paterson, accessible through the link below.
  19. Content Article
    Traditionally, clinicians present complications at surgical morbidity and mortality (M&M) conferences, and the AHRQ Patient Safety Indicators (PSIs) use inpatient administrative data to identify certain adverse outcomes. Although both methods are used to identify adverse events and inform quality improvement efforts, these two methods might not overlap. This is a retrospective observational study from Anderson et al. of all hospitalisations at a single academic department of surgery (including subspecialties) in 2016 involving a PSI-defined event identified by surgery faculty and residents for review by departmental M&M conference or administrative data. The authors analysed the degree to which these two processes captured PSI-defined events and reasons for exclusion by each process. The study found that surgical M&M and the PSIs are complementary approaches to identifying complications. Both case-finding processes should be used to inform quality improvement efforts.
  20. Content Article
    CORESS Programme Director Frank Smith's talk at the Royal College of Surgeons of Edinburgh.
  21. Content Article
    Surekha Shivalkar was a 78-year-old woman who was scheduled for elective total hip replacement revision surgery. Following surgery she suffered a cardiac arrest and subsequently died. The conclusion of the inquest was that died from multi-organ failure and complications arising during anaesthesia and hip revision surgery, which led to hypotension and hypoperfusion in a woman with ischaemic heart and chronic obstructive pulmonary disease. In his report, the Coroner raises concerns about the lack of a use of a formal risk assessment tool prior to her surgery, communication failures between the orthopaedic surgical team and the anaesthetist and the departure of the Senior Consultant surgeon prior to the surgeries conclusion. 
  22. Content Article
    Surgical morbidity and mortality (M&M) meetings have a central function in supporting services to achieve and maintain high standards of care. Throughout the UK, practices provides advice on the following topics: around the structure and content of M&M meetings vary widely and so does their quality. According to Good Surgical Practice, all surgeons should regularly attend morbidity and mortality meetings as a key activity for reviewing the performance of the surgical team and ensuring quality. 
  23. Content Article
    In October 2014, the Royal College of Surgeons in Edinburgh launched a UK-wide education campaign to get patients moving in the run-up to surgery. Addressing this costly and avoidable matter, the campaign asks patients to speak with their surgeon or GP to work out an exercise plan that suits their condition and the type of operation they will undergo.
  24. Content Article
    The Royal College of Surgeons of Edinburgh (RCSEd) has partnered with the anti-smoking charity ASH (Action on Smoking and Health) to support surgeons in encouraging patients to improve their survival chances by quitting smoking ahead of surgery. Fewer postoperative complications, shorter hospital stays and better long-term outcomes are some of the evidence-based benefits the College’s members are being asked to highlight to patients. The campaign urges all surgeons to view patient consultations as ‘teachable moments’, during which patients may be more receptive to intervention and more motivated to quit. As part of the discussion of risks associated with a procedure, surgeons should outline the reduction in risk associated with smoking cessation, with the recommendation to stop at least two months before the operation.
  25. Content Article
    In July 2017, the Royal College of Surgeons of Edinburgh published a number of critical recommendations to government to greatly improve safety in the delivery of surgical treatment and patient care, with seven recommendations for best practice. The RCSEd surveyed opinions from a cross-section of the UK surgical workforce - from trainees to consultants - which highlighted broad inefficiencies on the frontline which impact the working environment and the delivery of a safe service. The report notes factors adversely affecting morale, including a lack of team structure, poor communication, high stress levels, and limited training opportunities. The report also records how staff, at times, feel diverted away from the patient-centred care they strive to deliver because of administrative and IT issues, and believe that being more innovative and efficient with existing resources could make a positive difference.
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