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Found 218 results
  1. Content Article
    Since the rise of COVID-19 in the UK, many consultations between surgeons and patients take place remotely, via phone or video. These consultations include pre-operative assessments, discussions between surgeons and patients about the benefits and risks of their surgery, and gaining the patient’s consent to proceed with treatment.  This transition to remote consultations has been central in the healthcare system’s effort to prevent transmission of COVID-19, and has required a series of adjustments by patients, hospitals and members of the surgical team. However, when it comes to the consent process, the same principles and requirements should apply as set out by the GMC and The Royal College of Surgeons of England, regardless of whether the conversation takes place face-to-face or via phone or video. In addition, during the COVID-19 period, the consent discussion should include further considerations to ensure that patients have the necessary information to make an informed decision about their treatment. This guide sets out the main principles of the consent process and provides advice on what additional information should be included in conversations with patients while COVID-19 is still prevalent in society.
  2. Content Article
    Virtual consultations, involving a telephone or video call between surgeon and patient, have been used in several surgical specialties prior to COVID-19. It has, however, played a particularly significant role during the current pandemic which is likely to continue in the post COVID-19 era and in future pandemic planning. This guide provides practical advice for surgeons and managers for delivering virtual consultations with surgical patients.
  3. Content Article
    Now that hospitals are resuming elective surgery, what should surgeons tell patients about the perioperative risks of COVID-19? Many surgeons are now resuming elective work, yet some make no mention of the additional covid-related risks. Although the British Association of Spine Surgeons and some private hospitals have produced information sheets for patients undergoing surgery during the pandemic, to our knowledge no formal guidance has been issued by the General Medical Council or the Royal College of Surgeons on obtaining consent in such circumstances. The surgical community remains unclear as to what to tell patients about to undergo elective surgery. In this BMJ Opinion article, Daniel Sokol  and Rupen Dattani argue that patients who undergo elective surgery should be told that, despite measures to limit the risk of infection, there remains a risk of contracting covid-19 in hospital, whether before, during or after the operation. 
  4. Content Article
    This interview is part of the hub's 'Frontline insights during the pandemic' series where Martin Hogan interviews healthcare professionals from various specialties to capture their experience and insight during the coronavirus pandemic. Here Martin interviews an oral surgeon who has been in the post for a year in a trust that covers two sites in the West Country. 
  5. Content Article
    In this BMJ Opinion article, David Rowland from the Centre for Health and the Public Interest discusses why he thinks 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. David believes that 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. Yet these concerns about how the private hospital system works and the associated patient risks it produces had been established in a number of previous inquiries.   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.
  6. Content Article
    The independent inquiry into how the rogue breast surgeon Ian Paterson was able to inflict harm on patients over more than decade described the UK healthcare system as “dysfunctional at almost every level.” In this BMJ analysis, Gareth Iacobucci summarises the findings of the inquiry.
  7. Content Article
    In 1991, the Institute of Medicine released a landmark report revealing that as many as 98,000 patients a year were dying due to avoidable medical error. But even more recent research indicates that estimate was, if anything, a drastic understatement of the patient-safety crisis in the US healthcare system. In Malpractice, neurosurgeon and attorney Dr. Larry Schlachter demonstrates how most patients enter the system without any idea of the risks they face due to a medical culture that avoids transparency, perpetuates an atmosphere of blind deference to doctors, and protects dangerous doctors from any accountability. Drawing on twenty-three years of experience, Dr. Schlachter recounts unbelievable stories that illustrate the host of risks patients face whenever they seek diagnostic evaluation or go under the knife. This book brings readers inside the healthcare citadel, exposing the flawed culture that can fuel egos and outlining the steps every patent should take to protect himself or herself in “a bitter pill for an industry that for many years has avoided the hardest conversations about patient safety.”—Dr. Michael Dogali, MDCM, FACS, president of Pacific Neurosurgery
  8. Content Article
    The struggle to perform well is universal, but nowhere is this drive to do better more important than in medicine. In his book, Atul Gawande explores how doctors strive to close the gap between best intentions and best performance in the face of obstacles that sometimes seem insurmountable. His vivid stories take us to battlefield surgical tents in Iraq, to a polio outbreak in India and to malpractice courtrooms around the country. He discusses the ethical dilemmas of doctors' participation in lethal injections, examines the influence of money on modern medicine and recounts the astoundingly contentious history of hand-washing. Finally, he gives a brutally honest insight into life as a practising surgeon. Unflinching but compassionate, Gawande's investigation into medical professionals and their progression from good to great provides a detailed blueprint for success that can be used by everyone.
  9. Content Article
    This book is an account of the life of a surgeon: what it is like to cut into people's bodies and the life and death decisions that have to be made. 
  10. Content Article
    The Independent Inquiry into the Issues raised by Paterson, published on Tuesday 4 February 2020, was prompted by the case of Ian Paterson, a breast surgeon who was convicted of wounding with intent some of the 11,000 patients he treated and jailed for 20 years in 2017. More than 200 patients and family members gave evidence as part of the Inquiry and it is estimated that he could have harmed more than 1000 patients.[1] The Inquiry gave those involved an opportunity to be heard and to learn how this happened, in both the NHS and the independent sector. It found that this “is the story of a healthcare system which proved itself dysfunctional at almost every level when it came to keeping patients safe, and where those who were the victims of Paterson’s malpractice were let down time and time again”.[2] At Patient Safety Learning we have reflected on some of the key patient safety themes that have emerged from this Inquiry and the actions required these issues. You can read Patient Safety Learning's full response here.
  11. Content Article
    The Parliamentary Under-Secretary of State for Health and Social Care, Ms Nadine Dorries, responds to the Paterson Inquiry in the House of Commons. It is followed by questions from MPs in the chamber and Ms Dorries' responses.
  12. 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 this independent Inquiry to investigate Paterson’s malpractice and to make recommendations to improve patient safety. This report presents the Inquiry’s methodology, findings and recommendations. More importantly, it tells the story of the human cost of Paterson’s malpractice and the healthcare system’s failure to stop him, and something of the enduring impact this has had on the lives of so many people.
  13. 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 this independent Inquiry to investigate Paterson’s malpractice and to make recommendations to improve patient safety. This report presents the Inquiry’s methodology, findings and recommendations. More importantly, it tells the story of the human cost of Paterson’s malpractice and the healthcare system’s failure to stop him, and something of the enduring impact this has had on the lives of so many people.
  14. Content Article
    In May 2012, a working group from The Royal College of Surgeons of Edinburgh issued a report examining the provision of care for victims of major trauma in Scotland. This report recommended the development of a trauma system across Scotland which focuses on reducing disability as well as mortality.
  15. Content Article
    The non-technical skills of surgeons (NOTSS) play a significant role in patient safety.  The aim of the NOTSS project was to develop and test an educational system for assessment and training of non-technical skills in the intra-operative phase of surgery. NOTSS is a behaviour rating system based on a skills taxonomy that allows valid and reliable observation and assessment of four categories of surgeons' non-technical skill: situation awareness, decision making, communication & teamwork, and leadership. These are the essential non-technical skills surgeons need to perform safely in the operating room and NOTSS allows measurement of several ACGME (Accreditation Council for Graduate Medical Education) competencies, including professionalism, interpersonal and communication skills, and systems-based practice. The skills taxonomy can be used to structure training and assessment in this important area of surgical competence.
  16. Content Article
    Surgery is lifesaving or life-enhancing for millions of patients every year. However, the operation is not in itself an isolated ‘event’: it is part of a process which includes preparation and recovery. Ensuring the quality of the entire perioperative pathway is important to achieving the best possible outcome for every patient.  This guidance is intended to be used by primary care, surgeons, anaesthetists, perioperative teams and preoperative assessment (POA) services. It applies to all patients who are being considered for surgery, or are on a waiting list for surgery in the non-emergency setting, irrespective of the magnitude of procedure or the type of anaesthesia contemplated. Its recommendations will support the care of individual patients, the recovery of elective services, and achieving key goals of the NHS Long Term Plan including reducing health inequalities and preventing serious health deterioration.
  17. Content Article
    A great animated video brought to you by No More Throw Away People – voiced by Brian Blessed, this tale of blobs and squares paints an accurate picture of how co-production matters. This short animation shows why its vitally important to engage and include our patients and service users in clinical system design.  It explains simply what may happen if we don't listen to all parts of our system to make care safer.
  18. Content Article
    In 2021, a multi-professional staff support group was established under the Northern Care Alliance NHS Foundation Trust’s Freedom to Speak Up process which raised new questions and concerns around the probity and clinical standards of a Consultant Spinal Surgeon (“Consultant Spinal Surgeon A”) whilst they were employed at Salford Royal NHS Foundation Trust (now part of the Northern Care Alliance NHS Foundation Trust) (“the Trust”). As a result, the Trust commissioned the Spinal Patient Safety Look Back Review (“SPSLBR”) and Investigation Group to evaluate these concerns, including obtaining independent expert advice.In January 2022, the Trust commenced the SPSLBR to investigate and manage patient safety concerns raised in respect of Consultant Spinal Surgeon A who was employed at Salford Royal NHS Foundation Trust (now part of the Northern Care Alliance NHS Foundation Trust) between 1991 and January 2015. This report outlines the investigation carried out by the SPSLBR Investigation Group on behalf of the Trust to investigate and manage potential Serious Incidents (“SI”) caused by the errors and omissions attributable to clinics, surgery and/or consultations undertaken by Consultant Spinal Surgeon A within the scope identified in the Terms of Reference. 
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