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Found 70 results
  1. Content Article
    Waiting lists for some procedures in Devon have been cut by converting a Nightingale hospital into a protected elective centre delivering additional orthopaedic, ophthalmology and diagnostic activity. Cooperation between clinicians from different trusts has resulted in innovative ways of working. The Devon integrated care system has worked with local trusts – principally the Royal Devon University Health Foundation Trust but also Torbay and South Devon Foundation Trust and University Hospitals Plymouth Trust – to deliver the extra capacity. Key benefits and outcomes Patients who would have faced a long wait from across Devon are being seen more quickly in a facility that is not at risk of cancellation from emergency pressures. Shorter stays for orthopaedic patients receiving hip and knee replacements, many of whom can be discharged on the same day as their operation. The centre has been a catalyst to encourage a ‘system first’ mindset.
  2. Content Article
    Key findings National Hip Fracture Database (NHFD) The number of hip fractures changed very little during the pandemic, so this is an ideal marker of the pandemic’s impact on the care of frail and older people and shows how successive waves of Covid-19 affected outcomes (mobility, return home, length of stay and mortality) in Wales. National Audit of Inpatient Falls (NAIF) There were approximately 12,500 inpatient falls in 2021. These led to: over 195 hip fractures loss of confidence and slower recovery distress to families and staff litigation against health boards. Fracture Liaison Service Database (FLS-DB) Based on 1,956 fragility fractures in 2020 and 2,033 fragility fractures in 2021, the number receiving FLS assessment within 12 weeks was similar in 2020 and 2021 (64% and 65% respectively). Recommendations Local health boards should ensure that they have appointed an orthogeriatrician and that they actively support their leadership of multidisciplinary care in each trauma unit. Local health boards should ensure that falls teams in acute, community and mental health hospitals are included in quality improvement activities and are using the data from the National Audit of Inpatient Falls. With falls teams reviewing health board level data and implementing focused quality improvement interventions should help improve the quality and safety of care in hospitals. Health boards without an FLS should contact the Royal Osteoporosis Society and use their implementation toolkit to support them in preparing a business case. Health boards that already have an FLS should ensure it is actively participating in the FLS-DB, and meeting its expected outcomes as defined by the FLS-DB’s set of KPIs.
  3. Content Article
    The resources below have been categorised into the three audits within FFFAP: National Hip Fracture Database (NHFD) National Audit of Inpatient Falls (NAIF) Fracture Liaison Service Database (FLS-DB) Hip fracture: a guide for families and carers All about your hip fracture and what to expect on the road to recovery Recovering after a hip fracture: helping people understand physiotherapy in the NHS How should your hospital prevent and respond falls during your stay Inpatient falls Falls prevention in hospital: a guide for parents, their families and carers What should happen if you or someone you know experiences a fragility fracture Six golden rules for stronger bones Strong bones after 50 - after staying on treatment
  4. Content Article
  5. News Article
    Nursing shortages are contributing to children waiting up to three times longer for spinal surgery than pre-pandemic, a top surgeon has claimed. Chris Adams says up to one in four operations are cancelled at NHS Lothian, with staffing the main reason. Mr Adams also claims that some children are not being put on waiting lists as early as they should be. NHS Lothian disputes some of Mr Adams' statements but says "significant pressures" are affecting waiting times. The senior clinician, one of Scotland's three paediatric spinal surgeons, said he was speaking out of behalf of spinal patients and their families The surgeon's claims appear in a new BBC Disclosure investigation into Scotland's NHS, which reveals that some children are waiting up to three times longer than pre-pandemic for spinal surgery, with some waiting more than a year. At least 51 out of a possible 190 planned spinal surgeries at RHCYP were cancelled at short notice in 2022, with nursing shortages understood to be the main cause Read full story Source: BBC News, 7 March 2023
  6. News Article
    Changes to hip and knee surgery could halve waiting lists at one hospital within a year, say doctors. Tweaks to surgeries at the Princess of Wales hospital in Bridgend have allowed more patients to be sent home on the same day. Therefore, a shortage of hospital beds is not a barrier for them. It comes as over 37,000 orthopaedic patients are waiting over one year for surgery in Wales. Consultant orthopaedic surgeon Keshav Singhal said a number of "minor tweaks" were made to the procedure "but all of them add up to a huge effect". He said the anaesthetic and pain medication given to patients is "fine-tuned" to reduce pain and nausea after the operation and extra time is spent pinpointing any potential area of bleeding and cauterising it to "prevent wound leakage". "In day surgery we are not constrained by beds - there are no beds here," said Mr Singhal. "Patients can come in, be very well cared for in a state of the art day-surgery unit, and go home in the evening, and that totally cuts down on the inpatient beds." Read full story Source: BBC News, 10 February 2023
  7. 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
  8. News Article
    Artificial hip and knee joints that have to be removed after failing early are to be examined routinely to save the NHS £200million a year – and reduce unnecessary pain for patients in future. Less than 1 in 100 removed implants are examined to see why they failed, so surgeons don’t learn what went wrong or pick up on potential scandals. Consultant orthopaedic surgeon Raghavendra Sidaginamale, of North Tees and Hartlepool NHS Trust, said: "Most removed implants are put in the bin. A wealth of information goes down the drain." Now the NHS is setting up an Implants Analysis Service, enabling hospitals to send them off to be analysed for signs of unusual wear or chemical degradation. Each year, 15,000 hip and knee replacements are replaced. If this happens within ten years, they are deemed to have failed early. Jason Wilson, of the IAS, said they are ‘like a black box flight recorder in a plane’, adding: "They hold a wealth of information we can learn from." Read full story Source: Daily Mail, 29 January 2023
  9. Content Article
  10. Content Article
    Summary recommendations The National Screening Committee should reconsider the case for a targeted national screening programme to detect high fracture risk in 2023. The Government should instigate a public health campaign to address the lack of awareness and complacency in the public about bone health. Osteoporosis must be given parity with other long-term conditions, and defined as such within the NHS, to allow enhanced and equitable care and management. NHS England must outline plans to expand DXA services to deliver and exceed their recommended 4% increase in capacity in order to tackle the current backlog and future-proof services, and improve access by including DXA in minimum specifications for Community Diagnostic Centres. Every individual who requires ongoing management or surveillance to reduce their fracture risk should have a personalised ‘bone health management plan’ with a specified timescale for reviews. ICSs should utilise the breadth of skills and expertise within the multi-disciplinary team to optimise and streamline local management pathways for people at high risk of fragility fracture. Establish a new National Specialty Adviser for Fracture prevention and Osteoporosis within the NHS England and NHS Improvement clinical advisory structure, and equivalent in Scotland, Wales and Northern Ireland. The APPG recommends proportionate recognition of the importance of osteoporosis throughout healthcare education, with increased prominence in undergraduate and post-graduate healthcare professional training. Specialist services must support primary care colleagues to provide the best care to patients. All relevant national guidelines should be reviewed to better support imaging of the spine where there is a suspicion of vertebral fracture, particularly in patients with risk factors for osteoporosis. NHS England must provide sufficient funding for ICSs to deliver against national quality standards and NICE clinical guidance.
  11. Content Article
  12. News Article
    Orthopaedic patients in NHS Highland face a wait of up to seven years for surgery, new research has found. A University of Aberdeen study said the worst case estimate would apply if surgical rates did not increase for those listed in July this year. Researchers also discovered the average wait across Scotland's 14 health boards could be as long as two years and three months. The Scottish government said it was working to maximise NHS capacity. Luke Farrow, clinical research fellow, warned that the significance of the delays could not be underestimated. He said: "Prolonged waits for certain orthopaedic procedures can have a major negative impact on patient health. "This occurs both in terms of deterioration in quality of life whilst awaiting surgery, as well as potential negative connotations for post-operative recovery and longer-term health in addition to reduced independence and increased social care needs." Read full story Source: BBC News, 14 December 2022
  13. Content Article
    December issue Delphi Study Round One – A study across NHS England Hospital Trust operating theatres. Managing NHS backlogs and waiting times in England. Steroid injections worsen knee arthritis, according to two new studies. First robotic hysterectomy completed in Wales. World’s first algae-based local anaesthetic another step closer to reality. How new bacterial species siscovered in Asian soil could help battle against antibiotic resistance November issue New research calls for all health and care staff to be trained in AI Reducing noise in operating theatre improves children’s behaviour after surgery, study finds Brain tumour patient operated on awake while playing saxophone No difference between spinal versus general anaesthesia in patients having hip fracture surgery finds study October issue Why are intra-operative surgical Never Events still occurring in NHS operating theatres? Radical rethink needed to improve safety in health and social care. World Anaesthesia Day 2022: History, significance, celebrations and theme. £4 million “space-age” operating theatre will help bring down eye surgery backlog. Two thirds of nurses choosing between food and fuel as cost of living bites and one in five turn to food banks. ‘An inspirational story’: Hartlepool cleaner changes career to become hospital nurse. September issue Service evaluation of the current World Health Organisation’s Surgical Safety Checklist in spine surgery at the University Hospitals of Derby & Burton. Could this lead to a change in NHS Improvement? The Anaesthetic Gas Scavenging System Project. Cancelled operations could be prevented by an earlier anaemia test and time to prepare. The top 10 things experts need you to know about screening during Gynaecological Cancer Awareness Month September 2022 £35.5m for New Friarage Hospital Operating Theatres. New robotic surgical system revolutionises patient care at UHCW. Insourcing: Giving NHS operating theatre teams a helping hand. Arterial stiffness raises blood pressure in adolescents via insulin resistance. Birmingham’s Public Health Chief is among sector leaders to receive university honours,
  14. 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
  15. News Article
    More than 10,000 patients have been given a faulty knee replacement which doubles the risk of joint failure, The Telegraph has disclosed. The implant, which has been in use since 2003, was withdrawn from the market by its manufacturer in October. The Telegraph has learnt that UK health regulator the Medicines and Healthcare products Regulatory Agency (MHRA) is now preparing to issue a field safety notice, prohibiting its use. Available across multiple NHS trusts, the implant, manufactured by Zimmer Biomet, a US firm, has been shown to fail in up to 7% of patients after ten years - twice the accepted failure rate of 3.5% set by the National Joint Registry. One study found the failure rate to be much higher at 17.6% - more than five times as high as the accepted level. This can have catastrophic consequences for patients, many of whom are elderly, as undergoing a second knee replacement operation poses a much greater risk. The knee replacement, called the Nexgen, is part of a family of Zimmer Biomet implant devices with 88 possible variants. In total, these have been given to over 183,000 people in England, Wales and Northern Ireland, and more than five million worldwide. Of these variants, three combinations have been proven to place patients at a dangerously high risk of joint failure. Read full story (paywalled) Source: The Telegraph, 5 December 2022
  16. News Article
    When 85-year-old Koulla fell at home, her family immediately rang for an ambulance. She was in agonising pain - she had broken her hip. It was around 8pm. It took another 14 hours for an ambulance to get to her, leaving her pregnant granddaughter to care for her through the night. When they arrived the crews were able to give her pain relief and quickly transported her to the Royal Cornwall Hospital. But there the wait continued - there were around 30 ambulances queuing to handover patients to A&E staff. It was another 26 hours before she was taken inside to A&E. She then faced many hours in A&E before being taken for surgery. Koulla's daughter, Marianna Flint, 53, said: "It was awful. You feel helpless because you're giving your trust over to them to look after a family member who's in agony and who needs surgery." She has since received a written apology from the Royal Cornwall for the care provided to her mother in August. Ms Flint said: "I almost feel sorry for those looking after her. It's not down to them. There was no room inside to accept her in." Read full story Source: BBC News, 1 December 2022
  17. Content Article
    Key messages Fall-related fractures can happen on any ward There is only one chance to get it right High quality multi-factorial risk assessment (MFRA) is necessary to ensure important fall risk factors are addressed Accurate post-fall checks support effective care All inpatients should have access to flat lifting equipment to move patients from the floor Inpatients who sustain a femoral fracture should have immediate access to analgesia Improvement activities should focus on fall prevention and post-fall management processes
  18. Content Article
  19. Content Article
  20. News Article
    Spire Healthcare, a private healthcare company, has confirmed it will recall patients amid concerns about a surgeon's operations. It comes after Walsall Healthcare Trust announced it was recalling 600 NHS patients who underwent shoulder surgery performed by Mr Shah. Spire said it was committed to promptly responding to concerns and undertaking good governance. Mr Shah is the third shoulder surgeon since 2019 operating from Spire premises to have had issues. One private patient, Martin Byrne, said he was in immediate pain after an operation to repair his rotator cuff performed by Mr Shah at Spire, Little Aston, in Sutton Coldfield in August 2018. He had a further two operations, one on the NHS by Mr Shah and another at Spire, but has since been told nothing more can be done surgically. "This has broken me as a man," he said. "I can't do the things that I used to do with my children. I can't help out lifting at work. "I have sat on the bed crying at night from the pain and I feel that Spire have offered me a lot of tea and sympathy, but they have just fobbed me off. "In my opinion, he has ruined me." Read full story Source: BBC News, 11 October 2022
  21. Content Article
    Recommendations Early mobilisation Collaborative multidisciplinary working is needed to ensure that pain, hypotension and delirium do not hold back early progress in physiotherapy. Patients should be helped to get up by the day after surgery – such ‘mobilisation’ is key to patients’ wellbeing and avoidance of complications such as delirium, deconditioning and pressure damage. This mobilisation is just one element of the physiotherapy provided to patients, but it is the key measure that the National Hip Fracture Database (NHFD) will use to drive forward local quality improvement after Hip Sprint. Local therapy teams should review how they record patients’ progress, so that there is clear communication of patient outcomes to multidisciplinary team (MDT) colleagues and correct reporting to the NHFD. Intensive rehabilitation Hip fracture programmes should invest in early intensive rehabilitation to maximise the number of people who can be discharged directly home from the acute orthopaedic ward. Hospital physiotherapy teams should put in place systems to ensure that more intense rehabilitation includes attention to strength, balance and endurance, as well as mobility. Physiotherapists should consider how they are teaching and working with colleagues, as Hip Sprint found little evidence that therapy work is being delegated to other staff; a missed opportunity for multidisciplinary working. Local governance and quality improvement Physiotherapists, surgeons, anaesthetists, orthogeriatricians and nurses should all attend monthly hip fracture programme clinical governance meetings. Physiotherapists, surgeons, anaesthetists, orthogeriatricians and nurses should review their own unit’s Hip Sprint data at the NHFD and agree on a local quality improvement action plan. Staffing levels affect patient care, especially after the first postoperative day and at weekends, and physiotherapists should continue the transparent approach developed in Hip Sprint to highlight concerns if staffing limits their ability to deliver care as per NICE recommendations.
  22. Content Article
  23. 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
  24. News Article
    Several patients awaiting treatment on the Welsh NHS have turned to surgery abroad as waiting lists hit record levels again. Waiting lists hit a record of almost 750,000 in July prompting surgeons to demand "urgent action". The Welsh government said waits of more than two years were improving. Health Minister Eluned Morgan said there were "signs of hope" that a target for no-one to wait more than a year for their first outpatient appointment could be hit by the end of 2022. But the Conservatives accused Labour ministers of having "little strategy" to tackle "extraordinary waits", while Plaid Cymru called for action "to increase capacity and improve patient flow". Sharon Seymour, 62, from Monmouthshire, went to Lithuania after being told she faced a "two years plus" wait for a hip replacement. The council worker said she also found out about Lithuania from other patients in Wales and had her surgery in July. She said the fact that people were taking matters into their own hands suggested the health system in Wales was not working. "[The NHS] does need a huge cash injection... a rethink completely now," she said. "The sadder point is the people who have the ability to pay will get it. "The inequality between those who can't and that [can is] a sad state of affairs," she added. "It's only through luck that we've managed to find the funds to go to Lithuania. "For most people, it isn't an option and that's horrible." Read full story Source: BBC News, 22 September 2022
  25. 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
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