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Found 208 results
  1. News Article
    Great Ormond Street Hospital has written to the families of all children treated by one of its former surgeons after concerns were raised about his practice. Yaser Jabbar, a consultant orthopaedic surgeon, has not had a licence to practise medicine in the UK since 8 January, the medical register shows. Independent experts are now reviewing the concerns raised. The hospital trust said the Royal College of Surgeons (RCS) was asked to review its paediatric orthopaedic service following concerns raised by family members and staff. The RCS then raised concerns about Mr Jabbar, which the trust said were being taken "incredibly seriously" and would be reviewed by independent experts from other paediatric hospitals. A spokesman for the trust said: "We are sorry for the worry and uncertainty this may cause the families who are impacted. "We are committed to learning from every single patient that we treat, and to being open and transparent with our families when care falls below the high standards we strive for." The spokesperson said Mr Jabbar, reported to be an expert in limb reconstruction, no longer worked at the hospital. Read full story Source: BBC News, 28 February 2024
  2. Content Article
    Leadership in a safety culture environment is essential in avoiding patient harm. However, leadership in surgery is not routinely taught or assessed. This study aimed to identify a framework, metrics and tools to improve surgical leadership and safety outcomes. It identified three areas of leadership needed to build a culture of safety in surgery: Control risk (risk management) Drive progress (opportunity management) Rally support for the mission (people management) A leadership assessment tool (SLAM) was developed to provide objective metrics of surgical leadership behaviours based on nine key performance indicators.
  3. News Article
    Michelle Nolan takes morphine daily for the pain she has lived with for 14 years after botched surgery at the hands of a once renowned surgeon. She suffered irreversible nerve damage in July 2010 when John Bradley Williamson, a former president of the British Scoliosis Society, inserted a screw that was too long into her spine at Spire Manchester Hospital. The 49-year-old from Chadderton, near Oldham, needs crutches and lost her job as a legal secretary and later her house and marriage. “I lost everything because of him,” she said. “I thought I was the only one he had harmed.” She was not. Families and patients operated on by Williamson over two decades at the Salford Royal Hospital, Spire Manchester Hospital and the Royal Manchester Children’s Hospital, have formed a support group and want a full recall of all of his patients. They fear some could be suffering without realising they are victims of poor care. Williamson told the coroner investigating Catherine’s death that her surgery “progressed uneventfully” and “the blood loss was perhaps a little higher than one would usually anticipate but was certainly not extreme”. Yet days after her death, Williamson sent an internal letter to the hospital’s haematology department head Simon Jowitt describing the surgery as “difficult” and involving “a catastrophic haemorrhage”. Read full story (paywalled) Source: The Times, 18 February 2024
  4. News Article
    A senior surgeon has raised concerns about the way whistleblowers are dealt with, claiming he was sacked after speaking out. Serryth Colbert told the BBC that following attempts to "stop wrongdoing", he was investigated by the trust at Bath's Royal United Hospital. As a result, he said he was dismissed for gross misconduct in October 2023. The RUH said it has "never dismissed anybody for raising concerns and never will". It added that Mr Colbert's dismissal related to "significant concerns about bullying" and its investigation into his conduct was "thorough" and "robust". Mr Colbert said he raised safety concerns without regard for the impact it might have on his career. "It was never a question in my mind. This is wrong. I'm stopping the wrongdoing. I stand for justice. I stand to protect patients," he said. The BBC has seen no evidence his most serious concern was ever investigated and Mr Colbert is now taking the RUH to an employment tribunal. Read full story Source: BBC News, 9 February 2024
  5. Event
    This event gives trainees at all levels the opportunity to attend, present and gain feedback on their Audit and QI work. Further lectures will include the McKeown Medal Lecture, a keynote on patient safety and discussion from a Trainee Committee member. Trainees are invited to submit their abstracts for consideration for presentation at this event. Topics for submission: General Surgery, Trauma & Orthopaedic Surgery, Specialties & Common Interest and Patient Safety. Register
  6. Content Article
    In 2023, the Royal College of Surgeons of England surveyed the UK surgical workforce to identify the key challenges facing surgical teams and to inform workforce planning. Respondents included consultants, surgeons in training, Specialist, Associate Specialist and Specialty (SAS) surgeons, Locally Employed Doctors in surgery (LEDs) and members of the extended surgical team (EST).   Advancing the Surgical Workforce reveals a number of interesting insights and paints a picture of a surgical workforce working long hours and in stressful environments. Too many staff are trying to navigate a system which frustrates the delivery of surgical services rather than enabling them. Surgical trainees in particular are increasingly being affected by these pressures. 
  7. Content Article
    Left-handedness was historically considered a disability and a social stigma, and teachers would make efforts to suppress it in their students. Little data are available on the impact of left-handedness on surgical training and this report aimed to review available data on this subject. The review revealed 19 studies on the subject of left-handedness and surgical training. Key findings include: Left-handedness produced anxiety in residents and their trainers. There was a lack of mentoring on laterality. Surgical instruments, both conventional and laparoscopic, are not adapted to left-handed use and require ambilaterality training from the resident. There is significant pressure to change hand laterality during training. Left-handedness might present an advantage in operations involving situs inversus or left lower limb operations.
  8. News Article
    Theatre staff at a major hospital “deliberately slowed down” elective activity to limit the number of operations that could be done each day, an NHS England review has been told. The culture in theatres at the William Harvey Hospital in Ashford, run by East Kent Hospitals University Foundation Trust, was a “significant issue” according to an education quality intervention review report into trauma and orthopaedic training at the hospital. The review, dated October and made public by NHSE in December 2023, was launched after concerns were raised by staff at the trust in the General Medical Council’s national training survey, published every July. Problems raised by junior doctors and their supervisors to the NHSE review included perceptions that juniors were made to feel uncomfortable by the trauma theatre team and that there was also “animosity” from the trauma theatre team towards surgeons. The review said trauma theatre staff were heard “bragging” about their behaviour towards surgeons and that they resisted the number of cases scheduled on a list, claiming it was “unrealistic". Read full story (paywalled) Source: HSJ, 19 January 2024
  9. News Article
    Half of surgeons in England have considered leaving the NHS amid frustration over a lack of access to operating rooms, a new survey shows. More than 3,000 surgeons contemplated quitting the health service in the last year, with two-thirds reporting burn out and work-related stress to be their main challenge, a new survey by the Royal College of Surgeons England has revealed. As the NHS tries to reduce the 7.61 million waiting list backlog, the survey, covering one quarter of all UK surgeons, found that 56% believe that access to operating theatres is a major challenge. RCS England president, Mr Tim Mitchell, said: “At a time when record waiting lists persist across the UK, it is deeply concerning that NHS productivity has decreased. “The reasons for this are multifactorial, but access to operating theatres and staff wellbeing certainly play a major part. If surgical teams cannot get into operating theatres, patients will continue to endure unacceptably long waits for surgery. “There is an urgent need to increase theatre capacity and ensure existing theatre spaces are used to maximum capacity. There is also a lot of work to be done to retain staff at all levels by reducing burnout and improving morale.” Read full story Source: The Independent, 18 January 2024
  10. Content Article
    This narrative review in the journal Anaesthesia reviews the background to overlapping surgery, an approach in which a single senior surgeon operates across two parallel operating theatres. Anaesthesia is induced and surgery commenced by junior surgeons in the second operating theatre while the lead surgeon completes the operation in the first. The authors assessed whether there is any theoretical basis to expect increased productivity in terms of number of operations completed. A review of observational studies found that while there is a perception of increased surgical output for one surgeon, there is no evidence of increased productivity compared with two surgeons working in parallel. There is potential for overlapping surgery to have some positive impact in situations where turnover times between cases are long, operations are short and where ‘critical portions’ of surgery constitute about half of the total operation time. However, any advantages must be balanced against safety, ethical and training concerns.
  11. News Article
    A mother who endured a botched surgery at the hands of a disgraced neurosurgeon claims NHS Tayside tried to silence her against making complaints. Professor Sam Eljamel removed Jules Rose's tear duct during a failed attempt to operate on a brain tumour - setting the 55-year-old on a path to becoming a prolific campaigner for patients' rights. Ms Rose, however, has received sight of documents that show NHS Tayside writing to the then-health minister Humza Yousaf to say she had been "aggressive" and "vulgar" and they would no longer communicate with her. In a letter in response, Mr Yousaf says he sees no evidence of any such conduct by the mother-of-two and tells the health board to enter into mediation with her. Ms Rose said: "In the letter I have been given, Humza Yousaf writes back and say, 'She's quite right to feel aggrieved at the treatment she's received. "'Therefore, I suggest that you continue liaising with Miss Rose and enter into mediation.' "This was last November but I've only just had copies of the letters sent to me and when I saw them I thought, 'They've tried to shut me down, they're tried to silence me'." The ongoing dispute with NHS Tayside is as a result of Ms Rose's long-running campaign for justice for patients - thought to be as many as 270 - harmed by Eljamel while he was in the health board's employ. Read full story Source: The Herald, 16 December 2023
  12. Content Article
    These two Introductory Videos on Non-technical skills for surgeons (NOTSS) were produced by the University of Edinburgh in conjunction with the RCSEd for the ChM in Clinical Ophthalmology programme.  These videos introduce the principles behind the NOTSS system, and although they were made to accompany the ChM in Clinical Ophthalmology, they are suitable for all surgical specialties.
  13. News Article
    A surgeon has said it would have been "cruel and unacceptable" to have woken up a patient to get consent for a mesh operation. Anthony Dixon is accused of failing to provide adequate clinical care to five patients at Southmead Hospital and the private Spire Hospital in Bristol. He had pioneered the use of artificial mesh to lift prolapsed bowels. Mr Dixon appeared at a Medical Practitioners Tribunal Service (MPTS) hearing in Manchester on Thursday. He faces charges of performing procedures that were not "clinically indicated", failing to carry out tests and investigations and failing to obtain consent from patients. It followed complaints many had suffered pain or trauma after having pelvic floor surgery using artificial mesh, a technique known as laparoscopic ventral mesh rectopexy (LVMR). Giving evidence, he was asked why he did not consider waking up one female patient who underwent an LVMR, to get her consent to surgery. Mr Dixon said it would have meant giving her more drugs for pain relief and could have "multiplied the risks" to her. He is also accused of failing to advise patients about the risks of procedures, failing to discuss non-surgical options and dismissing patients' concerns when they experienced pain or other symptoms following surgery. Read full story Source: BBC News, 23 November 2023 Related reading on the hub: Woman’s mesh consent form was changed after signing – how can patients be better protected?
  14. Content Article
    The harsh reality of surgery often involves grappling with the distressing and emotionally taxing aspects of human suffering that many people outside of healthcare never witness. When complications occur, surgeons feel the weight of their responsibility and are often alone to ruminate with negative thoughts of self-doubt, sometimes leading to anxiety and depression. This article in The American Journal of Surgery examines existing literature on Second Victim Syndrome (SVS) specifically focusing on prevalence among surgeons and factors related to different responses. The authors identify women and junior surgeons at particularly high risk of SVS and peer support as a preferred method of coping but an overall lack of institutional support highlighting the need for ongoing, open conversations about the topic of surgeon well-being.
  15. Content Article
    Disruptive behaviour can have a significant impact on care delivery, which can adversely affect patient safety and quality outcomes of care. Disruptive behaviour occurs across all disciplines but is of particular concern when it involves physicians and nurses who have primary responsibility for patient care. There is a higher frequency of disruptive behaviour in neurologists compared to most other nonsurgical specialties. Disruptive behaviour causes stress, anxiety, frustration, and anger, which can impede communication and collaboration, which can result in avoidable medical errors, adverse events, and other compromises in quality care. Healthcare organisations need to be aware of the significance of disruptive behaviours and develop appropriate policies, standards, and procedures to effectively deal with this serious issue and reinforce appropriate standards of behaviour. Having a better understanding of what contributes to, incites, or provokes disruptive behaviours will help organizations provide appropriate educational and training programs that can lessen the likelihood of occurrence and improve the overall effectiveness of communication among the health care team.
  16. Content Article
    The depleting effect of repeated decision making is often referred to as decision fatigue. Understanding how decision fatigue affects medical decision making is important for achieving both efficiency and fairness in health care. In this study, Persson et al. investigate the potential role of decision fatigue in orthopaedic surgeons' decisions to operate, exploiting a natural experiment whereby patient allocation to time slots is plausibly randomised at the level of the patient. The results show that patients who met a surgeon toward the end of his or her work shift were 33 percentage points less likely to be scheduled for an operation compared with those who were seen first. In a logistic regression with doctor-fixed effects and standard errors clustered at the level of the doctor, the odds of operation were estimated to decrease by 10.5% for each additional patient appointment in the doctors' work shift. This pattern in surgeons' decision making is consistent with decision fatigue. Because long shifts are common in medicine, the effect of decision fatigue could be substantial and may have important implications for patient outcomes.
  17. Content Article
    Doctors are dying by suicide at higher rates than the general population—somewhere between 300 to 400 physicians a year in the US take their own lives. This article in The Guardian looks at why so many surgeons are dying to suicide and what can be done to stop the trend. It examines how the culture of working long hours and the expectation to be 'superhuman' leads surgeons to suppress their symptoms and avoid seeking help for mental health issues. The article also tells the story of US surgeon and President of the Association of Academic Surgery Carrie Cunningham, who has lived with depression, anxiety and a substance abuse disorder for many years.
  18. Content Article
    A recent report found that a third of female surgeons have been sexually harassed at work. In this opinion piece, Dr Liz O’Riordan speaks out about the abuse she suffered from male colleagues while working for the NHS. She describes her experiences, highlighting that incidents of sexual harassment are common amongst female surgical trainees who fear speaking out as it may affect their careers. She also draws attention to the fact that it is not just an issue amongst surgeons, but that many other healthcare professionals experience inappropriate sexual comments and behaviour while at work.
  19. News Article
    A police investigation into allegations of cover-up and medical negligence over dozens of deaths at the Royal Sussex county hospital (RSCH) in Brighton has been expanded to include more recent cases, amid internal claims about dangerous surgery. In June the Guardian revealed that Sussex police were investigating the deaths of about 40 patients in the general surgery and neurosurgery departments at the RSCH. The force initially said the investigation, since named Operation Bramber, related to allegations of medical negligence in these departments between 2015 and 2020. It has now extended the scope of the investigation to more recent cases, amid internal allegations that the departments continue to be unsafe and fail to properly review serious incidents. An insider said the police should review what was considered to be an avoidable death after a procedure in July. The source said some of the surgeons remained a danger to the public. “You would not want your family members touched by these people,” they said. They added: “This is not a historic issue, it is ongoing. The same surgeons that were involved in previous problems remain in place.” They cited a woman who lost the power of speech in April after an alleged mistake in surgery to remove a brain tumour led to a stroke, and a man who was left with a brain abscess in May after being operated on despite a heightened risk of infection. Read full story Source: The Guardian, 13 September 2023
  20. News Article
    A cosmetic surgeon has been suspended from the UK medical register for nine months for failures in obtaining informed consent, pressuring a patient into surgery by offering a discount, and laughing when passing on a patient’s complaint of sexual assault by another doctor. Ashish Dutta is the nominated member for the European Society of Aesthetic Surgery on the European Commission for Standardisation of Aesthetic Surgery Services. He is also an examiner for the World Board of Cosmetic Surgery. Read full story (paywalled) Source: BMJ, 27 November 2019
  21. News Article
    A cosmetic surgeon who did not have adequate insurance for operations that went wrong has been struck off. Dr Arnaldo Paganelli worked privately for The Hospital Group in Birmingham. The Medical Practitioners' Tribunal Service ruled his actions constituted misconduct. Four women took their case to the body and the tribunal heard evidence about his time at Birmingham's Dolan Park Hospital where he made regular trips from Italy to work. Lead campaigner Dawn Knight, from Stanley, County Durham, said too much skin was removed from her eyes during an eyelift in 2012 and they became "constantly sore". She told BBC Radio 4's You and Yours programme she felt relieved Dr Paganelli "cannot injure anyone else on UK soil" and called for the government to tighten regulation around cosmetic procedures to protect the public. "The process has been long, emotional and exhausting. This situation must never be repeated. After all, when are you more vulnerable than when under aesthetic at the hands of a surgeon who has no insurance?" Read full story Source: BBC News, 12 August 2020
  22. News Article
    MPs will investigate the sexual harassment and sexual assault of female surgeons taking place within the NHS. BBC News reported women being sexually assaulted even in the operating theatre, while surgery took place. And the first major report into the problem found female trainees being abused by senior male surgeons. The Health and Social Care Committee said it would look into the issue and its chair, Steve Brine, said the revelations were "shocking". "The NHS has a duty to ensure that hospitals are safe spaces for all staff to work in and to hold managers to account to ensure that action is taken against those responsible," Mr Brine said. "We expect to look into this when we consider leadership in the NHS in our future work." Read full story Source: BBC News, 13 September 2023
  23. News Article
    Female surgeons say they are being sexually harassed, assaulted and in some cases raped by colleagues, a major analysis of NHS staff has found. The Royal College of Surgeons said the findings were "truly shocking". Sexual harassment, sexual assault and rape have been referred to as surgery's open secret. There is an untold story of women being fondled inside their scrubs, of male surgeons wiping their brow on their breasts and men rubbing erections against female staff. Some have been offered career opportunities for sex. Nearly two-thirds of women surgeons that responded to the researchers said they had been the target of sexual harassment and a third had been sexually assaulted by colleagues in the past five years. Women say they fear reporting incidents will damage their careers and they lack confidence the NHS will take action. It is widely accepted there is a culture of silence around such behaviour. Surgical training relies on learning from senior colleagues in the operating theatre and women have told us it is risky to speak out about those who have power and influence over their future careers. Read full story Source: BBC News, 12 September 2023 Related reading on the hub: Breaking the silence: Addressing sexual misconduct in healthcare Calling out the sexist and misogynist culture within healthcare: a blog by Dr Chelcie Jewitt, co-founder of the Surviving in Scrubs campaign GMC's Good medical practice 2024
  24. Content Article
    This research examined sexual misconduct occurring in surgery in the UK, so that more informed and targeted actions can be taken to make healthcare safer for staff and patients. A survey assessed individuals’ experiences with being sexually harassed, sexually assaulted, and raped by work colleagues. Individuals were also asked whether they had seen this happen to others at work. Compared with men, women were much more likely to have seen sexual misconduct happening to others, and to have it happen to them.  Individuals were also asked whether they thought healthcare-related organizations were handling issues of sexual misconduct adequately; most did not think they were. The General Medical Council (GMC) received the lowest evaluations.  The results of this study have implications for all stakeholders, including patients. Sexual misconduct was commonly experienced by respondents, representing a serious issue for the profession. There is a widespread lack of faith in the UK organizations responsible for dealing with this issue. Those organizations have a duty to protect the workforce, and to protect patients. Further reading: Breaking the silence: Addressing sexual misconduct in healthcare Calling out the sexist and misogynist culture within healthcare: a blog by Dr Chelcie Jewitt, co-founder of the Surviving in Scrubs campaign GMC's Good medical practice 2024
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