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Found 212 results
  1. News Article
    A trust which last year was ordered to pay a whistleblowing nurse nearly £500,000 must now give a surgeon £430,000 to compensate him for the racial discrimination and harassment he faced after raising patient safety concerns. Tribunal judges previously upheld complaints made by Manuf Kassem against North Tees and Hartlepool Foundation Trust and have published a remedy judgment this week setting out the levels of damages the NHS organisation must pay. The judgment comes just over a year after a former senior nurse at the trust was awarded £472,600 for unfair dismissal after she warned high workloads had led to a patient’s death. Mr Kassem raised 25 concerns regarding patients’ care during a grievance meeting in August 2017. He alleged patients had “suffered complications, negligence, delayed treatment and avoidable deaths”. A trust review concluded appropriate processes were followed in the 25 cases. However, the tribunal ruled Mr Kassem was subjected to detriment after making the protected disclosure. According to the judgment, Mr Kassem was subsequently removed from the on-call emergency rota and his identity as a whistleblower was revealed by clinical director Anil Agarwal. In September 2018, he was the subject of a disciplinary investigation following several allegations against him made by colleagues and others, which concerned “unsafe working practices,” “excessive working hours,” and “potential fraudulent activity.” The investigation lasted 17 months and none of the allegations against Mr Kassem were upheld or progressed to a disciplinary hearing. Read full story (paywalled) Source: HSJ, 15 March 2024
  2. Content Article
    The Northern Care Alliance NHS Foundation Trust (NCA) has published an independent report by Barrister Mr Carlo Breen into the Trust’s historic management of concerns in relation to a Consultant Spinal Surgeon. The investigation found that certain patients, relatives and colleagues had been significantly let down. The Trust fully accepts the findings and apologises for any distress or harm caused by the issues identified within the report. In response to a significant Freedom to Speak Up concern, NCA Chief Executive Dr Owen Williams commissioned Mr Breen in March 2022 to investigate how historic concerns and complaints dating back to 2007 relating to this consultant’s conduct, probity and capability had been previously handled and what lessons could be learned. Mr Breen’s review is the second review commissioned by the Trust relating to these important matters. The first report detailed the findings of the “Spinal Patient Safety Look Back Review” and was published last year. Dr Williams said: “I am deeply sorry and apologise to the patients and their families for the care which is described in both Mr Breen’s report released today and the patient look back review from last year. “I also apologise to my NCA colleagues who have had to work too hard to get their concerns heard and thoroughly investigated. I am thankful that they persisted. We will do right by them and our patients by continuing to put into practice what we have learned”.
  3. News Article
    It is a high-stakes scenario for any surgeon: a 65-year-old male patient with a high BMI and a heart condition is undergoing emergency surgery for a perforated appendix. An internal bleed has been detected, an anaesthetics monitor is malfunctioning and various bleepers are sounding – before an urgent call comes in about an ectopic pregnancy on another ward. This kind of drama routinely plays out in operating theatres, but in this case trainee surgeon Mary Goble is being put through her paces by a team of researchers at Imperial College London who are studying what goes on inside the brains of surgeons as they perform life-or-death procedures. Goble looks cool and collected as she laparoscopically excises the silicon appendix, while fending off a barrage of distractions. But her brain activity, monitored through a cap covered in optical probes, may tell a different story. The researchers, led by Daniel Leff, a senior researcher and consultant breast surgeon at Imperial College healthcare NHS Trust, are working to detect telltale signs of cognitive overload based on brain activity. In future, they say, this could help flag warning signs during surgery. “The operating theatre can be a very chaotic environment and, as a surgeon, you have to keep your head and stay calm when everyone is losing theirs,” said Leff. “As the cognitive load increases, it has major implications for patient safety. There’s no tool we can use to know that surgeon is coping with the cognitive demands of that environment. What happens when the surgeon is maxed out?” In the future, Leff envisages a system that could read out brain activity in real-time in the operating theatre and trigger an intervention if a surgeon is at risk of overload. Read full story Source: 2 March 2024
  4. News Article
    A surgeon sacked by a hospital after raising safety concerns has accused the trust of a cover-up after a patient was partially blinded during an operation. Juanita Graham, 41, lost the sight in her left eye during an operation at Bath's Royal United Hospital (RUH) in 2019. She is now suing the trust. Serryth Colbert said he was put down as the lead author on an investigation into the incident, but said he "did not write a word" of it. Mr Colbert has described the hospital investigation into Mrs Graham's operation as "deeply flawed". The surgeon, who specialises in the head, neck, face and jaw, has made several serious allegations about patient safety at the RUH, and believes these claims led to him being regarded as a troublemaker and dismissed in October 2023. Mrs Graham, from Trowbridge, said she was still traumatised by the operation on her eye. "I remember coming round, seeing the time and felt like a gush and I couldn't see," she said. "The next time I remember waking up again, I thought it was my partner but it was a surgeon and he was crying. I said 'what's gone wrong?'". After the operation, a Root Cause Analyses (RCA) report produced by the trust said the hospital was not to blame, although it did say the risks could have been explained more clearly to Mrs Graham. Mr Colbert, whose name was added as the lead investigator, said his only involvement in the report was when he was called on the phone by a nurse, who he said did the RCA, to explain what the operation involved. The 48-year-old surgeon said: "I have been put down here to my amazement as the lead author on this. "That is not correct. I did not write a word of this. "The conclusion is the root cause of the complication was down to a bit of paperwork which could have been performed a bit better. "The root cause was not down to paperwork. It was all covered up... that was indefensible." Read full story Source: BBC News, 29 February 2024
  5. 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
  6. 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.
  7. 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
  8. 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
  9. 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
  10. 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. 
  11. 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.
  12. 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
  13. 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
  14. 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.
  15. 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
  16. 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.
  17. 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?
  18. 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.
  19. 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.
  20. 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.
  21. 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.
  22. 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.
  23. 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
  24. 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
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