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Showing results for tags 'Surgery - Paediatric'.
Found 22 results
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News Article
How NHS strikes put thousands of sick children in peril
Patient Safety Learning posted a news article in News
Hundreds of children’s appointments – including for lifesaving operations and cancer treatments – have been cancelled on each day that NHS strikes took place over the last year, as hundreds of thousands of youngsters languish on the waiting list for treatment, The Independent can reveal. More than 20,000 paediatric treatments and surgeries were shelved because of the walkouts, while the families of 400 children were told that their lifesaving operations had been cancelled. With junior doctors due to stage the longest strike in NHS history this week – for six days, starting on Wednesday – the problem is set to get worse. Dr Camilla Kingdon, president of the Royal College of Paediatrics and Child Health, warned that long waits for children can be particularly damaging, and can have a lifelong impact as treatment is often time-critical. She said that children are seldom prioritised in national policy-making, and urged the government to put children’s needs “back on the agenda”. Read full story Source: The Independent, 2 January 2024 -
Event
Future surgery 2022
Patient Safety Learning posted an event in Community Calendar
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 -
Content ArticleSince 2015 Quomodus has developed the digital course 'Diathermy – a practical guide to electrosurgery' for surgeons and other professional users of electrosurgery. The 30-minute course covers the history of electrosurgery, indication and proper use, adverse effects and complications associated with the use of diathermy. The course has been tested and quality assured by health professionals in Scandinavia. The course is flexible, user friendly and applies to all models of diathermy equipment currently on the market.
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Content ArticleThis US study, published in Pediatrics, found that even among apparently healthy children, being African American is strongly associated with a higher risk of postoperative complications and mortality. Mechanisms underlying the established racial differences in postoperative outcomes may not be fully explained by the racial variation in preoperative comorbidity.
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Content ArticleThe Inquiry into the management of care of children receiving complex heart surgery at the Bristol Royal Infirmary. View all of the material published throughout the course of the Inquiry.
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News ArticleA leading NHS children’s hospital is reviewing the care 721 patients received after an investigation found that children treated by one of its surgeons came to “severe harm” during limb reconstruction operations. Great Ormond Street hospital (Gosh) in London has offered its “sincere apologies” to children who have suffered what the Sunday Times reported was in some cases lifelong damage. Some of the children were left with one leg up to 20cm shorter than the other, the paper reported, while others are still in chronic pain years after their treatment, and one had a limb amputated – an outcome that experts said later could have been avoided. An external review of the care of 39 of the 721 patients has found that 13 came to “severe harm”, another nine suffered “low/moderate harm”, while two cases have been referred for peer review, and the other 15 experienced no harm. The children are reported to have been treated byYaser Jabbar, a consultant orthopaedic surgeon. Jabbar’s behaviour became a concern after the hospital asked the Royal College of Surgeons (RCS) in 2022 to investigate the performance of its paediatric surgery department and patient outcomes, after staff and families voiced concerns about the quality of care it provided. A spokesperson for Gosh said in a statement: “As part of the review, the RCS raised concerns around the practice of a surgeon who no longer works at the trust, and other practice within the service. We are taking these concerns incredibly seriously. “We have contacted all patients of the surgeon and a group of independent experts from other paediatric hospitals are reviewing the care of all the patients of this surgeon. We are incredibly sorry for the worry and uncertainty this review may cause them.” Read full story Source: The Guardian, 8 September 2024
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News Article
Children’s surgery backlog grows as NHS prioritises adult waiting lists
Patient Safety Learning posted a news article in News
Hundreds of thousands of children are waiting for surgery as new figures show the backlog has spiralled by almost 50 per cent in two years. The latest NHS data for December lays bare the parlous state of paediatric medicine, with NHS leaders and doctors warning that adult care is being prioritised over children’s. In December 2022, 364,000 children were waiting for treatment, from neurosurgery to ear, nose and throat operations, while a further 200,000 needed community services such as speech and language therapy. The surgery figure is up by 48%t since April 2021 – a far bigger increase than was seen in the overall NHS waiting list, which grew by 36% over the same period. Mike McKean, vice-president of policy at the Royal College of Paediatrics and Child Health, said “Lengthy waits are unacceptable for any patient, but for children and young people, waits can be catastrophic, as many treatments need to be given by a specific age or developmental stage. It is not the same as for adults. If you miss the right window to treat a child, or wait too long, the consequences can be irrevocable.” Read full story Source: The Independent, 19 February 2023 -
News ArticleHospitals are failing to tackle spiralling children's surgery waiting lists as the backlog hits more than 400,000 for the first time. Leaked documents show children’s waiting lists for both inpatient and outpatient care are “increasing at double the rate of adults” and, despite efforts, services have failed to catch up after they were paused during the pandemic. NHS leaders have repeatedly raised concerns about the backlog amid warnings that services for young people have been “deprioritised” to cut adult lists. One NHS leader warned that the long waits would be likely to affect some children’s “ability to lead full and active lives” and worsen existing inequalities between adult and children’s care. Read full story Source: The Independent, 11 May 2023
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News ArticleResearch led by Trinity College in Ireland has found that a regulation which came into effect in May 2021 with the aim of improving the oversight of medical devices in Ireland is leading to unintended consequences which may put some surgeries for children, and the treatment of rare diseases, at risk. The study has been published in the journal Pediatric Cardiology. Medical devices include a great diversity of technologies, which are evaluated and approved in the European Union (EU) according to a revised law that came into effect on 26 May 2021, known as the Medical Device Regulation or MDR (EU 745/2017). It has a transition period that allows products that were approved under the previous rules (the EU Medical Device Directives) to continue to be marketed until 26 May 2024 at the latest. As a result of a series of unforeseen factors, there is a possibility that the MDR may result in products becoming unavailable, with the consequent risk of a loss of some interventions that are reliant upon those devices. Devices that are used for orphan or paediatric indications are particularly vulnerable to this. The paper provides an example of one device, the Rashkind balloon catheter, first developed by Dr William Rashkind in 1966 to open the upper chambers in the heart in neonates with congenital heart disease. A number of these balloons were once available in Europe and now there is only one. This device may become unavailable next year. If this happens, it will not be possible to continue this procedure, and alternative surgeries or treatments are far less optimal. The paper also describes the timeline and cost of bringing the device to market in the EU, the US and Canada, and the cost and time needed to access the EU market has become much greater. Researchers believe there is now an urgent need for policy to be developed to protect essential medical devices for orphan indications and for use in children, to ensure that necessary interventions can continue, and to ensure a more sustainable system in Europe over the longer term. Read full story Source: Trinity College Dublin, 20 October 2022
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Content ArticleThis article, published in BMJ Quality and Safety, examines the relationships between non-routine events, teamwork and patient outcomes in paediatric cardiac surgery. Structured observation of effective teamwork in the operating room can identify deficiencies in the system and conduct of procedures, even in otherwise successful operations. High performing teams are more resilient, displaying effective teamwork when operations become more difficult.
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Content ArticleNHS colleagues are working hard to restore elective care, but data shows that activity for children and young people (CYP) is still below pre-pandemic levels and recovery remains behind rates seen in adult services. The specialties of ENT, dental services, ophthalmology, urology, and trauma and orthopaedics (including spinal surgery) are especially challenged, with the longest waiting lists for surgery for young patients. Getting It Right First Time (GIRFT) has supported NHS England’s drive for CYP elective recovery by developing concise guidance –Closing the gap: Actions to reduce waiting times for children and young people – offering ten actions which can help reduce waiting times for children, as well as quick links to data, resources and best practice case studies. The ten actions address how to improve theatre capacity, increase theatre utilisation and streamline pathways of care, and include practical measure such as adding extra sessions or ‘super events’ for children’s surgery, avoiding procedures of limited medical benefit by using clinical decision tools, and staggering children’s admission times. The guidance links to a series of case studies demonstrating how teams across England have taken innovative measures to address their waiting times.
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Content ArticleGetting It Right First Time (GIRFT) is designed to improve the quality of care within the NHS by reducing unwarranted variations. By tackling variations in the way services are delivered across the NHS, and by sharing best practice between trusts, GIRFT identifies changes that will help improve care and patient outcomes, as well as delivering efficiencies such as the reduction of unnecessary procedures and cost savings. In England, there are around 200 specialist paediatric surgeons working across 22 specialist trusts. This report presents recommendations to improve surgery for children based on visits to these specialist centres and 67 high-volume, non-specialist trusts. Key recommendations include: delivering surgery for the most complex conditions in fewer centres of expertise. reducing the number of unnecessary operations. increasing the scope of day surgery. You will need a FutureNHS account to view this report, or you can view a short video summary which includes key recommendations.
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Content ArticleThis infographic by the Royal College of Anaesthetists shows some of the common events and risks that healthy children and young people of normal weight face when having a general anaesthetic (GA) for routine surgery. It highlights that modern anaesthetics are very safe and that most common side effects are usually not serious or long lasting. It also outlines the conversations children and their families should expect to have with their anaesthetist prior to their procedure.
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Content Article
This online comic has been developed by the Royal College of Anaesthetists and the Association of Paediatric Anaesthetists of Great Britain and Ireland to help children aged 7-11 understand what it’s like to have a general anaesthetic, using familiar Beano characters to help reduce any anxiety they may have about surgery. It is a fun and playful way to help children understand more about their operation and how to prepare for it, and includes links to other resources. Readers can accompany Dennis on a fun-filled journey as he prepares to have his tonsils removed, from diagnosis to discharge from hospital. The comic answers children's questions, including: what is a general anaesthetic and is it safe? how will I feel when I wake up? how can I prepare for my operation? what should I do if I am worried or have questions? 'Dennis has an anaesthetic' will also help children and their parents and carers understand what happens in the run-up to an operation, the care children will need afterwards and how they can best prepare. -
Content ArticleJoin Claire Morgan, Consultant in Restorative Dentistry and Deputy Chair of the College’s Patient Safety Group, and Gregory Ekatah, Consultant Colorectal Surgeon and host of RCSEd’s Let’s Talk Surgery podcast, as they speak with Professor Sanjiv Sharma, Paediatric Intensive Care Consultant and Chief Medical Officer at Barts Health, about his leadership journey, challenges, and reflections on WPSD 2025. Further reading on the hub: Patient Safety Learning: World Patient Safety Day 2025 Patient safety for babies and children: key resources World Patient Safety Day 2025 at the Royal College of Surgeons of Edinburgh
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Content Article
After Martha: Paul Laity on a preventable death
MikeB posted an article in By patients and public
In the London Review of Books, Paul Laity reflects on his daughter's avoidable death in treatment following injury to her pancreas. Systemic failure, complacency, culture and lack of urgency at King's College Hospital. Paul Laity story of his daughter’s preventable death describes a familiar sequence of lack of urgency, a failure to listen, broken promises and an investigation process that does not seem to act in the patients or patients' families interests. "I realised what patient safety campaigners have wearily reiterated for years: hospital scandals lead to inquiries, which lead to reports that produce a set of recommendations, which are ignored or not implemented." -
Content Article
Martha’s Rule is a patient safety initiative to support the early detection of deterioration by ensuring the concerns of patients, families, carers and staff are listened to and acted upon. It has been developed in response to the death of Martha Mills and other cases related to the management of deterioration. Central to Martha’s Rule is the right for patients, families and carers to request a rapid review if they are worried that their own or their loved one’s condition is getting worse and their concerns are not being responded to. The Royal Manchester Children's Hospital's (RMCH) was one of the pilot sites during the first year of the Martha's Rule pilot. This blog outlines the hospital's efforts over the past year to integrate Martha’s Rule into everyday clinical practice, aiming to empower staff and families to raise concerns effectively on patient deterioration. Embedding Martha's Rule into practice: Lessons from our pilot Over the past year, our focus has been on embedding the components of Martha's Rule (MR) into everyday clinical practice—ensuring that staff across all levels understand their role in the process and feel equipped to respond effectively to concerns raised by patients and families. Tailored education for diverse staff groups One of our earliest challenges was designing education that resonated with different staff roles. We recognised that ward nurses, medics and other clinical teams needed training that reflected their specific responsibilities within the MR pathway. Initially, we concentrated on face-to-face sessions supported by PowerPoint presentations. These laid the groundwork for understanding MR, but we knew we needed something more scalable. That’s why we developed an e-learning package, which is now live on our hospital's e-learning hub and is included in staff mandatory training. The e-learning package is structured to provide appropriate awareness within individual staff groups, ensuring consistent understanding of deterioration across the board. Using data to drive safety and insight From a data perspective, we explored how to assess the safety of our current system and identify what information we needed to monitor effectiveness. We examined numerical indicators such as: deterioration rates cardiac arrest calls admissions to paediatric critical care. In addition, we collected qualitative data around complaints and incidents—especially those involving parental concerns. We triangulated these data sources to build a clearer picture of where improvements were needed. Although much of this analysis has been internal, we’ve begun integrating elements into the HIVE system (our electronic patient record system), to create dashboard-style visibility. We’ve also developed a dedicated database to track MR calls, allowing us to identify themes and trends by team, location, age, ethnicity and, potentially, deprivation. Listening to families: A crucial voice Although patient groups weren’t directly involved in shaping the e-learning package, we did engage with families during the early stages of the MR pilot. Their feedback was invaluable. Many expressed frustrations about unanswered queries and feeling left in limbo and feeling disempowered by a lack of cohesive response. These insights helped us reinforce key messages in the training, particularly around how concerns are acknowledged and escalated. Looking back, we recognise that capturing family feedback earlier would have strengthened the process. We’re now addressing ongoing challenges, especially for families whose first language isn’t English. While many preferred phone communication, we’ve taken steps to improve accessibility. Expanding access and inclusion We’ve created a multilingual space on the MR site, allowing users to select their preferred language. To bridge the gap between ward posters and digital resources, we have added QR codes that link directly to the site. This will include contact details for the MR team and background information about the initiative. It’s a tangible outcome of the pilot and a testament to how much we’ve learned along the way. What happens after a call? Encouragingly, families have reported that their concerns are being responded to once MR calls are made. We’re also mindful not to interpret low call volumes as a sign that everything is fine. That’s why we continue to monitor all sources of information, ensuring we’re not missing signs of deterioration. From pilot wards, we haven’t seen incidents or complaints that suggest missed cases, nor admissions to critical care that raise red flags. But vigilance remains key. What’s next? The e-learning package will be rolled out beyond pilot wards, ready for a hospital-wide rollout in mid-October 2025, ensuring widespread access and training before full expansion. MR principles are now embedded in induction for new nursing staff and resident doctors, reinforcing our commitment to making MR a core part of our culture. What has your experience been in implementing Martha's Rule? We'd welcome more experiences of implementing Martha's Rule we can share on the hub. What were the challenges? What worked well? You can share your with us by commenting below (sign up here for free first), or submitting a blog, or by emailing us at [email protected].- Posted
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Content ArticleFor over a decade, the preoperative timeout procedure has been implemented in most paediatric surgery units. However, the impact of this intervention has not been systematically studied. This study from Muensterer et al. evaluates whether purposefully introduced errors during the timeout routine are detected and reported by the operating team members. The study found that errors in the timeout routine go unnoticed by the team in almost half of cases. Therefore, even if preoperative timeout routines are strictly implemented, mistakes may be overlooked. Hence, the timeout procedure in its current form appears unreliable. Future developments may be useful to improve the quality of the surgical timeout and should be studied in detail.
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Content Article
Surgeons' News (Royal College of Surgeons of Edinburgh)
Patient Safety Learning posted an article in Surgery
Surgeons' News is a magazine for surgical, dental and allied healthcare professionals. Published quarterly by the Royal College of Surgeons of Edinburgh, it features comment and opinion from leading professionals, plus reviews and reports on subjects relevant to all career levels. -
Content Article
CORESS reports
Patient Safety Learning posted an article in Surgery
CORESS is an independent charity, which aims to promote safety in surgical practice in the NHS and the private sector. CORESS receives confidential incident reports from surgeons and theatre staff. These reports are analysed by the Advisory Board, who make comments and extract lessons to be learned. Aiming to educate, and avoid blame, CORESS calls on surgeons to recognise a near miss or adverse event, react by taking action to stop it happening and then report the incident to CORESS so that the lessons can be published. The focus of CORESS is on detecting and learning from no-harm, near-miss and low harm events encountered during routine surgical practice. The programme collects reports of such events, analyses them and disseminates the learning contained within them to a wide surgical audience and other agencies involved in Patient Safety matters. These events are known collectively as ‘Accident Precursor Events’ or simply ‘Precursors’. CORESS Online reporting form Any surgeon or surgical trainee, irrespective of specialty, can submit reports in confidence. CORESS encourages all to report incidents of actual or near harm, as well as near misses, where there are lessons from which the whole community can learn. Every submission is treated in the strictest confidence and when published will never contain any clues as to its origin. CORESS Case Database Reports are analysed, edited and anonymised by members of the CORESS Advisory Board. They are then converted into narrative reports or vignettes. These are then published in a number of widely read surgical journals, in particular RCSEd Surgeons’ News and RCSEng Annals. The published reports are also available via the CORESS database. CORESS Reports -
Content Article
Latest issue of the Operating Theatre Journal
Patient Safety Learning posted an article in Surgery
A monthly journal for all operating theatre staff covering surgical and anaesthesia news. -
Content ArticleThis webpage provides an overview of how human factors affect outcomes in surgical emergencies. It includes: An introduction to human factors Video exploring the case of Elaine Bromiley Explanation of human error and the Swiss Cheese Model Table of factors that reduce human error 'What if?' video showing how simple changes could have resulted in a different outcome in Elaine Bromiley's case Practical tips for managing the paediatric airway in a critically ill child
