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Showing results for tags 'Surgery - Trauma and orthopaedic'.
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News Article
Obese patients denied knee and hip replacements to slash NHS costs
Patient Safety Learning posted a news article in News
Obese patients are being denied life-changing hip and knee replacements and left in pain in a bid to slash spiralling NHS costs, The Independent can reveal. One-third of NHS areas in England and multiple health boards in Wales are blocking patient access based on their body mass index (BMI). The move, deemed “unfair” and “discriminatory”, goes against guidance from the National Institute for Care Excellence (NICE), which states BMI shouldn’t be used to restrict patients’ access to joint replacement surgery. Patients are instead being told they must lose weight before they are eligible but waiting lists for NHS weight loss programmes have ballooned, with some people waiting up to three years to be seen while other services have shut, unable to cope with demand. The Royal College of Surgeons of England criticised the policy, saying that denying patients care could cost them their mobility and cause their health to deteriorate, while Tory peer and former health minister James Bethell called on the government to do more to tackle the obesity crisis and end the “misery for millions”. Read full story Source: The Independent, 31 May 2025- Posted
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- Surgery - Trauma and orthopaedic
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News Article
A 15-year-old boy who was operated on twice by a now unlicensed Great Ormond Street surgeon says he is living with "continuous" pain. Finias Sandu has been told by an independent review the procedures he underwent on his legs were "unacceptable" and "inappropriate" for his age. The teenager from Essex was born with a condition that causes curved bones in his legs. Aged seven, a reconstructive procedure was carried out on Finias's left leg, lengthening the limb by 3.5cm. A few years later, the same operation was carried out on his right leg which involved wearing an invasive and heavy metal frame for months. He has now been told by independent experts these procedures should not have taken place and concerns have been raised over a lack of imaging taken prior to the operations. His doctor at London's prestigious Great Ormond Street Hospital was former consultant orthopaedic surgeon Yaser Jabbar. Sky News has spoken to others he treated. Mr Jabbar also did not arrange for updated scans or for relevant X-rays to be conducted ahead of the procedures. The surgeries have been found to have caused Finias "harm" and left him in constant pain. "Every day I'm continuously in pain," he told Sky News. "It's not something really sharp, although it does get to a certain point where it hurts quite a lot, but it's always there. It just doesn't leave, it's a companion to me, just always there." Read full story Source: Sky News. 18 May 2025- Posted
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Orthopaedic surgeon Sunny Deo has spent three decades diagnosing and treating knee joint issues. In this blog, Sunny argues that the healthcare community needs to take a more nuanced approach to diagnosis and decision making so that it can provide patients with safer, more appropriate treatment options. He reflects on why medicine prefers simple answers and looks at how this affects patient care. He goes on to explore how better data collection and the use of artificial intelligence (AI) could provide a more accurate picture of complexity and allow treatment options to be better tailored to individual patients’ needs. "To know the patient that has the disease is more important than to know the disease that the patient has." William Osler, father of modern medicine, 1849-1919. Diagnosis is the process of identifying the nature of an illness or other problem by examining the symptoms and objective findings from investigations. In modern medicine, it is a key focal point of the assessment and management of all patients. A huge amount of clinical medicine training is focused on the art and science of obtaining a diagnosis, and this focus continues into medical practice. The ease of getting to a diagnosis ranges from the glaringly obvious, the so-called ‘spot diagnosis’, through to cases that are very difficult to solve. In between these extremes there is a range from delayed to missed to incorrect diagnosis. The aim of doctors over the centuries has been to work out diagnoses from patients’ symptoms, presenting features (clinical signs) and, in the past century or so, from the evidence of clinical investigations. Quite often, symptoms, signs and investigations produce consistent patterns, and it is these patterns that are taught to medical and other healthcare professionals. This is how diagnoses and outcomes are portrayed in television series or films—just think back to the last episode of Casualty or Grey’s Anatomy you watched. It's also how things often appear in internet searches and on websites and social media. Seeking simple answers to complex questions However, the reality is different. When a patient is sitting in front of me, what I hear and observe may not exactly be what the textbooks, evidence or research tells me I should be seeing. But because we are wired and trained to recognise patterns, we tend to look for diagnoses and solutions that fit within the well-worn narrative. What if the pattern doesn’t fit the actual diagnosis? There are classic presentations for nearly every condition, and these are what you tend to find at the start of a Google search or when using NHS Choices. The expectation of typical symptoms sometimes means we ignore what we might see as annoying variance, superfluous detail or the patient embellishing the truth. This discordance then causes tension with a very basic trait of humans: when we’re faced with a difficult problem, we still seek the simplest solution. This is an evolutionary feature hardwired into us to optimise survival chances. It means we often believe there is a truth to be found that will provide us with a definite answer. From this answer we will come to the best, and ideally only, ‘correct’ solution. Patients who don’t fit the set patterns of diagnosis may then run into trouble when we offer them what is considered to be the ideal treatment. This is an important problem in clinical thinking, language and practice. As a medical community, we tend to create oversimplified approaches based on research that looks for binary answers to complex questions. This research evidence may be based on a small, highly selective ‘typical’ patient cohort, but its findings and conclusions are then translated on to the entire population. This approach results in poor patient outcomes and experience for a small but significant proportion of patients. Pathways designed for ideal diagnoses can cause harm to patients Over my 30 years as an orthopaedic surgeon, 15 as a knee specialist, I have seen that the assessment and treatment of any given condition isn't quite as predictable as we would like it to be. While many patients fit the pattern we are expecting, some do not. I would empirically put the proportion at 60:40, but some unpublished research we did a decade ago suggested the proportion of truly ‘typical’ case presentations for a common condition is much lower. For example, we found that in the case of suspected meniscal tear, this diagnosis actually applied to only 33% of patients with a variety of other diagnoses accounting for the rest. It gets worse when large organisations start to lump patients into a category by condition in a ‘one diagnosis fits all’ strategy. When this approach is taken, there are winners and losers. The winners are those patients whose condition very closely matches the classic presentation of a given condition in isolation. Let’s take the example of knee osteoarthritis—patients with the ‘right type’ of symptoms, physical signs and x-ray changes are generally more likely to do well. Their recovery is more likely to sit within the knowledge base of treating the condition that has evolved over the past half-century. In contrast, patients whose symptoms and test results fall outside of this category may be less likely to do well or recover in the predicted timeframe. This also applies to patients with additional diagnoses or conditions, often termed comorbidities, which may interact, usually in a bad way, with the condition at hand. Failure to consider other diagnoses, either by over-focus on one condition causing wilful ignorance, inattention or lack of attention, may lead to unexpected poor outcomes from a given treatment. It may also mean that the symptoms from the condition that the patient presents with are worse than expected. This doesn’t mean that they won't gain any benefit from a particular treatment, but the risks and potential outcomes may not be communicated adequately by the patient’s healthcare team, if at all. For example, for patients with painful knee osteoarthritis, the current diagnosis to treatment logic runs like this: Knee osteoarthritis is a painful condition. Total knee replacement surgery is a validated safe procedure with significant improvements in quality of life. Other treatment options do not produce as much positive therapeutic benefit compared to total knee replacement surgery. Therefore, total knee replacement surgery is the only treatment for painful knee osteoarthritis. However, there are patients for whom knee replacement surgery is not a safe or practical option, and these patients may benefit from alternative treatments that are not currently offered as they are seen as providing limited benefit. This may be because the participants in trials undertaken over the years had varying diagnoses, meaning that true comparisons of alternative options may have had additional interacting diagnoses or failed to account for differing severity. Understanding the spectrum of complexity As healthcare professionals, we have a duty to diagnose patients as accurately as possible. In orthopaedics, if treatments go wrong or are poorly undertaken, it may lead to prolonged or permanent pain or disability, and we obviously want to avoid this as much as possible. Incomplete identification and documentation of all relevant symptoms and health conditions can potentially lead to an increased risk of treatment failure and complications. Our priority should be to identify these diagnoses or diagnostic clusters as accurately as possible. I think these are basic principles we need to apply to create better systems and improved care for as many patients as possible. In my view, there are grades of ‘atypical patients’ and I have devoted the past decade to trying to demonstrate this, with surprisingly stiff resistance from peer-reviewed journals and funding organisations. I have tried to move away from lumping all patients into a single category. I have done some research on seemingly straightforward soft tissue problems and osteoarthritis in the knee. My initial analysis suggests that we need to collect more detailed and accurate data, rather than simplifying data into minimum datasets. This is where AI can really come into its own, not as a diagnostic tool initially, but as a powerful aid to unlocking and interpreting some of the diagnostic interactions that create problems for patients. However, the use of AI does need to be undertaken with extreme care and consideration, and this isn’t always happening currently. To offer healthcare that is truly person-centred, we need to look beyond our well-worn simple answers and solutions. By using better data and new machine learning tools to understand the nuances of each person’s condition and how it relates to their wider health, we can offer treatment options that are safer, kinder and more cost-effective. Share your views We would love to hear your views on the issues highlighted in Sunny’s blog Are you a clinician who would like to share your experiences? Do these challenges resonate with you? Or are you a patient who has experienced complications because of poor, missed or inadequate diagnosis? Add your comment below (you will need to be a hub member and signed in) or contact us at [email protected] and we can share your story anonymously. Related content on the hub: Using data to improve decision making and person-centred care in surgery: An interview with Sunny Deo and Matthew Bacon Diagnostic errors and delays: why quality investigations are key- Posted
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- Surgery - Trauma and orthopaedic
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News Article
New NHS probe into spinal surgeon's care
Patient Safety Learning posted a news article in News
Hundreds of patients treated by a spinal surgeon who was found to have caused them serious harm could have their cases reviewed. NHS England has confirmed it will look back into two hospital reviews into John Bradley Williamson, who worked at Salford Royal Hospital and the Royal Manchester Children's Hospital from 1991 to 2015. It comes after former patients, who said they had experienced problems linked to his surgery, said they believed the previous reviews were too limited. Mr Williamson said he has "always strived to provide the very best care for patients" and would cooperate with any patient care investigation. A report into the surgeon's care between 2009 and 2014 found he had caused "severe harm" to seven patients at Salford Royal Hospital. Some screws were poorly placed, and some patients suffered heavy blood loss, the report found. One former patient, treated by Mr Williamson when she was 11, said she had been living in "agony" after the surgery at the former Pendlebury Children's Hospital, now Royal Manchester Children's Hospital. Campaigners, including the sister of a teenager who died during spinal surgery by Mr Williamson, have called for a full recall of all patients on whom the surgeon operated. Read full story Source: BBC News, 24 April 2025- Posted
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News Article
‘Below-standard care’ surgeon named — 800 patients to be reviewed
Patient Safety Learning posted a news article in News
The care of hundreds of NHS patients — many of them children — is being urgently reviewed because concerns about a surgeon at one of England’s leading hospitals. She is Kuldeep Stohr, a specialist paediatric orthopaedic consultant at Cambridge University Hospitals Trust. Stohr, who spoke of seeing 200 patients a month at Addenbrooke’s Hospital during a 2022 webinar, has been suspended by the trust after an initial review in January identified nine children who had suffered care “below the standard” the trust would expect. This review was conducted by James Hunter, a surgeon and the national clinical leader for paediatric trauma and orthopaedics at NHS England, who found that the quality of some children’s lives had been affected. Now the trust has worked with Hunter to identify 800 of Stohr’s patients to be assessed by a team of experts in a new review. Of these, about 560 are children and 140 are adults. Another 100 adults and children who were treated as emergencies at the Cambridge hospital will have their care reviewed. Many of the cases involving Stohr are linked to osteotomies — a surgical procedure where a bone is cut to reshape or realign bones such as those in the legs. Some families fear the operations were not performed correctly, with some children having to have multiple operations over several years. There are concerns about poor post-surgery follow-up and alleged delays in complications being recognised and treated. Read full story (paywalled) Source: The Times, 5 April 2025- Posted
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- Surgery - Trauma and orthopaedic
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News Article
Trust reviewing 800 cases over child surgery failures
Patient Safety Learning posted a news article in News
A large teaching trust has launched reviews of surgery on nearly 800 patients operated on by a children’s orthopaedic surgeon – and whether concerns raised 10 years ago could have prevented harm. Cambridge University Hospitals Foundation Trust said concerns were first raised about the surgeon’s work in 2015 and an external clinical review was carried out. A new review by Verita will look at whether the 2015 recommendations “was acted upon appropriately and, if not, why”. The surgeon, who has not been named, had their work restricted last year while a smaller external review was carried out into new concerns. They were suspended when this identified outcomes below expected standards in nine cases. The BBC has reported that these involved complex hip surgery cases and found some of the children’s quality of life had been affected, including their mobility. The trust announced that, following further findings, it has asked barrister Andrew Kennedy to chair a panel of expert clinicians reviewing the care of almost 700 patients who had planned surgery. It will also review an initial 100 adult and paediatric orthopaedic trauma cases. Read full story (paywalled) Source: HSJ, 24 March 2025- Posted
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- Children and Young People
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News Article
Children who underwent operations with a now-suspended surgeon at a Cambridge hospital are being let down again by a lack of information and transparency from the hospital's trust, according to a lawyer representing one of the families. Last month, Addenbrooke's Hospital announced it had contacted the families of nine children whose complex hip surgeries "fell below" the expected standard, following an external review. The orthopaedic surgeon, who has not been named, has since been suspended while a second external review is carried out. But families are said to be "frustrated" by a lack of communication from Addenbrooke's, which is yet to release the findings of the first review. A lawyer instructed by one of the families has accused Cambridge University Hospitals NHS Foundation Trust of failing to follow official guidance in their handling of the patients and their families. Catherine Slattery, associate solicitor at Irwin Mitchell, told Sky News: "Families should feel they are being supported through this process, and that their child is the centre of this investigation. The National Patient Recall Framework - for patients "recalled" by a healthcare provider after a problem has been identified - states that the patient's needs should "always be placed at the centre" of the process. The guidance adds: "There should be appropriate and compassionate engagement with patients to ensure that the process remains patient focused." Read full story Source: Sky News, 19 March 2025- Posted
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- Children and Young People
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Content Article
When someone needs a joint replacement, there are many factors that affect how well they will respond, how quickly they will recover from the procedure and the potential risks of surgery. Patient complexity is the term used to describe these factors and includes other health conditions, sometimes called co-morbidities, as well as local risk factors related to the specific joint needing to be replaced. In this interview, consultant orthopaedic surgeon Sunny Deo and engineer and founder of TCC-Casemix Matthew Bacon, discuss how new technology is allowing surgeons to more accurately predict the surgical risk and outcomes for patients having knee replacement surgery. They describe how a new approach to data modelling is allowing the orthopaedic team at Great Western Hospital NHS Foundation Trust to more accurately assess complexity for individual patients. This has benefits for patient care and outcomes, theatre productivity and the development of pathways that are more patient-centred. They also highlight some patient safety issues associated with elective surgical hubs, which were set up to deal with high volume low complexity patients, including the deprioritising of more complex patients who may be at greatest need of surgery. Finally, they discuss the applicability of this approach to other specialties and areas of healthcare. Read more about clinical complexity in joint replacement surgery in this presentation by Sunny Presentation - Overview of clinical complexity by Sunny Deo.pdf- Posted
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- Surgery - Trauma and orthopaedic
- Risk assessment
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News Article
Surgeon with ‘complete freedom’ harmed dozens of patients
Patient Safety Learning posted a news article in News
An orthopaedic surgeon with “almost complete clinical freedom” is likely to have harmed nearly 100 patients, a long-running investigation has found. The review examined 382 elective complex upper limb procedures at Walsall Healthcare Trust in the West Midlands. It found treatment was “sufficiently sub-optimal to have caused moderate or serious harm” in 24% of cases. As well as the surgeon who carried out the procedures being “apparently not fully competent to perform” them, there was a lack of robust oversight and poor coding, and notes which made it difficult to establish what had happened. The cases studied involved “procedures of concern”, meaning the rate of harm among other all patients operated on by the surgeon is likely to be lower. Surgeon Mian Munawar Shah was stopped from carrying out some operations after concerns were raised about his work in 2020 and was later suspended from patient-facing work. He also worked at a nearby private hospital, Spire Little Aston, but work there is not covered by the reviews published today. After two external reviews, the trust decided to notify and recall patients who had undergone complex upper limb surgery done by him. Some hand and wrist surgery was also examined and found to involve poor or very poor care, including cases where the wrong bone was removed. The final reviews were completed in September, and findings have been published by the Trust. Read full story (paywalled) Source: HSJ, 11 March 2025- Posted
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- Surgeon
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Content Article
Following concerns raised in early 2020 about surgical outcomes of an individual orthopaedic Surgeon, Mr Mian Munawar Shah, his employer, Walsall Healthcare NHS Trust (the Trust) sought external review of a small number (17) of complex upper limb surgery cases by a specialist team from the Royal College of Surgeons (the RCS) through the invited review mechanism. This reported in November 2020 and identified some concerns regarding practice within the trauma and orthopaedic department. The Trust subsequently requested a further RCS review specifically of Mr Shah’s practise, to more fully assess possible concerns regarding outcome after his surgery. Through this the total number of cases reviewed by the RCS was extended to 99. The results of this review were released in April 2022, and following evaluation of both reviews, the Trust decided to undertake a patient notification exercise (PNE) and recall of patients who had undergone complex upper limb surgery by Mr Shah. The recall was initiated in September 2022, the final patient case reviews being completed in September 2024. This report describes the process, oversight, scrutiny and findings of that recall.- Posted
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News Article
When Alexandra McTeare was told she might have to wait three years for knee replacement surgery, she felt desperate. “Because of how miserable your life is, how small it has become,” she says. The problems with her knee started in 2017. “It was painful and would swell up, particularly in the heat.” She would take painkillers and keep her leg elevated when she was sitting down, and did stretching exercises for her muscles. But over the next few years, “it gradually got worse, the intervals between swelling episodes reduced and the pain increased”. It reached a point where it was no longer bearable. Ten years ago, McTeare could get a GP appointment within a week. “Now, you phone up and you’re lucky if you get an appointment within a month, and nine times out of 10 it’ll be a nurse practitioner.” McTeare has nothing against nurse practitioners; she used to be a nurse herself and she was working for the NHS when they were introduced to GP practices. “But they’re not appropriate for everything,” she says. “People do need to be able to see a GP.” Her knee didn’t get better. The opposite happened. “I didn’t believe it was a torn meniscus, it was going on and on, so I decided: to hell with it, I’ll pay and see somebody privately.” In March 2023, she saw an orthopaedic consultant, got an X-ray, was told she had arthritis in her knee and needed a total knee replacement. It took no more than half an hour and cost her £400. McTeare says she is lucky she could raise the money for a private consultation. But she wants to make something clear: “I have always despised private medicine.” Read full story Source: The Guardian, 27 November 2024 Related reading on the hub: One hour with a women's health expert and finally I felt seen- Posted
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Content Article
Diagnostic safety: Royal College of Surgeons Edinburgh
Patient Safety Learning posted an article in Diagnosis
The Royal College of Surgeons of Edinburgh launched a series of blogs in recognition of the World Patient Safety Day (WPSD) 2024 theme of "Improving Diagnosis for Patient Safety". RCSEd World Patient Safety Day 2024 A Novel Facial Cellulitis Pathway: Improving the Time to Surgery for Facial Necrotising Fasciitis Improving Diagnosis for Safety in Dentistry Using Audit to Improve Outcomes for Patients with Upper Tract Urothelial Cancer Diagnostic Safety in Surgery WHO World Patient Safety Day 2024: Improving Diagnosis for Patient Safety The Importance of Teamwork for Surgical Diagnostic Safety in Outpatients Challenges in the Diagnosis of Twin Silent Killers: Aortic Aneurysm and Acute Aortic Dissection Improving Diagnostic Safety in Orthopaedics NCEPOD: Prioritising Diagnostic Safety for Better Health Outcomes Protecting our Precious Gift of Life World Patient Safety Day 2024 — A View from the Bridge Can My Stool be Tested for Bowel Cancer? Virtual Diagnostics The Potential of AI to Help Reduce Diagnostic Errors Non-Technical Skills for Surgeons (NOTSS). Vignette 3 of 3. Leadership in Surgery: A Case Study Non-Technical Skills for Surgeons (NOTSS). Vignette 2 of 3. Team Communication: The Key to Clarity and Precisio Non-Technical Skills for Surgeons (NOTSS). Vignette 1 of 3. Situation Awareness: Staying Ahead of Potential Issues Enhancing Diagnostic Safety in Surgery Through Non-Technical Skills Diagnosing Acute Aortic Dissection – The Patient Perspective- Posted
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Content Article
Despite their widespread use, the impact of commissioners’ policies for body mass index (BMI) for access to elective surgery is not clear. Policy use varies by locality, and there are concerns that these policies may worsen health inequalities. This study in BMC Medicine aimed to assess the impact of policies for BMI on access to hip replacement surgery in England. The authors used National Joint Registry data for 480,364 patients who had primary hip replacement surgery in England between January 2009 and December 2019. They found that rates of surgery fell after localities introduced policies restricting access to surgery based on BMI, whereas rates rose in localities with no policy. Localities with BMI policies have higher proportions of independently funded surgery and more affluent patients receiving surgery, indicating increasing health inequalities, and policies enforcing extra waiting time before surgery were associated with worsening mean pre-operative symptom scores and rising obesity. The authors recommend that BMI policies involving extra waiting time or mandatory BMI thresholds are no longer used to reduce access to hip replacement surgery.- Posted
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- Obesity
- Health inequalities
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Content Article
This state-of-the-nation report from the National Hip Fracture Database (NHFD) focuses on the period from 1 January to 31 December 2022. It shows that the number of people who died in the month following a hip fracture now stands at 6.2%; down from 10.9% in 2007, when the NHFD was set up. However, the report also finds that it took longer for patients to reach a ward where a hip fracture team can work together (where there is the best chance of recovery) in 2022. It also states that fewer patients received prompt surgery to repair their broken hip by the day after they presented to hospital. There was an improvement in how many people with hip fracture received bone strengthening medicines to avoid future fractures in 2022, but some hospitals continue to report that none of their patients receive such treatment. The report calls for hospitals to improve how they move patients to the right ward, operate and get patients out of bed promptly, recommending that hip fracture teams: review the care provided in the Emergency Department (ED), so that patients are seen promptly, offered pain relief, and admitted to an appropriate specialist ward within four hours. use the NHFD website to see why surgery is delayed, and work together so that this happens by the day after patients present with a hip fracture. use the NHFD website to see what more can be done to avoid patients becoming confused in hospital and to ensure that they are well enough to get out of bed on the day after their operation.- Posted
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- Quality improvement
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News Article
Consultant carried out 'unnecessary' surgery for financial gain, tribunal hears
Patient Safety Learning posted a news article in News
A doctor who worked for the same private healthcare company as rogue surgeon Ian Paterson performed unnecessary shoulder operations for financial gain, a medical tribunal has heard. Orthopaedic consultant Michael Walsh worked at a Spire Healthcare hospital in Leeds from 1993 until 2018, when he was suspended after concerns were raised about his work. Spire, which runs 38 hospitals around the UK, reported him to the General Medical Council (GMC) after an investigation found he carried out operations unnecessarily or badly, with many patients left suffering pain or trauma. Mr Walsh, who also worked at another private hospital in Leeds run by Nuffield Health but is now retired, is facing dozens of medical negligence claims from patients, with some already having received payouts. Read full story Source: Medscape, 8 November 2023- Posted
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- Private sector
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News Article
More hips replaced in private hospitals than in NHS
Patient Safety Learning posted a news article in News
The number of NHS-funded hip replacements carried out last year remained well below pre-covid levels, while the total funded privately nearly doubled to cover the shortfall, new data reveals. The National Joint Registry annual report, which tracks orthopaedic activity across the NHS, showed the number of NHS-funded elective hip replacements carried out at NHS facilities in 2022 was at its lowest level since 2007. However, the number of procedures performed in independent hospitals – both funded by the NHS and funded privately – has increased sharply. Orthopaedics is the biggest single elective specialty, with 847,000 of the current waiting list of 7.7 million on a trauma and orthopaedics pathway. As of July, 43% of these patients had been waiting longer than 18 weeks. The NJR report said: “The independent sector provision has increased hugely [since 2007] particularly in the last few years of covid recovery and there are now more hip replacements carried out in the independent sector than in the NHS. “Despite the cost-of-living crisis the number of hip replacements paid for privately has almost doubled since 2019.” Read full story (paywalled) Source: HSJ, 10 October 2023 -
News Article
It is still unclear how unauthorised metal parts came to be implanted in a number of the 19 children with spina bifida who suffered significant complications after spinal surgery. But it has emerged that one child died and 18 others suffered a range of complications after surgery at Temple Street Children’s Hospital – with several needing further surgery, including the removal of metal parts which were not authorised for use. Parents of the children undergoing complex surgery were left distraught by the disclosures that emerged yesterday, after campaigning for years while the young patients in need of operations deteriorated on waiting lists. Gerry Maguire, of Spina Bifida Hydrocephalus Ireland, said “absolute horror is being visited on parents and their advocates”. He condemned as disturbing the information which is “being drip-fed to his group and “more alarmingly the families concerned”. One mother expressed concern about further delays in surgery and said children are too complex to be taken for care abroad. Read full story Source: Irish Independent, 19 September 2023- Posted
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- Surgery - Trauma and orthopaedic
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Content Article
How one Devon ICS has worked with local trusts to cut deliver extra capacity at a former Nightingale hospital, now converted into an elective centre. 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.- Posted
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- Long waiting list
- Innovation
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Content Article
A repository of resources aimed at patients and carers which have been co-produced by the Falls and Fragility Fracture Audit Programme (FFFAP) patient and carer panel. 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- Posted
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News Article
Can AI techniques help clinicians assess and treat patients with bone fractures?
Patient Safety Learning posted a news article in News
Investigators have applied artificial intelligence (AI) techniques to gait analyses and medical records data to provide insights about individuals with leg fractures and aspects of their recovery. The study, published in the Journal of Orthopaedic Research, uncovered a significant association between the rates of hospital readmission after fracture surgery and the presence of underlying medical conditions. Correlations were also found between underlying medical conditions and orthopedic complications, although these links were not significant. It was also apparent that gait analyses in the early postinjury phase offer valuable insights into the injury’s impact on locomotion and recovery. For clinical professionals, these patterns were key to optimizing rehabilitation strategies. "Our findings demonstrate the profound impact that integrating machine learning and gait analysis into orthopaedic practice can have, not only in improving the accuracy of post-injury complication predictions but also in tailoring rehabilitation strategies to individual patient needs," said corresponding author Mostafa Rezapour, PhD, of Wake Forest University School of Medicine. "This approach represents a pivotal shift towards more personalised, predictive, and ultimately more effective orthopaedic care." Read full story Source: Digital Health News, 12 April 2024- Posted
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News Article
Victims of failed surgery demand recall of all patients
Patient Safety Learning posted a news article in News
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- Posted
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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- Posted
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- Surgery - General
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Event
The Professional Records Standard Body (PRSB) are holding a workshop on 4 March to help us develop a shared decision-making standard, so that individuals can be more involved in the decisions that affect their health, care and wellbeing. The online workshop will bring together health and care professionals, patients and system vendors to focus on different topics including diabetes and other long-term conditions, mental health, child health, gynaecology, colorectal cancer, genetic conditions, multi-medications and orthopaedics. We will be asking questions about the way information about treatment and care options are discussed and decisions recorded. This would include consent for treatment, when it is agreed, and any pre-operative assessments and requirements. By standardising the process, it will ensure that information can be shared consistently using any digital systems. If you’re interested in getting involved in the project, please contact [email protected] -
News Article
Labour demands new NHS investment as patients wait longer for surgery
Patient Safety Learning posted a news article in News
Labour is demanding new investment for the NHS as part of the government’s spending review next week, after analysis shows hundreds of thousands of patients are waiting for life-changing operations. The party’s shadow health secretary, Jonathan Ashworth, will challenge Matt Hancock in Parliament on today over the latest NHS data, which reveal almost 500,000 patients are waiting for surgery on their hips, knees and other bones. Last week, NHS England published new data showing more than 1.7 million people were waiting longer than the NHS target of 18-weeks for treatment. The target was last met in February 2016. An analysis of NHS England data reveal which specialities have been hardest hit by the growing backlog of operations, which has soared since the first wave of coronavirus caused widespread hospital cancellations earlier this year. There were 4.3 million patients on NHS waiting lists for hospital treatments in September. Labour said this included 477,250 waiting for trauma and orthopaedic surgery, with 252,247 patients waiting over 18 weeks. The next worst specialty was ophthalmology, which treats eye disorders, with 444,828 patients on waiting lists, 233,425 of whom have waited more than 18 weeks. There were six figure waiting lists over 18 weeks for other specialties including gynaecology, urology, general surgery, and ear, nose and throat patients. Read full story Source: 17 November 2020 -
News Article
Patients harmed amid ‘internecine squabbles’ and cover-up claims
Patient Safety Learning posted a news article in News
Several patients were harmed after leaders at an acute trust failed to act on multiple concerns being raised about a surgeon, documents obtained by HSJ suggest. The documents reveal a catalogue of governance and safety concerns over the trauma and orthopaedics department at University Hospitals of Morecambe Bay Foundation Trust in the last three years. They include an external review which described the process for investigating clinical incidents as akin to “marking your own homework” and found the T&O department at Royal Lancaster Infirmary driven by “internecine squabbles”. It comes as the trust, which is widely known for a patient safety scandal within its maternity department, also faces a major investigation into whistleblowing concerns over its urology services. Read full story (paywalled) Source: HSJ, 17 November 2020- Posted
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- Patient harmed
- Surgeon
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