02/Sep/2014 - Last News Update: 07:03

Emergency care needs a shake-up, say surgeons at RCS

Category: Wales

Published: 7th Apr 2011 07:14:02

A report from the Royal College of Surgeons says lives are being put at risk because some hospitals focus too much on waiting lists for routine surgery rather than on emergency operations.

It claims emergency patients account for up to half the NHS surgical workload in Wales and England, but that deaths rates and complications vary widely between hospitals

Local health boards are looking at centralised specialist centres. They say the RCS report endorses the plans.

The RCS has published a list of new standards to help hospitals in Wales and England "to get things right".

It says priority is often given to routine surgery in order to meet "arbitrary targets" and which delays vital surgery, resulting in "poor outcomes for patients".

Colin Ferguson, RCS director of professional affairs for Wales, said it is common in every branch of surgery to see patients with serious conditions given a lower priority than they deserve.

Because perhaps patients are not managed as patients but rather to accommodate targets, that's why we are seeing these anomalies in the system”

He claimed patients are often placed in inappropriate wards and frequently wait far too long for a space on an emergency operating list.

"These patients should be treated in centres that can offer the highest quality of care," he said.

"Sadly, this is currently often not the case."

The RCS say while detailed performance statistics are gathered for routine, pre-planned operations, there is currently little gathered on timeliness of emergency surgery.

Among its recommendations it calls for better monitoring of emergency patients, and dedicated wards and access to critical care.

Professor Ceri Phillips, health economist at Swansea University, said the report was warning that not properly managing emergency patients was actually increasing the cost to the NHS.

He said targets for emergency and A&E admissions puts pressure on other parts of the system.

"Because perhaps patients are not managed as patients but rather to accommodate targets, that's why we are seeing these anomalies in the system," he told BBC Radio Wales.

"What we probably need to think about, and it has been suggested, is that we see a clear demarcation between emergency surgical procedures and elective procedures.

"For example, it has been suggested that over the Christmas period, we do not plan any routine surgery because of the pressure on beds in hospital.

"Obviously this goes against some of the things we've been talking about in terms of waiting times, but it does mean patients with emergency needs can be dealt with in an appropriate and effective and efficient manner rather than an ad hoc basis."

Kate Watkins, acting director of the Welsh NHS Confederation, which represents local health boards, said it would be considering the recommendations to see what improvements they could make.

She said the report backs the argument that it was crucial to have fully staffed and equipped emergency facilities, which currently can't be safely provided in all hospitals across Wales because the expertise would be spread too thinly.

"That is why some health boards in Wales are looking to provide all emergency surgery in one central, highly-equipped and staffed centre of excellence, supported by very effective emergency transport," she said.

Wales' chief medical officer Dr Tony Jewell said it is for NHS organisations to "ensure they have the appropriate skill mix of staff to meet fluctuating demand".

"Emergency departments aim to stabilise patients ready for surgery, usually at the same hospital, but where specialised surgery is required, we would expect patients to be transferred to the appropriate hospital to ensure they receive the best care," he said.

BBC News External Link Show Citation

Latest News

Harvard Citation

BBC News, 2011. Emergency care needs a shake-up, say surgeons at RCS [Online] (Updated 7th Apr 2011)
Available at: http://www.ukwirednews.com/news/143763/Emergency-care-needs-a-shake-up-say-surgeons-at-RCS [Accessed 2nd Sep 2014]

News In Other Categories

  • Boris Island airport plan rejected

    A plan for an island airport in the Thames estuary has been rejected by a commission looking into the UK's airport needs.
  • Electromagnetic Field: Can geeks get kids into science?

    The government is desperate to get more young people interested in scientific subjects. Could a self-proclaimed "geek festival" held last weekend in Milton Keynes hold the answer?
  • Boris Island airport plan rejected

    A plan for an island airport in the Thames estuary has been rejected by a commission looking into the UK's airport needs.
  • Bristol Academy extends reach overseas with first foreign students

    With the doors to its brand new £1million training centre officially open, one of the UK's leading apprentice training providers, Bristol based S&B Automotive Academy, is showcasing its world-class facilities by launching a series of foreign student exchanges for the first time in its 41-year history. To get a flavour of what life is like as an apprentice in the UK, the Academy hosted 16 apprentice engineers and bus drivers from the G9 Automotive College in Hamburg, Germany, as part of a Europe-wide vocational training initiative called the ‘Leonardo Programme’ with support from the European Social Fund. In a reciprocal arrangement, S&B will be sending nine apprentices to Germany during February 2012 so that they can get an appreciation of life in the automotive industry on the Continent. A further three German exchange groups are being planned for next year. Designed to assist the development of vocational skills and training across Europe, including work placements for trainees, the Leonardo Programme has a budget of €1.75bn, which is helping to encourage UK organisations to work with their counterparts abroad. In what is expected to be another challenging year for employers in the UK automotive sector, S&B’s Chief Executive, Jon Winter, claims that the exchange initiative will bring many benefits to the Academy and its apprentices: “In a world of global automotive brands, it’s important for our learners to understand the international context of the industry they have chosen to make their career. This new exchange programme will enable apprentices and Academy staff alike to achieve a better understanding of the challenges and opportunities within the automotive arena in Europe. With the Academy’s influence also extending to the USA and Asia, there’s every possibility that this initiative could move further afield in the future.” Continued Winter: “The need for skilled technicians across the world is on the increase and we actively encourage our apprentices to look at broader horizons during their training. Many of them have already learned the phrase ‘Vorsprung durch Gelehrtheit’, quite simply, ‘Advancement through learning.” In the 2010/11 academic year, S&B doubled the number of successful Apprenticeships over the previous year with some 350 apprentices graduating from the Academy. At the same time, achievement levels reached an all-time high with an overall success rate of 85%. For those learners on the Advanced Apprenticeship three-year programme, success rates were even higher, at over 98%. PHOTO CAPTION: As part of their exchange visit, S&B Automotive Academy arranged for the German apprentices to visit Hampshire bus operator, Bluestar, at its Barton Park depot. The students are pictured with S&B’s Andy West (3rd right) and Steve Prewett, Bluestar’s Area Engineering Manager (2nd right). Ends http://www.sandbaa.com
  • Scottish independence: Does the rest of the UK care?

    With the Scottish referendum just weeks away, the rest of the UK is speaking up. Some want the union to stay intact; others think Scotland should go its own way. But how much do people in England, Wales and Northern Ireland care about what happens?
  • Boris Island airport plan rejected

    A plan for an island airport in the Thames estuary has been rejected by a commission looking into the UK's airport needs.