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Emergency Surgery is Risking Patients' Lives

Emergency Surgery is Risking Patients' Lives

Poor care and delays are putting the lives of thousands of NHS emergency surgery patients at risk.

The Royal College of Surgeons (RCS) has published a report criticising the way non-cardiac emergency surgery is handled.

It suggests that poor access to facilities such as operating theatres and scanning machines is putting patients with abdominal emergencies in danger. It also finds too few patients are receiving critical care after surgery, and that junior staff are often left to deal with complex and dangerous cases.

The report supported these findings with a series of statistics. It revealed that of the 170,000 patients who have non-cardiac operations every year, 100,000 will develop complications, and 25,000 of these will die. The figures show mortality rates are highest amongst the elderly, where deaths can reach as high as 40%.

Although it was noted that survival rates vary from hospital to hospital, there can also be shocking differences on a day to day basis within the same healthcare establishment.

When exploring the reasons for this substandard level of care, the report suggests that emergency surgery is being put second to elective surgery. Prioritising operations that have already been planned could in turn be linked to the pressure on hospital to improve waiting lists.

Iain Anderson, the author of the report, is himself a consultant general surgeon at Salford Royal NHS Foundation Trust. He said it is vital NHS Trusts recognise the problems he has highlighted, and review the way the service works.

“Every single emergency patient who comes through the door of an NHS hospital should have an individual risk assessment, diagnosis, treatment plan and post-operative care plan prioritised according to need,” he said.

“Instead we have some of the NHS's sickest patients languishing on inappropriate wards, treated by juniors and with no plan in place to deal promptly with unexpected complications. These tend to be the patients who end up in intensive care units for lengthy periods of time or, sadly, too sick to be helped."

“I think there's been a general failure to understand just how high risk [non-cardiac] surgery is, both by the patients - sometimes by the doctors - but certainly by health service managers.”

In response, NHS manages said that they, surgeons and ambulance workers must work together if “real change” is to be achieved.

A spokesman at the Department of Health said the NHS said improving patient safety was at the top of their agenda.

“It is essential that hospitals provide the safest possible care for patients,” he said. “Hospitals should follow this guidance and monitor the quality of care they are giving to their patients and ensure that they are providing appropriate levels of services and staffing.”

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