Sunday 6 March 2011

Death and the NHS

 
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Been a while since I posted here, real life has a habit of buggering up your blogging.

 

Couple of items today the first is from the Telegraph, it seems that if you have Vascular surgery in a small Hospital you are more likely to die than if you were admitted to a large hospital for the same operation.

Death rates in planned vascular surgery varied from fewer than one in 50 in some hospitals to more than one in 10 in others, according to data collected by the Guardian from surgeons at 116 hospital trusts.

More than 5,000 vascular operations are carried out each year, most of which are planned.

Patients were found to be less likely to die during a planned operation in the bigger hospital units where surgical teams are more skilled because they perform the operations more frequently.

Andrew Lansley, the health secretary, announced a moratorium on anyreorganisation within the health service last month, including the closure of smaller hospitals in favour of larger institutions.

The death rate at Scarborough Hospital in Yorkshire was among the highest, with 29 per cent of patients admitted for planned vascular surgery having died in the three-year period from 2006 to 2008. The national average was just over 4%.

Scarborough said it has stopped offering the operation.

Other hospital trusts where the death rates following planned surgery were high included Gateshead, on 12.9 per cent and Hull on 9 per cent and Leeds on 7.1per cent.

Gateshead and Hull blamed a high number of difficult cases; while Leeds pointed out that it has brought its death rates steadily down over recent years.

Professor Sir Bruce Keogh, medical director of the NHS and a former heart surgeon, told the Guardian: "Surgeons have a moral and professional duty to know what they are doing, how well they are doing it and to use that information to help them improve – otherwise they have no right to be doing it at all."

 

Have I been beamed to a parallel universe? A knob from the NHS who is also a surgeon admitting that the walking on water, arrogant, club together, omnipotent surgeons cock up and kill people, is this a first? Will this change the way surgeons “operate” and will they humbly beg forgiveness from the relatives of those butchered by the “untouchables”?

 

Of course it won’t;  they will carry on maiming, killing and denying any responsibility, the old boy’s club is stronger now than ever, the GMC has developed many different personas, which enable it to let those that are senior walk away from evidence based incompetence and those that are junior lose their careers for the smallest of mistakes.

 
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The other tale also comes from the Telegraph.

Patients are much more likely to die if they are rushed to hospital at weekends than during the week, because too few senior staff are working, a new study suggests.

Higher deaths rates at weekends mean thousands of patients every year are dying unnecessarily, according to the findings.

Patients were seven per cent more likely to die if they were admitted as an emergency case on a Saturday or Sunday, the largest study of its kind shows.

The higher rates were equivalent to 3,369 extra deaths a year, more than the total number who die every year on Britain’s roads.

Conditions including heart attacks, heart failure, stroke and some cancers all had higher deaths rates at weekends than Monday to Friday.

The team behind the findings warned that a lack of senior staff, such as consultants, working weekends and reduced access to specialist services could be behind the higher death rates.

Hospitals should look closely at weekend staffing rotas and other potential problem areas, according to researchers.

Dr Paul Aylin, from Imperial College London, who led the study, said: "We estimate that there were over 3,000 more deaths than expected at weekends in 2005/06 compared to weekdays – more than the number of people dying in road accidents in 2006.

“Clearly this is a significant number of people and we need to get to the bottom of what this means.

"Staffing levels are often lower at weekends, with fewer senior medical staff around, and some specialist services are less available.

The study looked at all emergency patients admitted to 163 hospital trusts across England between 2005 and 2006.

The findings are published in the journal Quality & Safety in Health Care.

The study, supported by Dr Foster Intelligence, the independent research company, reviewed more than four million admissions and 215,000 deaths.

 

No surprises there really, the £175,000 pa consultants can’t be expected to work at weekends, after all they have to keep up their golf handicap.

 

Angus

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