THE NHS must address the significant variations in care experienced by the 170,000 patients who have major emergency abdominal surgery each year, says a new report published by the Royal College of Surgeons (RCS).
Norman Williams, President of the RCS, said: ‘The focus on reducing waiting times for elective procedures has resulted in a large group, of mostly elderly patients, becoming seriously under prioritised to the point of neglect in some NHS hospitals.’
Poorly designed hospital services, particularly access to emergency operating theatres and radiology treatment, are among the problems highlighted in the report. This results in patients missing out on early diagnosis and rapid life-saving care.
Mr Iain Anderson, report author and Consultant General Surgeon at Salford Royal NHS Foundation Trust, said: ‘Every acute hospital in the UK deals with many emergency patients every single day, among who three or four will typically meet these higher risk criteria.’
He added: ‘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.
‘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.’
Williams stressed: ‘These changes won’t happen on their own and we are calling on all surgeons and managers to work together to deliver the high quality care that these patients need and which some hospitals are already proving can be delivered.’
The report, The Higher Risk General Surgical Patient: Towards Improved Care for a Forgotten Group makes nine detailed recommendations.
These include:
• Recognition of the need for improved services, including access to operating theatres.
• Routine risk assessment and tailored management of every patient.
• Better use of critical care: Patients at highest risk should be admitted to critical care after surgery. Due to a limited number of critical care beds, less than a third of high risk NHS patients are currently admitted to critical care following surgery.
• Improved post operative care, including treatment of severe infection.
• Routine audit of emergency patients.
