100,000 high-risk surgery patients suffer sub-standard care after treatment
As many as 100,000 high-risk patients undergoing surgery in NHS hospitals each year get sub-standard care, a study suggests.
It says too many patients are sent back to general wards after surgery rather than being looked after in critical care, increasing their risk of death.
Experts from the National Confidential Enquiry into Patient Outcome and Death believe a significant number of hospitals are not well equipped for dealing with surgical patients, whether they are high or low risk.
Patients undergoing high-risk surgeries such as heart transplants are at risk away from the operating table
They carried out a snapshot investigation of care for more than 19,000 patients having routine and emergency surgery in one week at 300 hospitals, including 829 high-risk patients.
Such patients include those who have multiple conditions, serious illness or who are older, and they make up 10 to 20 per cent of more than one million operations carried out each year.
In the general population, about 1 per cent of people can be expected to die after surgery, but this rises to 10 to 15 per cent of high-risk patients.
In the study, only 48 per cent of high-risk patients got ‘good care’, there was room for improvement in 20 per cent of cases and the care of 12 per cent was ‘less than satisfactory’.
Almost 20 per cent of high-risk patients were not seen in a pre-assessment clinic before planned surgery, which led to higher death rates among this group.
Between 50,000 and 100,000 high-risk patients operated on each year are receiving less than good care
Just 22 per cent of high-risk patients were sent to critical care following surgery, and the report found the death rate was more than three times higher in those who experts assessed as being wrongly sent elsewhere.
The experts say the figures mean the equivalent of between 50,000 and 100,000 high-risk patients operated on each year are receiving less than good care.
Recommendations in the report include introducing a UK-wide system for rapid and easy identification of patients who are at high risk of dying or suffering complications after surgery, and for all such patients to be seen and ‘fully investigated’ in pre-assessment clinics.
The Royal College of Surgeons said its own studies had uncovered similar concerns.
Professor Norman Williams, president of the RCS, said: ‘It is now time for Government to grasp the nettle and ask hospitals to provide publicly available evidence on how they manage high-risk cases.’
Professor Sir Bruce Keogh, NHS medical director, said: ‘The vast majority of operations performed by the NHS are safe and successful.
‘But all patients, especially those at high risk, should receive good care – anything less is simply unacceptable.’