NHS trust to check death rates
Published 01/10/2013 | 16:46
An NHS trust is checking death rates for all its surgeons and reviewing 48 cases of potential patient harm following a 14-year feud between its staff.
Heatherwood and Wexham Park NHS Foundation Trust has ordered the audit on around 70 of its surgeons to establish their death and complication rates.
It follows a feud between surgeons at the trust dating back to 1999 and the discovery that 48 cases of potential harm to patients were not investigated properly.
Over the last 14 years, the trust has commissioned six internal audits to look at the matter alongside e ight internal investigations, three reviews by the Royal College of Surgeons, reviews by the National Clinical Assessment Service, two other external reviews and six external expert note reviews.
The trust serves more than 450,000 people in areas including Ascot, Bracknell, Maidenhead, Slough, south Bucks and Windsor.
An 18-month review by InPractice, a medico‐legal consultancy, found concerns had been raised repeatedly since 1999.
Those mostly centred on disagreements between surgeons Anil Desai and Andrew Gordon, both of whom are still employed by the trust.
In 1999, Mr Desai raised concerns about Mr Gordon's gastrectomy results - an operation that surgically removes all or part of the stomach.
A subsequent investigation found Mr Gordon's death rate for the procedure was 40% and he agreed to stop performing this type of operation.
But concerns continued to be raised throughout the department, including by Mr Desai, about the quality of internal investigations.
He was labelled "vexatious" and summoned to meetings about his behaviour in continuing to raise complaints.
Relations became so bad that local GPs began to raise concerns about the functioning of the department.
Chief executive Philippa Slinger has now ordered a review of the 48 cases of potential patient harm as well as an audit of the performance of all surgeons.
The analysis of surgeons, which will be carried out by health analytics firm Dr Foster, will provide an individual "scorecard" for each surgeon on how they compare.
The 48 patient cases have been referred to a legal team to assess whether any amount to any form of misconduct on the part of the trust.
Ms Slinger said the trust had tried to sort out its problems over several years but had not always investigated thoroughly.
"God knows how many reviews and God knows how many investigations were carried out," she said. "But when you look at these reviews, the terms of reference were not right or they give an answer to a question you had not asked in the first place."
She said lessons had been learned on how the trust responds to such matters to prevent such a build-up of "bad will" over many years.
She added: "There's no problem with our mortality rates.
"I want to make certain that if anybody raises concerns about a surgeon that I have a contemporary record of their current rate of complications, mortality and case mix."