Latest news with #RoyalCollegeofSurgeons
Belfast Telegraph
17 hours ago
- Health
- Belfast Telegraph
Department of Health bypassed own regulator over report into the Royal's cardiac unit
A leaked report made headlines last week after it found an 'intolerable working environment and a pattern of consistently poor behaviour within the unit'. It indicated operations had been cancelled due to 'personal grievances' between staff and that four consultants had been working from home, citing 'safety and wellbeing' concerns. Chair of the health committee, Sinn Féin's Philip McGuigan, has called on the department to publish the report 'in the interest of transparency', adding that he had not yet seen it. Northern Ireland's health watchdog, the Regulation and Quality Improvement Authority (RQIA), has confirmed it was not approached to carry out a review into the issues at the cardiac surgery unit. A spokesperson said: 'RQIA has not been asked to produce any such report recently.' The body had previously inspected the unit in December 2021. It came a year after a Royal College of Surgeons invited service review report which found a 'breakdown of communication and working relationships within the service'. The invited service review was completed in March 2020, just weeks before the Covid-19 pandemic took hold, and made 37 recommendations relating to interpersonal and behavioural issues within the service. RQIA's review found some improvements had been made. 'RQIA were pleased to see early signs of change and improvement whilst cognisant that it takes time to make cultural changes and embed these fully within a service; it is a journey that requires strong and resilient leadership to embed the vision, align behaviours accordingly and instil robust systems of monitoring and accountability,' concluded the regulator. It recommended that the Trust should 'ensure the cardiothoracic management team involves and actively engages with all staff disciplines and groups'. 'Meetings should be structured to promote constructive discussion and collaboration to address the recommendations of the invited service review,' added the review team. It is understood the leaked review was commissioned by the Public Health Agency (PHA) working alongside the department. A Department of Health spokesperson said 'expert input' from other parts of the UK was required to complete the report. 'Cardiac surgery is a highly specialised service and the Royal Victoria Hospital is the only unit in Northern Ireland to deliver this service,' they said. 'For this reason, securing expertise from people experienced in the area means going outside Northern Ireland. 'An earlier external review had been undertaken in the Royal Victoria Hospital by the Royal College of Surgeons. That review confirmed the cardiac service was safe, but highlighted areas for improvement. Whilst Belfast Trust subsequently undertook work to address issues raised, the department and PHA obtained further external expertise to help support the team with a focus on two metrics — patient safety and team working. 'It was agreed to engage an experienced team with specific expertise involving senior clinicians who had completed similar work in the UK, including in other cardiac surgery units.' Mr McGuigan told the BBC Sunday Politics programme that the report had led to 'very many public trust issues'. 'We are told there are recommendations and an action plan contained within the report. 'I think for proper scrutiny and to restore public trust, what we need to see is the report in the first instance published so we can interrogate the recommendations for restoring public trust in this issue,' he said. Health Minister Mike Nesbitt has said he wants to place the report in the library of the Assembly, but is currently receiving legal advice. 'People need to have confidence when they go to a hospital or whatever health setting that they are going to be looked after properly,' added Mr McGuigan. 'One of the things in the report was that the behaviour of the staff was posing a risk to patient safety, so that in itself is very concerning.'
The Independent
3 days ago
- Business
- The Independent
Life-changing surgery denied for overweight patients
NHS areas in England and Wales are denying obese patients hip and knee replacements based on BMI, despite NICE guidance against it, to cut costs. Patients are required to lose weight before surgery, but NHS weight loss programs have long waiting lists or are shut down. The Royal College of Surgeons of England has criticised the policy, warning that denying care could worsen patients' health and mobility. Former health minister James Bethell urges the government to address the obesity crisis, suggesting investment in weight-loss treatments or a stricter food strategy to avoid increased NHS costs and public misery. An audit by the National Institute for Health and Care Research found that 15 of 42 NHS areas in England restrict surgery access by BMI, with some patients resorting to private care.
Yahoo
3 days ago
- Business
- Yahoo
Obese patients denied knee and hip replacements to slash NHS costs
Obese patients are being denied life-changing hip and knee replacements and left in pain in a bid to slash spiralling NHS costs, The Independent can reveal. One third of NHS areas in England and multiple health boards in Wales are blocking patient access based on their body mass index (BMI). The move, deemed 'unfair' and 'discriminatory', goes against guidance from the National Institute for Care Excellence (Nice), which states BMI shouldn't be used to restrict patients' access to joint replacement surgery. Patients are instead being told they must lose weight before they are eligible but waiting lists for NHS weight loss programs have ballooned, with some people waiting up to three years to be seen while other services have shut, unable to cope with demand. The Royal College of Surgeons criticised the policy, saying that denying patients care could cost them their mobility and cause their health to deteriorate, while Tory peer and former health minister James Bethell called on the government to do more to tackle the obesity crisis and end the 'misery for millions'. More than 64 per cent of adults in England were overweight or living with obesity in 2022-23, up from 63 per cent the year before, the most recent data from the Office for National Statistics shows. The news comes as 7.4 million people were waiting for NHS treatments in March, while health service leaders have warned they are being forced to cut services to meet tough savings demands from the government. The shocking revelation of surgery refusals was uncovered in an audit of referral criteria used by NHS bodies in England by the National Institute for Health and Care Research (NIHR). It found 15 of 42 areas are restricting access to surgery by BMI, while The Independent discovered at least two health boards were doing the same in Wales. Thresholds varied by area, with some limiting access to those with a BMI of less than 35 (patients who are obese) or 40 (severely obese). Dr Joanna McLaughlin, lead researcher and NIHR clinical lecturer at the University of Bristol, told The Independent that through her research, policymakers, commissioners and surgeons 'acknowledged that NHS financial pressures were a main driver for BMI threshold policy use, and that they didn't have confidence that the policies were based in evidence of health benefits'. The research also found that NHS weight management support services were 'inadequate' and could not ensure that those excluded from surgery could be supported to lose enough weight. Some patients had resorted to paying privately for surgery. Dr McLaughlin said: 'The variety in the BMI limits and in the requirements to prove patients have made attempts at weight loss chosen by different ICBs [integrated care boards] highlights the postcode lottery and inequalities created by these policies.' Several ICBs identified by the study told The Independent that some patients with a high BMI could still access care if they passed an assessment, while others said they would need to prove they were 'fit for surgery'. But medics told The Independent that BMI should not be used as a sole restrictive measure. Tim Mitchell, president of the Royal College of Surgeons of England, said losing weight before surgery could reduce the risk of complications, and patients should be supported in this. However, he said that 'BMI alone should not be a barrier', adding: 'We must not penalise those who are less fit but still eligible for surgery, as this approach is unfair and ignores clinical guidance.' Mark Bowditch, president of the British Orthopaedic Association, said: 'Losing weight before surgery can be very difficult for people with limited mobility issues. 'Furthermore, obesity is more likely in people from certain socioeconomically deprived areas or ethnic groups, so care must be taken to avoid unintentionally disadvantaging certain patient groups.' Deborah Alsina, chief executive of charity Versus Arthritis, said: 'We hear heartbreaking stories from people desperate for the pain to stop, and accounts from people who face barriers to access even when they are referred for the surgery they urgently need. 'We frequently hear of people denied a referral, or being taken off the waiting list because of their weight, with body mass index being cited as a rationale. We must make sure this discriminatory practice doesn't become standard.' Lord Bethell said the row over BMI thresholds for operations showed the NHS 'needs to make a choice' over preventing disease with weight-loss jabs, which cost £100 a month, or to treat obesity-related diseases, such as those that lead to hip operations, which can cost £10,000. He said the government has a choice to either crack down on 'Junk Food Britain' with a tough food strategy or to give the NHS a lot more money to pay for the consequences of a sick population. He added: 'It's one or the other. Ducking this choice will cause misery for millions, the bankruptcy of our nation and the end of the Starmer administration.' A Department of Health and Social Care spokesperson said it expected ICBs to comply with Nice guidance. They added that the department's 'Plan for Change' for the NHS includes rolling out weight loss drugs to 'those who need it most'.
The Independent
3 days ago
- Business
- The Independent
Obese patients denied knee and hip replacements to slash NHS costs
Obese patients are being denied life-changing hip and knee replacements and left in pain in a bid to slash spiralling NHS costs, The Independent can reveal. One third of NHS areas in England and multiple health boards in Wales are blocking patient access based on their body mass index (BMI). The move, deemed 'unfair' and 'discriminatory', goes against guidance from the National Institute for Care Excellence (Nice), which states BMI shouldn't be used to restrict patients' access to joint replacement surgery. Patients are instead being told they must lose weight before they are eligible but waiting lists for NHS weight loss programs have ballooned, with some people waiting up to three years to be seen while other services have shut, unable to cope with demand. The Royal College of Surgeons criticised the policy, saying that denying patients care could cost them their mobility and cause their health to deteriorate, while Tory peer and former health minister James Bethell called on the government to do more to tackle the obesity crisis and end the 'misery for millions'. More than 64 per cent of adults in England were overweight or living with obesity in 2022-23, up from 63 per cent the year before, the most recent data from the Office for National Statistics shows. The news comes as 7.4 million people were waiting for NHS treatments in March, while health service leaders have warned they are being forced to cut services to meet tough savings demands from the government. The shocking revelation of surgery refusals was uncovered in an audit of referral criteria used by NHS bodies in England by the National Institute for Health and Care Research (NIHR). It found 15 of 42 areas are restricting access to surgery by BMI, while The Independent discovered at least two health boards were doing the same in Wales. Thresholds varied by area, with some limiting access to those with a BMI of less than 35 (patients who are obese) or 40 (severely obese). Dr Joanna McLaughlin, lead researcher and NIHR clinical lecturer at the University of Bristol, told The Independent that through her research, policymakers, commissioners and surgeons 'acknowledged that NHS financial pressures were a main driver for BMI threshold policy use, and that they didn't have confidence that the policies were based in evidence of health benefits'. The research also found that NHS weight management support services were 'inadequate' and could not ensure that those excluded from surgery could be supported to lose enough weight. Some patients had resorted to paying privately for surgery. Dr McLaughlin said: 'The variety in the BMI limits and in the requirements to prove patients have made attempts at weight loss chosen by different ICBs [integrated care boards] highlights the postcode lottery and inequalities created by these policies.' Several ICBs identified by the study told The Independent that some patients with a high BMI could still access care if they passed an assessment, while others said they would need to prove they were 'fit for surgery'. But medics told The Independent that BMI should not be used as a sole restrictive measure. Tim Mitchell, president of the Royal College of Surgeons of England, said losing weight before surgery could reduce the risk of complications, and patients should be supported in this. However, he said that 'BMI alone should not be a barrier', adding: 'We must not penalise those who are less fit but still eligible for surgery, as this approach is unfair and ignores clinical guidance.' Mark Bowditch, president of the British Orthopaedic Association, said: 'Losing weight before surgery can be very difficult for people with limited mobility issues. 'Furthermore, obesity is more likely in people from certain socioeconomically deprived areas or ethnic groups, so care must be taken to avoid unintentionally disadvantaging certain patient groups.' Deborah Alsina, chief executive of charity Versus Arthritis, said: 'We hear heartbreaking stories from people desperate for the pain to stop, and accounts from people who face barriers to access even when they are referred for the surgery they urgently need. 'We frequently hear of people denied a referral, or being taken off the waiting list because of their weight, with body mass index being cited as a rationale. We must make sure this discriminatory practice doesn't become standard.' Lord Bethell said the row over BMI thresholds for operations showed the NHS 'needs to make a choice' over preventing disease with weight-loss jabs, which cost £100 a month, or to treat obesity-related diseases, such as those that lead to hip operations, which can cost £10,000. He said the government has a choice to either crack down on 'Junk Food Britain' with a tough food strategy or to give the NHS a lot more money to pay for the consequences of a sick population. He added: 'It's one or the other. Ducking this choice will cause misery for millions, the bankruptcy of our nation and the end of the Starmer administration.' A Department of Health and Social Care spokesperson said it expected ICBs to comply with Nice guidance. They added that the department's 'Plan for Change' for the NHS includes rolling out weight loss drugs to 'those who need it most'.
RTÉ News
5 days ago
- Automotive
- RTÉ News
'This can happen to you too', warns young woman injured in road crash
A two-day Safer Roads conference is taking place in Killarney, Co Kerry, drawing on experts from across Europe in the areas of road design, engineering, policing, enforcement, technology and education. The conference will explore how artificial intelligence, and analysis of road collision trends and statistics can be used to improve road safety. Almost 300 delegates and speakers, including a young woman who was badly injured in a road collision nine years ago, will attend the event. Paschal Sheehy spoke to the 20-year-old about the impact of the crash on her life. Méabh White has just finished her second year of pharmacy studies, almost a decade after she suffered severe injuries in a car collision. She is 20, going on 21. She is studying at the Royal College of Surgeons in Dublin, and is looking forward to a bit of free time over the summer. At least some of that time will be spent with her family in Co Roscommon - with her mum, Clodagh, and younger brother and sister, Rían and Sadhbh. A decade is a long time in the life of a young person and almost ten years ago Méabh's life was changed forever, in a matter of seconds. On 9 July 2016, Méabh was on her way to a birthday party. Her mum was driving with Méabh in the front passenger seat and Rían in the back of the car in a rear-facing child seat. At a crossroads half a kilometre from their home in Kilteevan, Co Roscommon, they were involved in a collision with another vehicle and their Renault Scenic was propelled through a 2m wall into a field. Méabh suffered the most severe injuries. She had a cracked skull and intercranial haemorrhages, a fractured C1 vertebra in her neck, and she broke her back and pelvis. Méabh was transferred by helicopter to University Hospital Galway and from there to Temple Street Children's Hospital in Dublin. She spent three days on life support and a week-and-a-half in intensive care. When she finally woke up, Méabh was on a spinal board, staring at the ceiling. Her mum was still in hospital in Co Galway, being treated for serious, but non-life-threatening injuries. Rían escaped serious physical injury. His rear-facing car seat - fitted only four days before - probably saved his life. Méabh was watched over during this time by her grandmother, Teresa, in St Gabriel's Ward in Temple Street. "I just remember saying to her, 'is this all I'm going to be able to see - the ceiling, am I ever going to be able to see anything else again?'," she said. At that time, Méabh was under the care of consultant neurosurgeon, Muhammad Sattar. He told her there was no medical reason to explain why she woke up. 'This kind of stuff can happen to you' Méabh said it was a year or so before she started to return to herself. Initially, she used a wheelchair as she had to learn to walk again. Then, there were the mental scars that had to heal, that took time too. Today, Méabh is looking forward to enjoying the coming summer with her family. She embraces life with both arms. And, when she has time in her busy schedule, she addresses road safety. "I do it because there are so many teenage road deaths, so many young people dying on our roads," Méabh said. She said: "They think they are titanium, they don't understand that this kind of stuff can happen to you, even if you aren't in the wrong. "I was 12. I had my entire teenage years permeated with pain, permeated with the legal aftermath of the crash, the trauma, the physical injuries. "I felt I was living two separate lives, because obviously I was a teenager and there is so much to being a teenager without that on the side." Méabh is due to attend the two-day Safer Roads conference in Killarney, Co Kerry, that is being held today and tomorrow. The conference is not open to the public. Instead, it is drawing on experts from across Europe in the areas of road design, engineering, policing, enforcement, technology and education. The conference will explore how artificial intelligence, and analysis of road collision trends and statistics can be used to improve road safety. Almost 300 delegates and speakers are attending the event, which is being hosted by Kerry County Council. "Road safety is not just about the road or the vehicle but also about how technology, human behaviour, enforcement and education intersect to reduce risks and prevent accidents," Kerry County Council's Road Safety Officer Declan Keogh said. "Every branch of the road safety tree is represented and our main aim is to improve road safety for every road user," he added.
