Reports from Royal College of Surgeons

Why did the Royal College of Surgeons write two reports on our surgical services?

We invited the Royal College of Surgeons (RCS) to visit the Trust because we wanted to seek their advice in some areas of service delivery and training in general surgery. We wished to seek advice where any areas of concern were substantiated and would benefit from actions to remedy and improve.

This process of Invited Review is offered to NHS organisations by the Medical Royal Colleges as part of a national Framework to promote patient safety and improvement in patient care.   It is a valuable service and we are grateful for the input and advice of the RCS.

The RCS reports are available on the following links. For further information contact us at: communications@nnuh.nhs.uk:

·       Report by the Royal College of Surgeons – Upper Gastrointestinal (GI) and Emergency Surgical Service

·       Report by the Royal College of Surgeons – Clinical Practice of Surgeon A

We have put these reports into the public domain as part of the Trust’s commitment to openness and transparency.  In doing so we are obliged to protect confidential information, especially of identifiable individuals, and where names etc have been removed this is specified.  We are also conscious that such invited reviews can only be most effective if people feel freely able to contribute to the review.   We have therefore removed certain information that might lead to identification of individual interviewees.   The terms of reference, conclusions and recommendations of the RCS however remain clearly stated.

By their nature, Invited Reviews tend to address circumstances that may be difficult and sensitive.  It is important that the resulting reports should be received in an appropriately informed and mature way, recognising the complexities of modern healthcare delivered by multi-disciplinary teams.  The Trust is committed to supporting a Just Culture – in accordance with the NHS National Patient Safety Strategy.   We are grateful to the RCS for its advice and ask that the resulting reports should be viewed in a way that recognises their purpose of promoting patient safety, improvement and collective learning.

What have we done as a result?

We have already put in place a number of changes to our gastrointestinal and emergency surgery service in response to the RCS report, including:

• a new dedicated ‘hot gall bladder’ surgical list for patients who need urgent treatment, running three days per week to boost capacity and reduce waiting times, with protected staffing to ensure service quality and consistency (in place);
• creating a Standard Operating Procedure for management of the waiting list specifically for ‘hot’ gallbladder cases (in place and in use);
• additional clinical supervision and advanced training (in place);
• enhanced monitoring of outcomes through clinical audit and clinical review meetings (in place).

How will we know that changes have been made?

Changes have already been made (as detailed above) and ongoing progress in implementing these actions will be monitored through the Division of Surgery Clinical Governance Structure and overseen by the Trust’s Quality and Safety Committee.