Leading doctors have warned that two few surgeons are trained to handle emergency cases.
The increasing number of doctors who specialise in one field has created a situation where there are too few medics who can cope in any urgent situation, according to a report by the the Surgical Forum of Britain and Ireland.
Trainee doctors often think general surgery is “second class”, but as the NHS changes to adapt for the needs of patients there needs to be more doctors who can handle urgent care, the report says.
The report adds that the “current trend in configuration of services seems to be towards centralisation” - where patients are treated at specialist centres instead of local hospitals - but this would leave too few surgeons who specialise in general surgery at district general hospitals.
“In recent years, specialisation has often been at the expense of generalism which is required to deal with the breadth of emergency surgery,” the report says.
“Whilst it is inevitable that specialisation will continue, there is increasing recognition of the need to produce ‘generalists’ who can provide emergency cover.”
The forum, made up of the presidents of the four national royal colleges of surgeons, said urgent change is needed in the way clinicians are trained.
John MacFie, chairman of the Surgical Forum, said: “The conventional training and role of surgeons in some specialities is no longer appropriate to meet the demands of a changing society, where emergency surgery is the most common reason for hospital admission - something that will only increase with our growing ageing population and changing patterns to patient care.
“Safety and the best possible outcome for our patients are at the heart of all we do. To achieve these, we need a different surgical landscape for the future where in certain specialities we create consultants with a greater focus on providing emergency care.”
He added: “In recent years increasing specialisation and centralisation mean that we have fewer ‘generalist’ surgeons to provide emergency surgical cover - the term specialist often regarded as a proxy for ‘better’. This has led to emergency surgery to being considered by some as second class and as a result often under-resourced.”
Health officials are planning to review the way A&E services are run in England. The review, led by NHS Commissioning Board medical director Sir Bruce Keogh, could recommend that heart attack and stroke patients are treated at specialist centres instead of local A&E centres.
However, a move to centralise children’s specialist heart surgery units has been rebuffed by local activists and campaigners won a High Court challenge over the proposed changes after arguing that the consultation process was unfair.