PERFORMANCE: A troubled foundation trust has commissioned performance reports on each of its surgeons after an internal audit uncovered a 14-year feud among clinical staff and 48 cases of possible harm to patients that were never investigated.
The move, by Heatherwood and Wexham Park Foundation Trust, comes after a report it commissioned uncovered a litany of unresolved concerns relating to harm to patients and soured personal relationships in its general surgery team.
The trust has now commissioned health analytics company Dr Foster to produce performance scorecards for each surgeon, showing their mortality and complication rates, and case mixes. These will first be rolled out in general surgery, urology and trauma and orthopaedics.
All the surgeons – including those named in the external report who are still with the trust – are now operating safely, the trust says.
This week the trust released a summary of the report, which was written by consultancy InPractice over the past 15 months. It reveals the dispute has been going on since 1999, when concerns were raised about the safety of surgeon Andrew Gordon’s gastrectomy practice. He was later found to have a 40 per cent mortality rate for one particular high-risk operation, which he subsequently agreed to stop performing.
However, colleagues continued to complain about previous patient deaths. The InPractice review details how, over the following years, concerns were raised about other members of the team and some surgeons were referred to mediation to address their personal differences. The acrimony – and allegations of poor practice – continued despite six internal audits, eight internal investigations, three reviews by the Royal College of Surgeons and several other assessments and reports.
InPractice found there are 48 cases where concerns were raised over possible harm to patients, which were never investigated.
One consultant, Anil Desai, raised 37 concerns, 17 of which were not reviewed. He was labeled “vexatious”, and later lost an employment tribunal alleging discrimination by the trust.
InPractice found there was no evidence that the quality of the previous reviews had been checked, and found a number of concerns raised had not been investigated. It is now implementing a new policy for investigating concerns at the trust.
Chief executive Phillippa Slinger, who took over in 2011, said: “The impact of those few, dysfunctional relationships has been felt widely across departments.” She added that “more often than not, actions were taken in good faith on the basis of a series of inadequate investigations [by the trust].”