HSJ approached all the trusts that were at or beneath the threshold for one or more of the GIRFT vascular activity measures. Many gave candid descriptions of their issues and what they planned to do, or had done, about them.
London North West University Healthcare Trust recruits surgeon to tackle high mortality rate
One London trust said it had recruited a professor to a vascular surgery post specifically to combat a high death rate for some procedures.
London North West University Healthcare Trust had an in-hospital mortality rate of 63.5 per cent for ruptured AAA cases from 2014-16. A spokesman said this was because it treated frailer patients.
He said: “We had some mortality in 2014-2015 following open surgical repair of such relatively sick patients. In response to this the trust headhunted Professor Martin Malina to focus and drive a minimally invasive treatment approach of AAA repair.
“Since his arrival, the department has changed its practice to treat more patients with minimally invasive techniques – this has been reflected in improvements in mortality rates and a reduction in ITU admission and vascular bed days.”
The trust, which runs a vascular centre from Northwick Park Hospital, said it did not plan to make any large scale changes as part of the review.
Ashford at St Peter’s seeks partner
Director of operations at Ashford and St Peter’s Hospitals Foundation Trust James Thomas said although his trust now hit the thresholds, the organisation was looking for partner trusts to network services with.
He told HSJ: “We recognise, however, we are close to the threshold and this is the challenge of operating as a standalone vascular service. Last year we commenced a vascular transformation programme to look at the network opportunities available to us.
“We have been fortunate to have a number of trusts come forward and express an interest in working in partnership with us. Work is still underway to identify a preferred partner and establish a new operating model.”
Six west Yorkshire trusts to centralise vascular surgery
In west Yorkshire one of the three current centres is likely to stop performing vascular procedures.
A spokeswoman for Bradford Teaching Hospitals FT told HSJ although it was the vascular hub for the region, the six acute trusts in the area were looking to centralise down to two arterial centres from the current three. Bradford, Calderdale and Huddersfield FT and Leeds Teaching Hospital Trust currently provide the service.
Barking, Havering and Redbridge seeks to retain independence
Although the GIRFT review recommended all trusts be part of a hub and spoke model, one trust is going it alone.
Despite being below both procedure thresholds on the most recent data Barking, Havering and Redbridge University Hospitals Trust said it was “an independent arterial centre”.
It said it now hit the activity thresholds and had recently started performing complex fenestrated endovascular aneurysm repairs and that “these procedures typically performed in centralised teaching hospitals, and constitute our plans to progress and develop our unit”.
Borders trust reviews network with Scottish hospitals
North Cumbria University Hospitals Trust’s Cumberland Infirmary is the hub for a network that includes the Scottish border region. North Cumbria is “actively reviewing [its] networking arrangements with Dumfries and Galloway in order to increase the number of patients [it treats]”, a spokeswoman said.
Rural South West trusts discuss network
Plymouth Hospitals Trust is recruiting for two additional interventional radiologists to hit the GIRFT staffing recommendations and is in “ongoing discussions” with other trusts about developing a network.
The trust said: “It is important to take into consideration the geographical differentiation and population density for individual trusts as this will impact clinical volume.
“The South West is rural and none of the acute trusts has the required population to be able to perform the recommended number of procedures. Despite this the GIRFT report acknowledges the clinical outcomes at Plymouth remain good.”
Royal Cornwall Hospitals Trust, which is at the end of the peninsula, is networked with North Bristol Trust and Plymouth. A spokeswoman said its outcomes was good considering the low density of its population and that population’s age.
No comment responses
Northampton General Hospital Trust made no comment apart from to say that it met requirements from NHS England as commissioner. NHS England did not comment.
None of the four trusts in the North East that were beneath the thresholds made any comment.
Shrewsbury and Telford Hospitals Trust also made no comment.
- ASHFORD AND ST PETER'S HOSPITALS NHS FOUNDATION TRUST
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Trusts reveal plans to centralise services after GIRFT review
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In depth: Trusts respond to vascular GIRFT review