Exclusive: NHSE aware of concerns over surgery nearly three years before suspension

NHSE in the South East commissioned a report into upper GI cancer services in parts of the region in January 2020. In particular, HSJ understands the review was prompted by concerns the small number of surgeries carried out at the Royal Sussex County Hospital in Brighton meant it may be unable to comply with parts of the service specification and face difficulties maintaining an adequate surgical workforce rota.

Despite these concerns, Brighton continued to carry out upper GI surgery until the CQC suspended planned oesophagic-gastric resections last August. In a report published in December, its inspectors raised concerns including:

• A consultant refusing to attend hospital to carry out urgent surgery, and other incidents where surgeons could not be contacted;
• An on-call rota that was shared with the lower GI surgeons – which goes against professional body advice – because there were insufficient upper GI surgeons to cover it; and
• Mortality rates for oesophago-gastric patients that were twice the national average – although this did not make the trust an outlier – and an increasing number of emergency readmissions for patients who had had upper GI surgery.

NHSE said its review is still ongoing, having been “significantly impacted” by the pandemic and then paused again in September 2022 “to support response to operational issues”. It added there had been “review visits undertaken during this time to ensure the safety of services”. 

A spokesperson continued: “NHS England continues to work with the CQC, the integrated care board and UHSx to resolve identified issues and ensure there is a safe service provided to patients, including establishing an interim arrangement for patients requiring specific surgical intervention to access care at the Royal Surrey.”

UHSussex declined to comment seperately. 

Meanwhile, recently released National Oesophago-gastric Cancer Audit data covering 2018-21 shows the trust had better than average 30 and 90 day mortality for cancer patients.