Action urged on vascular surgery

The numbers of patients who die following complex surgery to repair blocked or damaged blood vessels could be significantly reduced if the NHS recognised vascular surgery as a full specialty and organised care within hospitals accordingly.

Too many Trusts are unable to offer the latest best operations and not enough data is being gathered on these patients, according to a new study. The UK Audit of Vascular Surgical Services, commissioned by The Healthcare Quality Improvement Partnership (HQIP), and produced by the Vascular Society and the Royal College of Physicians clinical standards unit, asked over one hundred NHS Trusts who undertook complex vascular surgery what they provided for patients and how they organised themselves. The study found:

• Surgeons are spread thinly – a quarter of Trusts have two or fewer vascular surgeons.
 • Formal networks should be established between Trusts – only around a half of the Trusts had formal arrangements to send complex cases to the best equipped centre in their region.
• Only a quarter of Trusts employ specialised radiologists – an increasing amount of vascular operations are undertaken by endovascular repair. To do so requires interventional radiologists who can use scanners to guide the operation.
• There are not enough specialist vascular care beds – fewer that half the Trusts offer dedicated vascular beds and these patients would benefit from closer monitoring as they face a higher risk of infection.
• Occasional practice must be stopped – there are still a small number of surgeons undertaking vascular surgery as less than 50% of their workload.

Cliff Shearman, consultant vascular surgeon and president of the Vascular Society, said: “Vascular surgery can reduce death and disability from cardiovascular disease. Ruptured aortic aneurysm, a common cause of death in men over 65 years of age, stroke and amputation can all be reduced by well organised vascular services. This audit shows that, while progress is being made on developing clinical teams and specialist nursing, not all patients with vascular disease receive the priority and standard of care they should expect. The evidence is clear that the more vascular surgery a team does, the better the outcome for patients and we need hospitals to work together to ensure patients go to the best unit for them.”


 

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