'Significant deficiencies' in emergency surgical care at trust

The Royal College of Surgeons was asked to investigate care at Barts and the London Trust in December after a consultant resigned in protest at a “relentless decrease in facilities”.

Orthopaedic surgeon David Goodier quit claiming there had been harm to patients after an increase in emergency admissions but that management had focussed instead on 18-week waiting times targets and finance.

The royal college’s report said a “continued rise” in emergency admissions from 2005 to 2011 “had a marked adverse effect on the ability of the hospital to manage surgical emergencies in a timely way”.

It found a four-fold increase in emergency surgical admissions was “not matched by an equivalent improvement in facilities” until early 2012.

The report also identified poor communication between clinicians and management and said “the emphasis on elective surgery to meet government waiting list targets appears to have militated against prioritisation of the emergency surgery workload.

The trust, now renamed Barts Health Trust following its merger with Newham and Whipps Cross hospitals in April, published the full text of the RCS report at its most recent board meeting.

The examiners from the royal college recognised the “significant attempts” by senior management at the trust to address the issues and said the opening of [a] new hospital should go “a long way towards addressing… the previously inadequate provision”.

The trust has also agreed an action plan for improvement and brought the orthopaedic team up to full strength. However it said “challenges remain”, with high patient volumes and raised standards for emergency care from NHS London.

The RCS team is due to revisit the trust for its follow-up visit in November.