Surgery Is Poorer At Treatment Centres Compared To Full NHS Hospitals, UK

Main Category: Bones / Orthopedics
Also Included In: Public Health
Article Date: 05 Feb 2009 - 3:00 PDT

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Research published today in The Journal of Bone and Joint Surgery, British Volume has demonstrated for the first time that the quality of elective surgery at Treatment Centres compares poorly with the same procedures carried out in full NHS hospitals. This confirms suspicions held by many surgeons over the quality of surgery in Treatment Centres.

In 2002 the NHS began a procurement drive in orthopaedic surgery because needs were predicted to increase beyond planned capacity. The main aim of this exercise was to develop Treatment Centres, in order to reduce waiting times and generate cost savings.

However, the experiences of 228 patients who underwent elective knee surgery from the Cardiff and Vale NHS Trust at the Treatment Centre in Weston-Super-Mare typify the problems with Treatment Centres. The majority of these problems seem to stem from staffing. Despite parameters being set that decreed that any orthopaedic specialist coming to the United Kingdom from overseas be at least equivalent to a British-trained specialist, these were not adhered to in many of the centres, including Weston-Super-Mare. The Weston-Super-Mare Treatment Centre 'was an entirely separate facility from the NHS hospital and was staffed by Swedish locums, flown in to perform operations'.

The cumulative survival rate for knee replacements at three years was 78%, 'significantly worse than that recorded in the published literature'. In a report on the treatment received by patients at the centre, Rhondda Cynon Taff Local Health Board recommended that 'all patients treated at the Weston NHS Treatment Centre should be ... offered a clinical review'.

The report's authors conclude that 'in the drive to reduce waiting times it is essential that all patients receive a high quality of treatment' and that 'the results of the Cardiff patients treated at the Weston-Super-Mare Treatment Centre are significantly worse than previously published findings'. Furthermore, 'there remains a large number of patients disappointed by the outcome' of their surgery and that these 'poor results have resulted in a significant economic impact on our service'. The much touted cost savings from Treatment Centres have so far failed to materialise, partly due to costs incurred from having to revise such a high proportion of operations.

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- The Journal of Bone and Joint Surgery - British Volume is a world leading orthopaedics journal with an Impact Factor of 1.868

- JBJS-Br publishes twelve issues a year of high-quality, peer-reviewed research, overseen by an international editorial board led by Editor James Scott

- The Journal was first published in 1948 by The British Editorial Society of Bone and Joint Surgery, a registered charity (No. 209299), with the object of the advancement and improvement of education in orthopaedic surgery and allied branches of surgery and the diffusion of knowledge of new and improved methods of teaching and practicing orthopaedic surgery in all its branches

- You can find out more about The Journal at http://www.jbjs.org.uk

Source
Becky Hall
Journal of Bone and Joint Surgery, British Volume
http://www.jbjs.org.uk

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