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Future Of Surgery To Take Place Close To Patients' Homes

Armen Hareyan's picture


A new report recommends that 80% of all surgery should be done locally with the remaining 20% of the more complex cases taking place at specialist centres where patients will have access to the most highly skilled surgeons in their field, using the most up to date technology.

In his report 'Saws and Scalpels to Lasers and Robots - Advances in Surgery' Prof. Sir Ara Darzi the National Advisor on Surgery, sets out the changes that have taken place over the past two decades which have led to a revolution in how surgery is carried out. The use of more lasers and keyhole surgery has led to a quicker recovery for patients and less risk of infection. Procedures that previously required long stays in hospitals, such as hernia operations, can now be done as day cases in more local settings. The development of new drugs have made some surgery, such as the treatment of stomach ulcers, completely unnecessary,

Prof. Sir Ara Darzi said: "Whilst I have been practising as a surgeon there have been major advances in surgical techniques. Advances that mean the physical and psychological trauma of surgery for the patient is much diminished. Smaller incisions plus a speedier recovery equals improved care for patients. Yet we could be doing much more minimally invasive day case surgery.

"As surgery has improved, it has also become more specialised. To take advantage of this specialisation we need to ensure that the most complex cases are being treated by the most skilled surgical teams (surgeons, nurses and anaesthetists). The NHS is not yet providing surgery in a way that makes the most of the progress in surgery over the last twenty years. I hope my report will be a step in changing that."

Speaking at the Royal College of Surgeons, Health Secretary Patricia Hewitt welcomed the report: "Patients will be pleased to know that they can receive high quality surgical care closer to their homes with short waiting times. The fact that patients can now have high tech surgery in one day, leaving a small scar and having a faster recovery time, will also be appreciated.

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"This report - for which I am grateful to Sir Ara Darzi - highlights the need for changes in surgery to happen now - not in ten years time. Past history has shown that surgeons have always been at the forefront of changes in healthcare, leading the way in the technological developments.

"It is vital that surgeons and other healthcare professionals are as equally involved in driving forward the service changes that are necessary for patients to get the best possible care in the most appropriate places. These clinical arguments need to be communicated to patients so that they also recognise that these changes are necessary to save lives.

"There are some small changes to working practices that can take place quickly with almost immediate benefit for patients. By working more effectively and using surgeons' and theatre time efficiently, we can deliver an even better service for patients."

Commenting on the report the President of the Royal College of Surgeons, Mr Ribeiro said, "I welcome the intention that most patients should have their surgery done locally as day cases as long as the required facilities are available for pre-operative assessment, surgery and post-operative care. This trend towards day case surgery is evidenced by increasing numbers performed by NHS consultants each year in many different settings. It is imperative that surgery is carried out by appropriately trained and qualified surgeons who meet the standards required by the College. This is essential to ensure the safe treatment of our patients.

"Equally, the College strongly supports the requirement that surgeons with the greatest experience in specialised areas should be operating on the most complex cases."

The Secretary of State also announced the new National Clinical Advisory Team today which will provide a pool of clinical experts to support and guide the local NHS on service change proposals to ensure that they are safe and accessible for patients. The team members, led by Prof. George Alberti, are all highly respected clinicians who can either lend their support to proposed changes or suggest adjustments to proposals which can feed in to the consultation process.