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Reaction to NELA report: “NHS must tackle inconsistency in emergency bowel surgery”

The National Emergency Laparotomy Audit (NELA) report has been published by the Royal College of Anaesthetists (RCoA). The audit analyses the care received by more than 20,000 emergency bowel surgery patients treated in NHS hospitals in England and Wales between December 2014 and November 2015.

Responding to the report’s findings, Miss Clare Marx, President of the Royal College of Surgeons, said:

“The RCS remains concerned that a lack of consistent care for patients undergoing emergency bowel surgery may be impacting patient outcomes. The 30-day mortality rate is still high at 11% and variations in the levels of patient care across NHS hospitals persist. Although standards of care for these seriously ill patients are getting better, there is still much room for improvement and it needs to be done quickly.

“As a priority, the NHS should look at access to critical care after surgery for these high risk patients. We already know that where these patients are receiving high dependency or intensive care after surgery they have better outcomes. This audit reported 39% of patients were not admitted directly to a critical care unit after surgery.

“We also note that ‘out of hours’ consultant presence is lower than during daylight weekday hours. Only 63% of patients saw both a consultant surgeon and anesthetist at the weekend, as opposed to 73% during the week. We would urge hospital teams to work together so that patients can receive the highest possible standard of care at all times.”

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