Hospital Dr News

Centralisation of general surgery in East Kent

High risk and emergency general surgery in East Kent is being centralised at Kent and Canterbury Hospital due to staff shortages.

The board of East Kent Hospitals University Foundation Trust said it was an interim measure to ensure that high risk emergency and elective general surgery for all of East Kent can be delivered in the safest way possible.

The move will be with effect from May 2014. The exact date will be dependent on ensuring the right infrastructure is in place.

The decision follows a report to the board, which outlined the reasons why the trust needed to take this action, and the risks of not taking the decision. This is entirely in line with the Royal College of Surgeons approach to delivery of high risk and out of hours surgery, the trust said.

Trust medical director Dr Paul Stevens said: “We have found it necessary to take this decision because of a serious clinical risk that will arise in high risk general surgery due to insufficient gastro – intestinal surgeons being available to provide emergency cover, twenty four hours a day and seven days a week.

“This has come about because of the increasing sub-specialisation of surgery, the lack of availability of surgeons with skills that are essential to managing high risk and emergency general surgery, and the difficulty recruiting both permanent and locum medical staff. If rotas were to be maintained at two centres they would become staffed predominately by locum surgeons, which would have potential implications for patient safety which the trust cannot ignore.

From May 2014, all emergency and elective high risk general surgery will be transferred to the Kent and Canterbury Hospital. Clinical assessment in the emergency department, day surgery and low risk general surgery will continue as now in both Ashford and Margate.

Stevens said: “The trust has taken steps to address these issues, but there remains a problem in recruiting sufficient appropriate surgical staff to maintain two emergency rotas.”

All other forms of surgery are unaffected by this decision as are Accident and Emergency and the interim Trauma Unit.

Stevens added: “We want to make it clear that this is an interim decision being taken to ensure high risk and emergency general surgery are delivered in the safest possible way. This decision will allow us to concentrate our staff resources and ensure the provision of high quality care for all our patients with positive outcomes as identified by national best practice.”

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