The Association of Coloproctology has read with dismay the findings of the Francis report on the Mid Staffordshire NHS Foundation Trust Public Inquiry and its possible applicability to other hospitals within the NHS. Whilst the reported findings relate to one Trust, members of ACPGBI will be aware that the issues are of relevance to all NHS hospitals in the UK and we should not be complacent about the standard of care in our individual institutions.
ACPGBI supports fully the recommendations made within the report and undertakes to assist in their implementation as far as it is possible for a professional association to do so. To this end, ACPGBI is already involved in a number of initiatives aimed at improving the quality of care afforded to patients with colorectal diseases. These include:-
- Direct involvement with the National audit of Colorectal Cancer outcomes (NBOCA) – soon to release surgeon specific outcome data.
- Developing standards in the treatment of Inflammatory Bowel Disease.
- Involvement in training surgeons new to laparoscopic Surgery via the LAPCO project.
- Involvement in advanced training in surgery for rectal cancer via the LOREC project.
- Publication of the Resources required for the delivery of Coloproctological services
- Responsibility for writing the National Curriculum for Coloproctological training.
- Identifying and badging Coloproctology training units.
- Involvement with national projects and NICE guidelines.
- Development of a Governance Board and Panel, able to provide appropriate colorectal experts for peer review of colorectal surgeons’ practice and support to surgeons who are experiencing professional difficulties.
- Supporting the professional development and education of nurses involved in delivering care to patients with colorectal diseases.
- Supporting the external assessment of hospitals and units delivering colorectal services by professional organisations such as the Colleges of Surgeons.
- Providing criteria which define which surgeons should be operating on and be responsible for patients with colorectal cancer.
We undertake to keep these activities up to date and current and to develop other means of improving quality in colorectal surgery, such as mentoring for newly appointed consultants and support for revalidation of existing consultants.
Members of ACPGBI are encouraged to read the report which can be found via this link , paying particular heed to the lessons learned on pp 65-83.
Particular relevance to our speciality is noted in recommendations number 11, 16-18, 22-25, 31, 52, 59, 143, 153-156, 168, 186, 223, 256, 262-271.
Special reference is made in the summary of findings on p 42 para 4 to the behaviour of surgeons:
The RCS reached critical conclusions about the operation and management of the Trust’s surgical department, which it described as “dysfunctional”.
It is clearly stated on p60 that:
All doctors, whether fully qualified or in training, work in environments where they are under a duty to protect patients.
We would do well to heed this advice.Asha Senapati President in Waiting, ACPGBI Graham Williams President, ACPGBI