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Poor team working leading cause of surgical practice problems, RCS says


By Valeria Fiore
Reporter
25 March 2019

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NHS leaders and surgical teams in the UK need to make sure they adopt strong team working across all services to help improve patient care, the Royal College of Surgeons (RCS) has said.

The college analysed over 100 surgical reviews it compiled over the past 10 years and revealed – in a report published today – that ineffective team working was the reason for surgical practice problems in 76% of the cases.

The UK’s surgical outcomes are among the best in the world, according to the RCS and the recent CQC’s Annual State of Care report.

However, more progress needs to be made as RCS’s analysis of the surgical reviews found that surgical teams were not meeting regularly, which means ‘problems can occur and patient safety can be affected’, the RCS said.

The report said that tensions between different teams of surgeons might arise after a merger, if little attention is given to the consolidation of the new team.

Key findings

Since 1998, the RCS has offered an ‘invited review mechanism’, which gives hospitals access to independent reviews of surgeons and surgical service.

In its Learning from Invited Reviews report, published today, the RCS analysed 100 of these reviews conducted between 2008 and the end of 2017.

In 68% of the RCS reviews, concerns emerged around the timely recognition and resolution of issues of surgical practice, while in 51% of the cases, the RCS said there were problems with the facilities and resources available.

These included a lack of ‘surgical ward beds and/or the ability to ring fence beds for elective procedures’ and the ‘number and skill-mix of nursing staff supporting surgical services’.

Leadership was also identified as an area of concern in 54% of the reviews. The RCS report said that in some cases, ‘clinicians and managers are perceived as operating in separate worlds, perpetuating a “them and us” mentality’.

Commenting on the RCS findings, RCS Invited Review Mechanism chair Professor Timothy Rockall said: ‘As difficult as it can be to question the practice of colleagues, it’s vital that surgical teams improve the quality and frequency of discussions about surgical performance, so that problems can be resolved before they affect the safety of patients.

‘It is also worth emphasising that problems with team-working are not unique to surgery and hospitals should be considering how improvements in team-working can be made across all services.’

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