Will recommendations on cardiothoracic surgery changes improve services?
A report from the getting it right first time (GIRFT) programme recommends changes to the way cardiothoracic surgical services are organised and delivered in England.
It claims the changes will deliver better outcomes for patients with chest, heart and lung conditions such as blocked arteries, lung cancer, and heart valve disease.
There are 31 cardiothoracic units in the NHS in England.
Surgeon and author of the report David Richens identifies 20 recommendations, among which are:
- more efficient bed management by ensuring surgery on day of admission is delivered routinely
- ring-fencing beds on intensive care units (ITU) and general wards
- sub-specialisation for certain critical procedures
- use of less invasive thoracic surgery known as VATS (video-assisted thoracoscopic surgery) for lung resection surgery
- emergency surgery rotas for major trauma to be covered by both thoracic and cardiac surgeon
- pooling non-elective cases ready for next available theatre session and next available appropriate surgeon
- ensuring cases of deep sternal wound infection are reviewed by a multidisciplinary team, led by a consultant microbiologist
- establishing a national formal policy for complex and very high-risk cases
- establishing collective responsibility for clinical outcomes.
British Medical Journal: Better patient flow in cardiac and thoracic surgery could save £45m a year in England