'Deep-rooted' Issues in Neurosurgery Unit Potentially Affected Care: Leaked Review

April 08, 2021

"Deep-rooted" relationship issues between consultants in an NHS trust’s neurosurgery department "had potential to compromise patient care", a leaked review concluded.

The review by the Royal College of Surgeons (RCS) into the departmental service at University Hospitals Birmingham (UHB) trust was completed in May 2020.

The RCS findings suggested there had been wide-ranging problems for several years, in conclusions first published on Wednesday in the Health Service Journal (HSJ) which had access to a leaked copy of the report.

It comes as a separate and independent review is underway into the care of 23 patients at the trust who, between 2017-19, had deep brain stimulation (DBS).

That review is not expected to report back until the autumn.

Improvements 'Ongoing'

UHB said it had "welcomed" the RCS review and had been able to "work through" the majority of its recommendations, adding improvements were "ongoing".

The RCS report authors said: "Poor team working and inter-relational difficulties, which had been deep-rooted and recognised to have existed for some time, have had the potential to compromise patient care and will be likely to continue to do so if these issues remain unresolved."

It suggested some consultants at the department, based at Birmingham’s Queen Elizabeth hospital, prioritised personal or professional differences over patient care, with relationship issues "amplified" within the wider surgical workforce.

The report said trust management had not addressed "unacceptable" behaviour from some consultants, and had taken "largely ineffective" steps to address problems.

There were also allegations trust management had failed to investigate or address bullying claims, while some consultants formed "cliques" and used meetings to "promote division and criticise trainees".

The RCS also found the trust was committed to addressing the issues, and there were signs of improvements.

A UHB spokesman said: "This review was carried out over a year ago at the request of the trust and was an opportunity to see where improvements might be made in line with our commitment to enhance the quality of patient care.

"We welcomed the report in May last year and, despite the pandemic, have so far been able to work through three quarters of the recommendations and reported this back to the RCS where improvements have been implemented, concluding their involvement in the process.

"This improvement work remains ongoing."

DBS Review

Meanwhile, a clinical review is continuing into DBS.

The independent review is expected to cover why some patients treated have not benefited as expected, and could be extended to include more than the 23 cases already being reassessed.

The process is being led by three external neurologists and two external neurosurgeons.

A spokesman for UHB added: "The trust has separately invited a clinical review into the outcomes of deep brain stimulation (DBS) procedures.

"The review will look at outcomes in patients who underwent procedures from 2017-2019 and will be conducted by independent specialists.

"The initial part of this review is expected to report in the autumn."

This article contains information from PA Media.

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