The NHS ‘use of private hospitals during the coronavirus pandemic was investigated following the death of a man.
Concerns have been raised that some private hospitals would perform more complex surgeries than they are used to.
Investigators also suggested that there are some “safety risks” when organizations take shared responsibility for caring for a patient, including a lack of clarity about roles and responsibilities and communication issues.
The Department of Health and Safety Investigations (HSIB) opened an investigation after a man died in a private hospital after receiving NHS treatment.
The man, known only as Rodney, was 58 years old and was listed for keyhole surgery to remove part of his bowel due to cancer.
However, his surgery at an NHS hospital was canceled and transferred to a nearby private hospital after cancer services were transferred to local independent care providers.
Rodney was asked to sign an informed consent form for open bowel surgery instead of the less invasive keyhole procedure, as there was a “potentially increased risk of Covid-19 transmission during laparoscopic surgery,” the HSIB said.
The cancerous part of his bowel was removed, but eight days later his condition deteriorated rapidly and he was transferred to the local hospital to receive intensive care that was not available at the private hospital.
When he arrived at the local NHS hospital, a scan and further operations revealed a leak in his bowel that led to sepsis and organ failure. He died later that day.
As a result of the case, the HSIB initiated an investigation into NHS surgical services performed in independent hospitals due to “dynamic situations” such as the coronavirus pandemic.
His conclusions included:
– The ability and capacity of independent hospitals to provide surgical care “varies” across the country.
– National and local NHS organizations had a “limited understanding” of the capabilities of independent hospitals. This led to different uses of independent hospitals during Covid-19.
– Other factors that gave rise to risk were “unclear roles and responsibilities; limited integration of information and communication systems; and variation of the operation deemed appropriate for an independent hospital ”.
His report highlighted that a national agreement was in place during the pandemic to provide additional support from the private sector, including certain types of operations.
The HSIB added that NHS patients were previously cared for by private health care providers and will continue to do so for years to come.
There were six recommendations for “improving surgical procedures”.
Kathryn Whitehill, Senior National Investigator at HSIB, said, “NHS patients are now being cared for more than ever in the independent health sector.
“The reference case we examined and the results of the national investigation show that gaps in the surgical treatment pathway can have devastating effects on patients, families and medical staff.”
David Hare, CEO of the Independent Healthcare Providers Network (IHPN) said, “This unprecedented agreement, signed in March 2020 at a time of significant upheaval and uncertainty in the healthcare system, resulted in the delivery of over 3.2 million NHS procedures, including over 160,000 life-saving cancer and cardiology treatments.
“We therefore welcome the HSIB’s recommendation for NHS New Integrated Care Systems (ICS) to fully understand local independent health care and to ensure that the sector is an important part of this new system.”
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