Senior managers and clinical staff in Oxford have defended witholding a report on alleged deficiencies in gallbladder surgery at the Horton General Hospital.
The report, written by the Royal College of Surgeons last December but only released in August, upheld the Oxford University Hospital’s Trust’s removal in 2011 of emergency gall bladder surgery to Oxford because of a very few ‘unexpected outcomes’ where complications had occurred during emergency procedures – of which the Horton performed two a month.
In January this year, the trust extended the move to all emergency surgery procedures, to include such ailments as strangulated hernias, bleeding ulcers and acute abscesses, due to a shortage of staff but with the stated intention of making it permanent.
On Tuesday Keep the Horton General campaigners quizzed managers over the report’s release. At the Community Partnership Network (CPN) meeting the group claimed even GPs had been kept in the dark and were led to believe the RCS report had been the basis for removal of all emergency surgery.
Member, Dr Peter Fisher, said: “It should have been made clearer earlier that [the RCS report] related only to gallbladder operations. The general opinion is that it went further on emergency surgery. It is clear from Oxfordshire Clinical Commissioning Group papers that they were under that impression too.”
Dr Fisher said there was no reason why the trust could not have released the final recommendations of the RCS when it received them last December, even if it did have a duty to withold other, personal information in the report.
Those recommendations included action on criticisms of management processes, communications between the Horton and Oxford hospitals, insufficient data collection and unexplained discrepancies between the data logs of surgeons’ and management’s records.
OUHT director of planning Andrew Stevens admitted the trust may have been given ‘bad legal advice in holding back for so long on information’.
He said: “We have learned a lesson on how we’ve dealt with this. It is the first time we have had Freedom of Information requests like this.”
Mr Stevens told the meeting the RCS recommendations were being worked on. One was criticism of compilation of theatre operating lists which staff at the Horton told the Banbury Guardian were drawn up by a clerk without consultation with the surgeons, resulting occasionally in difficult sessions of complex operations, back to back, that did not help surgeons perform at their ultimate best.
OUHT surgery clinical director, Nick Maynard, said: “It is a clerk’s job. They can see how long a case it is and whether it can be done by any member of a team. We had a generic booking system and cases were shared. Within reason they were matched.
“In retrospect there was too much generic booking. There were continuous complaints by surgeons at the Horton over the last three to four years but there was always the opportunity to see lists at least a week in advance. Some of the individuals didn’t take up the opportunity to see the lists, sometimes not until the morning of the operations.”
The decision to remove gall bladder surgery in November 2011 was prompted by an internal audit of gallbladder operations that year following concern voiced by a GP in July 2011 about outcomes.