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January/February 2009 Issue No. 220 ISSN 1747-728X

2 THE OPERATING THEATRE JOURNAL www.otjonline.com

QuadroPort: A unique design for safety and fl exibilityFor the past 12 years Mediplus has been supplying dedicated administration sets for TIVA and PCA to NHS and private hospitals across the UK.

The latest of our innovative designs is a new quadruple lumen for multi-drug delivery and intermittent boli. The QuadroPort offers a cost effective solution for many issues encountered during emergencies in Obstetrics, Trauma, or acute A&E admissions.

The QuadroPort high fl ow central gravity valve enables the clinician to deliver fl uids at a capacity of up to 270ml/min (dependent upon the size of the inserted cannula) and the needlefree valve offers a clean access port for injections

The QuadroPort is a truly universal connector for drug delivery and follows the latest infection control recommendations on use of needlefree ports. Included are the following features:

- Removable anti-kink bridge to prevent occlusion- Bright red end caps to comply with Department of Health recommendations- One-way valves at all ports to prevent backfl ow/free fl ow- Needlefree valve for clean intermittent boli

The QuadroPort is supplied sterile and is designed for single patient use.

For more information on the QuadroPort and other products, please contact:

Mediplus Limited. Tel: +44 (0) 1494 551200 Fax: +44 (0) 1494 536333Email: [email protected] www.mediplus.co.uk Please quote ‘OTJ’

Cut costs, boost safety with medical gases equipment from Unitate.com

High quality, affordable equipment for oxygen therapy and anaesthesia, fully compliant with British and European standards, is now available to purchase online at www.unitate.com for fast delivery throughout the United Kingdom. The range of oxygen pressure regulators, products for medical suction and oxygen therapy equipment includes the versatile EASYMED® fl owmeter with an integrated regulator to stabilise the inlet pressure and variable output dosage – all for only £22.14.

The Unitate range has the versatility to be right for a wide variety of situations, such as GP medical centres, emergency vehicles, hospitals, veterinary clinics, community nurses, home-based treatment, and anywhere where oxygen therapy or medical gases are required for patient care. Many of the products provide an affordable disposable or single patient option that reduces cross infection risks and increases safety.

Unitate.com (a trading name of Plan-B Marketing Ltd) is the sole UK distributor for Flow-meter™ products, which are manufactured in Italy. The online source www.unitate.com has been launched to enable medical equipment buyers throughout the UK the opportunity to assess and purchase the complete range on line.

Each product has been expertly designed to ensure safety, versatility, quality and affordability. Sales of Flow-meter™ medical products are increasing rapidly across Europe. The new resource at www.unitate.com brings UK users of medical gases ready access to the benefi ts of the range.

Visit www.unitate.com today to view the range, or call 01892 600136 for more information.

‘Injectable bone’ helps fractures

A material that can be squirted into broken bones, where it hardens within minutes, has been developed by UK scientists.

The toothpaste-like substance forms a biodegradeable scaffold over which the body’s own bone grows.

Its makers, from Nottingham University, said it could help remove the need for painful bone grafts in many cases.

They are working to start clinical trials in the UK, and expect it to be used in the US within 18 months.

The “injectable bone” won a prestigious medical innovation award recently and is the brainchild of Professor Kevin Shakesheff, from the University of Nottingham.

Its advantage over traditional bone cements is in the hardening process.

While conventional cements give off heat as they harden, killing surrounding cells, and making them unusable in some parts of the body, this polymer does not.

The material has the texture of toothpaste at room temperature, and when it rises to body temperature, this is enough to trigger the hardening reaction.

Professor Shakesheff said it was easy to inject into the right part of the body without a surgical incision, unlike bone grafts, which use bone taken from another part of the patient’s body, such as the hip, to plug a damaged gap.

“Not only does the patient need to be opened up, he or she is left with a damaged area - using this would avoid that.

“We believe we can just insert the needle, follow it to the right spot and inject the polymer, which will fi ll the desired area, and set as hard as the bone on either side.

“Because the material does not heat up, surrounding bone cells survive and can grow.”

Some limitations remain - even though the polymer is as hard as bone within minutes, the join between itself and old bone is weaker, and a leg fracture fi xed this way would still need metal pins to stop it shearing apart when the patient tried to walk.

However, he said that the lack of heat as the substance set meant that it could potentially be used in other applications where a tough scaffold was needed to support the growth of new cells.

This could one day even stretch to other damaged areas such as the heart, he said.

‘Fantastic potential’ Mr. Andy Goldberg, a consultant orthopaedic surgeon and a co-founder of the Medical Futures awards, which honoured the invention said: “This technology has fantastic potential.

“As an orthopaedic surgeon, being able to work with a substance that is fl exible, as opposed to using hard bone will make a real difference.

“The fact that it doesn’t heat up when in the body, like many other injectable substances is a signifi cant breakthrough.”

Professor Shakesheff has created a biotechnology fi rm to help develop and market the invention, and is now working to prove its safety so that it can be used in hospitals.

He said that the swiftest route to market was in the US, where the product could be available some time in 2010.

Professor Richard Oreffo, a specialist in musculoskeletal science at the University of Southampton, said that the material had potential.

“As I understand it, the advantage it has is that the patient’s own cells and growth factors can be delivered with it, and because everything happens at room temperature, they are delivered intact to the patient.”

Source BBC

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fi nd out more 020 7100 2867 • e-mail [email protected] Issue 220 JANUARY/FEBRUARY 2009 3 l

The Operating Theatre Journal is published twelve times per year. Available in electronic format from the pages of www.otjonline.comand in hard copy to hospitals throughout the UK. Personal copies are available by nominal subscription.

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Major UK NHS Trusts are investing substantial amounts in transforming their stock control, cost accounting and methods of working by installing automated stock control systems to store and dispense medical supplies. With supplies and medicines expenditure running into £billions nationally this is a very welcome development.

The Countess of Chester Hospital saw the potential of the technology very early on and was the fi rst NHS Foundation Trust to award a full EU contract for a hospital-wide roll-out of systems for supplies and medicines. The Omnicell cabinets are now installed in A&E, Theatres, ITU, HDU and Central Labour Suite and have had a marked effect on staff effi ciency and general cleanliness and organisation. Stocks have been cut, clinical time saved and waste strictly controlled.

The Trust’s Head of Procurement, Andrew O’Connor said: “This is a huge development for the Trust. The system will save time as staff will no longer be required to go through lengthy manual administrative procedures, meaning that more of their time can be directed to direct patient care.” The Procurement Lead Sue Donaldson has shown a long line of visitors from other Trusts around and many of these hospitals are moving now to automate as well.

Similarly, Sheffi eld Teaching Hospitals Cardiac theatres at the Northern General Hospital were fi rst to fully automate their operating suite by putting cabinets at the point-of-use in every theatre. The cabinets speed up the work of the theatre staff, reduce the risks for the patients and help the hospital manage and cost all its consumable supplies.

Following closely in their footsteps are the London Foundation Trusts of Guy’s and St Thomas’ and King’s College Hospital, who have recently ‘gone live’ with the stock cabinet systems in a contract worth over £6 million. At Guy’s and St Thomas’, the system is being installed in all clinical areas from theatres through to wards and will manage both supplies and medicines. At King’s, it is initially being used in operating theatres before being rolled out to wards and other departments.

Omnicell cabinets function like a supermarket check-out system, counting stock out as it is used and automatically re-ordering it when it reaches its re-order level. Orders are despatched the same day through the hospital ordering system to the supplier who will usually deliver direct the next day.

Products are organised in structured storage with a system of guiding lights to help users fi nd things and allow staff rapid access to all the products used whilst detecting and recording their use. Thus, items are dispensed to staff at the workface and all transactions are relayed back to the computer, which records what has been taken and for which patient.

Theatre staff at Sheffi eld’s North General Hospital were impressed by the speed of the change, as all the theatres and the main stores were automated in a matter of weeks. They also appreciate having everything they use close to hand. Once journeys in and out of theatre by clinical staff to restock trolleys or collect products were commonplace. Now they are very much the exception.

Nigel Roberts, Clinical Procurement Specialist leading the Cardiac team at Sheffi eld, “we’ve more than halved our central stores and reported initial stock savings of £165,000 in our 4 theatres, that have been verifi ed by Finance. There are more to come. More importantly though we can spend more time on our patients, because we aren’t bogged down fi nding products and counting and restocking shelves.

We’ve already hit many of the key objectives of the Productive Theatres initiative long before the government guidelines have been published”.

In addition to helping the clinical staff do their jobs the system delivers great fi nancial benefi ts to the Trust. The cabinets count out and control the issue of all products so any waste is tightly controlled. Stocks can be set at their leanest safe levels and the timing of re-orders organised so that products are ordered at the right time and in the right quantity.

Automated systems do not simply provide stock control; they represent a complete fi nancial revolution in patient costing with undeniable ramifi cations for the way the NHS of the future is run. For the fi rst time ever, Omnicell cabinets make available full material procedure costs for each patient and for each consultant so that proper comparisons of costs and revenues can be made. This enables Trusts to operate properly within the still emerging Payment by Results business framework laid down by the Government.

Avantec Ltd supply the Omnicell system in the UK. Their Sales director, Maurice Gale said “ We have systems in 15 UK Trusts today with ten more in the pipeline. Omnicell costs every patient and procedure and makes it possib;le for Trusts to make money out of Payment by Results because Trusts understand their cost. Given that the system pays for itself out of stock savings , consumption reductions and staff effi ciencies it is a very compelling business case”.

David Lawson, Head of Procurement at Guy’s and St Thomas’, said: ‘This project is a ground-breaking development in the NHS and has the potential to revolutionise the work patterns of clinical staff and produce a model of best practice in managing hospital supply chains. Unlike some IT innovations, this has been welcomed by staff who can see the benefi ts it has on their working days. Managers are also delighted as it provides them with an unprecedented level of cost control.’

Richard Miller, Associate Director of Procurement at King’s, added: ‘The new system interfaces with the current Trust e-procurement and will help us deliver further effi ciency in our supply chain. The project has also demonstrated how two large and complex NHS organisations can work closely together to maximize their purchasing power.’

For further information contact: Maurice Gale Tel: 07768 805350 Email: [email protected] [email protected]

LEADING HOSPITAL TRUSTS INVEST £MILLIONS IN EUROPE’S LARGEST DEPLOYMENT OF HIGH-TECH STOCK EQUIPMENT

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Breast cancer surgeon’s award for ‘instant’ test

A leading breast cancer surgeon has discovered how to detect the disease with rays of light.

Mohammed Keshtgar can establish if cancer has spread into a patient’s lymph glands within seconds using the pioneering procedure.

Currently women have to wait a week for results from a biopsy.

Mr Keshtgar, from the Royal Free hospital in Hampstead, was presented with a “medical Oscar” for the technique. The Medical Futures Innovation Awards are the most prestigious honours in healthcare.

Mr Keshtgar said the “optical biopsy” has the potential to be used to detect other types of cancer.

The technology allows surgeons to see whether cancer has spread while patients are still in the operating theatre. Light is shone on a sample of the sentinel lymph node, which is the fi rst lymph node that cancer drains into.

The patterns made by the light are analysed by a computer, giving an almost instantaneous picture of cancerous and healthy tissue. After further trials, surgeons will be able to remove the lymph gland during the same operation.

Mr Keshtgar said: “This will avoid second operations, which involve more anaesthetic, more worry and more cost. The other advantage is we are shining light onto the tissue, not destroying it, so the results can be double-checked.”

He added: “This could be used to detect other cancers, such as lung, skin and oral cancer.”

Mr Keshtgar is set to launch a trial using the optical biopsy to diagnose cancer within the lining of the breast ducts, using a miniature telescope passed through the nipple.

The surgeon is also pioneering keyhole mastectomies. He was the fi rst to carry out the procedure in Europe, and has so far operated on eight patients.

The procedure, which Mr Keshtgar learned in Japan, involves making two small incisions to remove the breast and an implant can then be inserted.

Paula McGinley, 46, from Camden, who was the fi rst woman in Europe to undergo the procedure, said: “The results of the surgery were amazing. The scarring was so minimal.”

Mr Keshtgar is also involved in a clinical trial where breast cancer patients are given a dose of radiotherapy as soon as the cancerous tissue has been removed, while still in theatre.

Source: Evening Standard Anna Davis

NHS ‘fast losing its compassion’

There has been a deterioration in the level of compassion in the NHS in recent years, the head of a leading health think-tank has told the BBC.

The King’s Fund is running a special project to try to get nurses and other staff to focus on being compassionate. Its chief executive, Niall Dickson, said this was a fundamental issue that should be a top priority for every hospital board. He blames work pressures for staff being less feeling.

Compassion is listed as a core value in the draft constitution for the NHS in England, and the government is developing methods for measuring it.

Mr Dickson said: “I have very little doubt that we’ve seen a deterioration in the level of compassion that is shown by staff to patients.

“It’s to do with staff facing very diffi cult situations - because patients are sicker and hospital stays are shorter - rather than them all turning into nasty people.

“If we can’t get compassion into our healthcare, the system is failing. It’s as fundamental as that.

“The board of every hospital should be looking at this as one of their top priorities - what is it like for someone who’s coming in to be treated, and how can we improve that experience?”

The King’s Fund is piloting an idea called “Schwartz rounds” at several NHS hospitals. This involves staff from various disciplines getting together every month to discuss the aspects of care that they have found diffi cult.

The Patients’ Association’s head of special projects and research, Vanessa Bourne, said: “Compassion is not an extra - it is an essential of nursing care. “It comes in many forms: privacy, dignity and, above all, caring for others as you would wish to be cared for yourself.”

There’s a renewed emphasis on looking at the quality of patients’ experience in the NHS, following Lord Darzi’s review of the health service in England. Ministers are strengthening the emphasis placed on patient views in rating NHS trusts.

A Department of Health spokesperson said: “Dignity and compassion in care are not a “nice to have”. Nor are they an optional extra.

“They are core values of the NHS and are at the heart of what we are trying to achieve through the NHS Next Stage Review, ‘High quality care for all’.”

Source: BBC : Jane Dreaper

Milton Keynes Hospital Consultant Pioneers Safer

Childbirth World Wide A Milton Keynes Hospital NHS Foundation Trust Consultant who is helping to save the lives of thousands of women throughout the world who would otherwise die following childbirth has launched a new website designed to provide expert support to health professionals across the globe in their care of women. The website was launched, on Thursday 20th November 2008, in London.

Professor Christopher B-Lynch, who invented the now famous B-Lynch Suture, a simple operation to stop haemorrhage and prevent the need for a hysterectomy, has played an integral part in the development of the safer motherhood section of the new website.

The Global Library of Womens Medicine www.glowm.com will be free to obstetricians, gynaecologists, reproductive health professionals and students across the globe to consult at anytime.

Professor B-Lynch, who has worked at Milton Keynes Hospital since it opened in 1984, is gifting his gynaecological skills to countries around the world to help tackle the high numbers of maternal deaths from post partum haemorrhage (bleeding following childbirth).

The new website includes an explanatory poster developed by Professor B-Lynch entitled Surgical Technique for the Control of Massive Postpartum Haemorrhage designed as an aide memoire for surgeons.

Over 250,000 women bleed to death unnecessarily each year and the problem is particularly acute in the developing world.

More than half a million women die in child birth in the world in a year, but only 1% of those deaths occur in the developed world. The majority occur in sub-Saharan Africa. Most of these deaths are caused by haemorrhage a fi eld in which Professor B-Lynch is an expert.

Professor B-Lynch was one of several top specialists from all over the world invited to speak at a recent World Health Organisation conference in Angola on Haemorrhage During Pregnancy, Childbirth and Post Partum, and at a Scientifi c Meeting on Maternal and Child Health organized by the Angolan Society of Gynaecologists and Obstetricians.

He demonstrated the technique to the conference medics, and is set to help train doctors worldwide to perform his signature suture.

Professor Christopher B-Lynch, Consultant Gynaecologist from Milton Keynes Hospital NHS Foundation Trust, said: “This operation is absolutely ideal for countries such as Angola. It is easy to perform, relatively cheap and very, very effective. I’m confi dent it will make a real difference to the mortality rate.

A team is now working on a distance learning computer programme that can demonstrate the technique to health workers thousands of miles away.

You Saw It In:


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The new Merivaara Promerix B3 operating table has just completed advanced testing at the company’s manufacturing facility in Finland.

The Promerix table, which was recently launched in the UK, has been strength tested to 2860lb (1300kg / 204 stones) in accordance with EU standard EN60601.2.46 without encountering any mechanical problem.

The exceptional performance of the Promerix B3 bariatric table is only matched by the competitive pricing.

Further information on the Promerix range of operating tables can be obtained from the UK distributor, Europa Medical Services on Tel: 0845 658 4328.

Fukuda Denshi secures framework agreement to supply pati ent monitors in the North West

Fukuda Denshi is a leading supplier of advanced patient monitoring and user-confi gurable clinical information management systems. As part of its continuing growth in the UK, Fukuda Denshi has secured a framework agreement with the Morecombe Bay NHS Trust to supply patient monitors to three hospitals from the start of 2008.

The hospitals supplied by Fukuda Denshi are the Furness General, the Westmorland General and The Royal Lancaster Infi rmary. Each is now equipped with the highly popular DS-7300 and DS-7100 models, where installation into CCU and A&E departments has already taken place.

The DS-7100 patients monitor provides a compact, all-in-one design with amplifi er modules and a 3 channel recorder. It monitors all the common parameters and incorporates an OCRG display function, making the DS-7100 series of monitors a valuable choice in the NICU and neonate wards.

The DS-7300’s array of impressive practical features include a 3, 5 and 12 lead ECG with respiration facility, 24 hour trending, wireless remote control, DS-LAN 2 support and a large touch screen showing 15-waveforms.

The success at Morecombe Bay was a team effort from the sales, clinical and technical management staff at Fukuda Denshi. For further information on the DS 7300/DS7100 patient monitor ranges, please call the company on 01483-728065.

Fukuda Denshi: Healthcare bound by technology.

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Innovative operating theatre equipment at Arab Health

Leading supplier of operating theatre equipment, UK-based Anetic Aid, is to showcase its latest products at the largest healthcare event in the Middle East – Arab Health in January 2009.

Among the exhibits will be its fl agship QA3 Variable Height Patient Trolley series, which includes a hydraulic lift mechanism, fi xed telescopic transfusion pole and foot-operated advanced braking system.

Used in more than 90 per cent of hospitals across the UK, the QA3 is popular thanks to its use of the latest materials and manufacturing methods - including its super lightweight yet rigid construction. The versatile trolley is used both for patient transport in theatre and casualty areas, and also for examinations, intubations and radiography.

Anetic Aid will also showcase its innovative QA4 Surgery Trolley System (Powered and Manual versions) which combine the capabilities of a patient transport trolley and an operating table, making it ideal for patient transportation, treatment and recovery – particularly in day case units, although increasingly in more general operating theatres.

Also on display will be Anetic Aid’s AET electronic tourniquet system which is user-friendly and easy-to-clean, with low maintenance costs.

Anetic Aid’s International Sales Manager Mike Pritchett said: “We are delighted to be exhibiting at Arab Health 2009. It is always an interesting event for us and we’re looking forward to seeing new products at the event, and catching up with our agents, as well as having the chance to meet new customers and potential distributors in parts of the world where we are not currently represented.”

Arab Health 2009 will take place at the Dubai International Convention and Exhibition Centre from 26th to 29th January.

For more information about Anetic Aid or any of its products visit www.aneticaid.co.uk

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GROUNDBREAKING SURGICAL PROCEDURE UNVEILED AT SURGEON’S CONFERENCE

US SILS™ expert presents at ALSGBI annual conference

A NEW surgical procedure which is set to generate huge interest in the UK in 2009 was outlined before members of the prestigious Association of Laparoscopic Surgeons of Great Britain and Northern Ireland (ALSGBI).

At the organisation’s annual conference held in December 2008 US expert Professor Alex Rosemurgy gave a keynote presentation on SILS™, a new surgical technique which utilizes a single abdominal incision which is hidden in the umbilicus. This laparoscopic surgery technique results in signifi cantly improved cosmetic outcomes for the patient.

Professor Rosemurgy, who is based at the University of South Florida and Tampa General Hospital, is Professor of Surgery and Medicine, and has 25 years experience as a surgeon and is now one of the leading practitioners and trainers in SILS™ in the USA.

The procedure involves going in through the umbilicus (belly button) and making a single 1.5-2.0cm incision. Using multiple surgical implements through the single incision, a surgeon can carry out a host of surgical procedures such as gall bladder, appendix and kidney removal, inguinal hernia and hysterectomy operations with no visible scar for the patient.

SILS™ is growing hugely in popularity in America because it does not leave the same visible scaring that traditional procedures entail. Training is relatively simple for advanced laparoscopic surgeons and the number of procedures which can use SILS™ is increasing.

Anecdotal evidence also suggests this minimally invasive technique may lead to shorter patient stays, reduced pain and better recovery rates.

Covidien has begun training surgeons in the U.S. and Europe in the SILS™ procedure, and will commercialise specialised SILS™ instrumentation in 2009.

Dr Rosemurgy said: “I’ve been performing SILS™ for over a year and it is really getting on people’s radar. I am performing more and more operations and we’re training about ten surgeons a week in our practice in Florida. What people can’t get over is the fact that there is no scar.

“You might have an older person who knows someone who had a similar operation and the kind of scars left by traditional surgery. They’re impressed by the results, even if they are not that bothered by a scar. For those patients who do care about scars they are really impressed. They literally can’t believe how good the results are.

“There is also some improvement in pain relief and recovery time.”

Dr Rosemurgy’s symposium at the conference was chaired by Mike Parker, President of the ALSGBI.

He said, “ The presentation given by Dr Rosemurgy was of great interest to ALSGBI members. This is an innovative and new technique which certainly improves cosmesis massively. Clearly this is an improvement from standard laparoscopic surgery techniques but more work will need to be done to ensure that SILS™ provides equivalent outcomes to conventional laparoscopic surgery. This is an exciting development in minimal access surgery and the ALSGBI is keen to support appropriate training programmes in the UK.”

Covidien will be running special pan European SILS™ training sessions in December and February where a number of UK surgeons will be attending. While there are only a handful of qualifi ed SILS™ surgeons in Europe the procedure is expected to be adopted by a far wider number in 2009.

This will be aided by a new access device from Covidien specifi cally designed for the SILS™ procedure, which will give surgeons far more access and freedom of movement than present techniques, therefore enabling easier adoption of this advance in laparoscopic surgery.


Lightman® detects faulty Pulse Oximeter Probes in the North West

The Electrode Company Ltd specialises in non-invasive monitoring, optical sensors and high performance pulse oximetry. The company’s leading product, The Lightman®, evaluates the most susceptible elements of the pulse oximeter system, namely the LEDs and photodiode. It can do this without the need to take the pulse oximeters out of commission – and this was just one benefi t of The Lightman® to a group of cooperating hospitals in the North West of England.

Chris Lamb is the Medical Devices Manager at the Royal Lancaster Infi rmary, who made the strategic decision to purchase a Lightman® after a thorough three site survey, also encompassing hospitals at Kendal and Barrow-in-Furness.

Among the advantages they found were:• The sensor could now be tested thoroughly for accuracy, whereas

conventional simulators only provide an indication of the main pulse oximeter device performance.

• Inaccurate sensors were detected as being ‘out’ of calibration, thereby making the whole pulse oximeter system unreliable.

• Before every single sensor test, The Lightman® calibrates itself against a neon/argon source, so each test can be trusted.

• New faulty stock could be recognised before it went into use, and rectifi ed with the supplier or manufacturer.

Mr Lamb said: “During our survey we did audits throughout the three hospitals within the Trust, performing sensor calibration tests on the wards and theatres. Overall accuracy failure rates of 23-36% were found in the probes. We have now corrected this situation and clinicians are now getting the correct data on which to make treatment decisions for patients.”

Mr Lamb added: “We are delighted with the benefi ts brought about by The Lightman®. It is compact and portable, so is easily transported between our three participating hospitals.

For further information on The Lightman® microspectrometer, please telephone The Electrode Company on 01291-650279 or visit www.electro.co.uk.

The Electrode Company: Ensuring accurate data for better clinical outcomes.

New Rigel medical safety testing products’ brochureRigel Medical has produced a new A4 colour brochure providing details of its extensive range of advanced medical safety testing instruments and accessories.

The ‘Helping to Keep the Medical Industries Safe’ brochure provides details of the Rigel electrical safety analysers’ 266 Plus, 277 Plus and the Bluetooth compatible 288.

There’s a section on the benefi ts of the new generation of fl exible, highly accurate simulators, including the new BP-Sim NIBP and OXY-Sim SPO2 simulators.The new 377 electrosurgical and 344 defi brillator analysers are also featured together with the ventilator tester and pressure meters.

Further sections provide information about accessories such as the Med-eBase asset management software, 601 calibration checkbox and Bluetooth scanner and details of the fast track UKAS accredited calibration and repair service.

A copy of the brochure is available from Rigel Medical, Bracken Hill, South West Industrial Estate, Peterlee, County Durham, SR8 2SW. Tel. +44 (0) 191 587 8730 Fax. +44 (0) 191 586 0227. [email protected] When responding to articles please quote ‘OTJ’Please quote ‘OTJ’


Next generation of C-arms demonstrates precision imaging and ease of use

ARCADIS product family highlights the cutting-edge of intraoperative imagingAt the 94th Scientifi c Assembly and Annual Meeting of the Radiological Society of North America (RSNA), Siemens Healthcare is showcasing its family of next-generation ARCADIS® C-arm systems, featuring outstanding image quality, streamlined workfl ow and enhanced precision in the operating environment.

The ARCADIS Family of C-ArmsThe latest generation of Siemens ARCADIS C-arm family is designed to optimise surgical workfl ow through new components. Innovations such as the ergonomic monitor trolley and the simple user interface improve the user experience, while an intelligent algorithm automatically adjusts and optimises the image quality in all imaging situations. All systems are suitable for broad clinical applications in orthopaedics, trauma, urology and neurosurgery, as well as gastroenterology, vascular and cardiac surgery.

Siemens ARCADIC Varic, ARCADIS Avantic, and ARCADIS Orbic (Orbic 3D) mobile systems are based on syngo®, an intuitively operated Siemens software platform that facilitates clinical workfl ow. With syngo it is possible to view images from other modalities, store acquired images to archives or external storage media, such as CD, DVD or USB and select up to 200 default examination programmes. The user interface also features a basic or extended menu to enhance system operation.

The next ARCADIS generation sets a new level of clinical excellence, said Lynn Blackburn, UK Product Manager of Special Products at Siemens Healthcare. Designed to improve everyday practice, ARCADIS incorporates a range of features making it a versatile and effi cient solution for surgical imaging.

Top-Rated Customer SatisfactionSince deliveries of the new generation ARCADIS C-arms began in May 2008, Siemens has completed more than 500 system installations worldwide, with high marks from within the industry.

A recent survey of fi rst-generation ARCADIS customers has shown that overall satisfaction is very high. Feedback on image quality has been especially positive, thanks to the newly implemented Enhanced Acquisition System (EASY), a bundle of automatic imaging processing features that further simplifi es intraoperative imaging. With EASY, ARCADIS C-arms automatically analyse images during acquisition to optimise dose, brightness, and contrast. Even off-centre objects can be displayed with excellent clarity.

In addition, the new monitor trolley’s revised design has been well received. The ergonomically optimised and easily manageable monitor trolley with monitor screens can be adjusted in height and rotated by 180 degrees in the horizontal. Further information can be found by visiting:http://www.siemens.co.uk/healthcare. or contacting Mike Bell, Siemens Healthcare Tel: 01276 696317 Email: [email protected]

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Life-saving medical technology business is recognised with

Frost & Sullivan Innovation awardPioneering medical technology business OBS Medical, a wholly-owned subsidiary of British company Oxford BioSignals, has been awarded the prestigious 2008 North American Frost & Sullivan Technology Innovation Award for its Visensia early-warning patient monitoring system.

Frost & Sullivans Best Practices Awards recognise companies in a variety of regional and global markets for demonstrating outstanding achievement and superior performance in areas such as leadership, technological innovation, customer service, and strategic product development.

Reducing avoidable deaths is a key part of the NHS, the Department of Health and the National Patient Safety Agencys campaigns for improving patient safety. Visensia is expected to play a major role in helping achieve their admirable goals and prevent tens of thousands of avoidable deaths each year in the US and UK alone by early detection of impending patient emergencies.

OBS Medicals Visensia product, now available in UK hospitals following extensive trials, is the only patient monitoring system that measures the interplay of the fi ve standard vital signs in continuous real-time, giving an overall view of patient risk status.

Until now, it has only been possible to separately monitor the various vital signs (blood pressure, blood oxygen, temperature, heart rate, respiration rate) rather than measuring the correlations between them. Visensias algorithms integrate available individual vital sign readings into a single numerical index, the Visensia Index (VSI), providing medical staff with a reliable crisis alarm. Visensia virtually eliminates false alarms, which currently make up 86% of all alarms in UK hospitals.

Results of clinical trials, recently published in peer-reviewed international journals, at the world-renowned University of Pittsburgh Medical Centre have shown that Visensia offers several hours advance warning of patient deterioration, buying valuable time for the medical staff to administer treatment or prepare the patient for surgery.

Unlike the traditional monitoring algorithms, Visensia personalises patient monitoring by evaluating the normal thresholds for individual patients against pre-measured normal thresholds, says Frost & Sullivan Research Analyst Mike Arani. The addition of this innovative solution to any monitored unit will greatly boost alarm integrity and timeliness.

Visensia can be integrated with any patient monitoring solution in the market, notes Arani. It can collect and analyse all fi ve vital parameters from conventional bedside or portable monitors, thereby enhancing the hospitals existing monitoring system without the need for costly upgrades.

Marc Smith, Business Manager at Oxford Biosignals adds: We are thrilled to be back in the UK at this vital and exciting time for the National Health Service. Given the consistently positive feedback from trials of the Visensia early warning system in the USA, I feel confi dent that we can act as both a support system for NHS nurses and life saver for NHS patients as hospitals continue to fi ght to improve patient safety.

Each year, Frost & Sullivan presents this award to the company that has demonstrated technological innovation within its industry. This Award recognises the ability of the company to successfully develop and introduce new/disruptive technology, formulate a well-designed product family, and make signifi cant technology contributions to the industry.


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Consultation launched on fi rst UK ethical healthcare procurement guidance

The fi rst national guidance on ethical procurement in healthcare wass published for consultation recently (December 8 2008) by the NHS Purchasing and Supply Agency (NHS PASA).

The government’s global health strategy, Health is Global: a UK Government Strategy, was launched in September by Health Secretary Alan Johnson and identifi ed the important role that freer and fairer trade can play in improving health and welfare worldwide.

NHS PASA has worked closely with key stakeholders including procurers, clinicians, industry and non government organisations to develop a meaningful and practical guide to support procurers in addressing concerns around labour standards in supply chains.

Health Minister Ben Bradshaw said: “Spending more than £20 billion a year on goods and services, the NHS is in a strong position to infl uence improvement in labour standards across healthcare supply chains.

“I welcome this guidance which highlights the importance of considering and improving the health and wellbeing of workers in supply chains in the course of delivering healthcare in the UK. This project should help procurers to identify how they can proactively manage these issues, to support the health agenda both in the UK and worldwide.”

Research conducted at the beginning of this year by NHS PASA and the ETI showed a clear need for more guidance and practical approaches.

Ethical Procurement for Health aims to provide procurers with a fl exible framework and toolkit to help them develop policies, good practice and performance monitoring, to exert a positive infl uence on employment conditions and employee welfare within supply chains they procure from. It includes guidance, templates, tools and case examples to support this process.

Recommendations include:

· Developing a clear business case for addressing labour standards, signed off by senior management;

· Appointing a senior level champion with responsibility for implementing ethical procurement;

· Awareness training for all procurement staff; and · Risk assessments for all major procurement exercises.

Dan Rees, Director of the Ethical Trading Initiative said: “There is clear evidence that labour standards abuses do exist within supply chains across all sectors and healthcare is no exception. We are pleased to be working with NHS PASA on the development of this guidance for the pubic sector which seeks to utilise experience built up by ETI members in other sectors such as food, garments and personal care.”

Dr Mahmood Bhutta, an NHS surgeon, founding member of the BMA MFETG, and advisor to the BMA International Committee raised the issue of labour standards abuses in supply chains through work with the BMA last year.

He said: “As a practicing doctor I have been appalled by recent reports of the abuse of labour in the manufacture of some healthcare products. Buying products that have been manufactured ethically is a statement from the healthcare profession that we will not care for our patients using goods that harm the health of the global community.

“We need to embed an ethos in the NHS that our suppliers should not only demonstrate quality, safety and a competitive price for their goods, but also a responsible attitude to their global workforce. I hope my colleagues in the health service will be ambitious and recognise the importance and the potential of this document from NHS PASA, and use it to really champion fair and ethical trade for the goods they use at work every day.”

Feedback is invited from procurers and senior management in healthcare organisations as well as clinical staff, patient groups and wider interested parties.

The consultation will run until the end of April next year and it is planned to publish fi nal guidance next summer.

Ethical Trading for Health is available to download from : www.pasa.nhs.uk/susprochealth


Letter to The Editor: Dear Sir,

Showing in your Theatre now!

THE

OPERATING

THEATRE

JOURNAL

Professor Lord Darzi’s attendance at the recent launch of the da Vinci Surgical S System at Heatherwood and Wexham Park NHS Trust reflects the importance of this technology to the future of surgery, particularly cancer surgery in this country.

Although the robot is still in its infancy in the UK, robotic surgery has proved it deserves a place in operating theatres across the country. Whilst, as a result of our considerable experience in robotic surgery, I am delighted that patients in my area will now be able to benefit from this revolutionary technology I am concerned that this latest installation here at Heatherwood and Wexham Park is one of only 14 in the country.

In the region of 1200 complex procedures will be carried out using the da Vinci Surgical System by the end of the year. This figure is in stark contrast to the US where over 100,000 will be carried out. Worldwide the figure is 135,000.

I accept that a sizeable investment is required from medical institutions to install the da Vinci Surgical System, but as a surgeon, the benefits I see to patients and our surgical technique, are irrefutable. I believe there will also be long term benefits for health providers, with drastically reduced hospital stays and post operative complications.

It is vital for British surgeons to be at the forefront of medical advances, we can no longer afford to lag behind our international colleagues when it comes to robotic surgical technology.

Mr Omer Karim Consultant Urological Surgeon, Heatherwood and Wexham Park Hospital, and St Mary’s Hospital, Paddington.

Doctors undergo robotic surgery training in UK SIX doctors from Qatar have undergone training at the Imperial College London for the Qatar Science and Technology Park’s new medical robotics facility as the Hamad Medical Corporation prepares to start robot-assisted surgery early 2009.

Five doctors from HMC and one from Weill Cornell Medical College in Qatar are being trained to teach at QSTP and perform surgery at HMC.

Imperial College London is partnering with QSTP to set up the Qatar Robotic Surgery Centre at the science park.

The centre, likely to open in the second half of 2009, will have three main purposes: to demonstrate new medical robots; train surgeons from Qatar and the region; and participate in further development of the technology.

It will engage in collaborative research with robot manufacturers and surgery centres worldwide, including that of Imperial College London, and it will also provide the opportunity for local surgeons to develop new clinical procedures.

It will be equipped with three Da Vinci brand medical robots, a simulation operating theatre and a “tele-mentoring” suite.

The centre aims to train 80 students and 50 surgeons from the region annually and as many from overseas.

HMC is also setting up its own functioning robotic-surgery training unit after taking possession of its fi rst medical robots earlier this year and envisages that they will be used for patient operations in four to six months.

Medical robotics is a fast-growing fi eld that combines the accuracy of machines with the skill of humans.

Computer-controlled mechanical “wrists” can scale-down a surgeon’s hand movements so that the surgical tool moves only a fraction of the distance the operator’s hand does, which allows tiny, stable movements that would be physically impossible by hand alone. Robots are most commonly used in prostate, heart and gynecologic surgery.

QSTP’s executive chairman Dr Tidu Maini said: “Being a leader in targeted medical research is core to Qatar’s strategy for building a knowledge economy. The Robotic Surgery Centre is an ambitious but achievable project that will make Qatar a global medical innovator, while delivering real health benefi ts for the local community.”

The chairman of the Department of Medicine and director of medical education at HMC, Dr Abdulatif al-Khal said: “The robotic surgery facilities of Hamad and QSTP complement each other perfectly. This close collaboration between QSTP and HMC is setting an example for mutually benefi cial partnership. Together they will transform Qatar into a regional hub of excellence in training, development and clinical practice in robotics surgery. This is a wonderful new technology and our doctors are keen to start using it to improve patient care in Qatar.”

Source: Gulf Times

Some of the doctors during the training in London

Surgeons’ mistakes (Australia)

AMONG an infant’s fi rst skills is counting, yet some of Victoria’s surgeons and theatre staff seem incapable of doing it.

It is the only explanation for an astonishing statistic: 756 assorted objects have been accidentally left in patients during surgery in Victorian hospitals since 2000.

Figures compiled exclusively for the Herald Sun by Monash University’s Victorian Injury Surveillance Unit are simply frightening.

Operating theatre personnel, for instance, left 78 objects inside patients last year - seven times more than the State Government’s offi cial “sentinel event” system of reporting counted.

The latter relies on hospitals to notify it of adverse happenings. It could come up with only 47 instruments or other items left in patients since 2002-03 that required surgery to extract.

Our fi gures show that in the same period 550 swabs, instruments and other items left inside patients led to extra hospital care. We do not know how many of them had to be removed surgically.

The consequences of leaving foreign bodies inside human ones are signifi cant and can be deadly. Moreover, mistakes should be easy enough to avoid.

There is clearly something wrong with the way theatre personnel count their tools of trade in and out of patients. The method needs revising.

Equally, it’s no longer good enough for the Government to count only incidents in which something was discovered inside a patient after an operation and extra surgery was needed to take it out.

The implications of theatre errors are great enough for the Department of Human Services to widen its scope.

And it is simply not good enough for the department’s spokesman Bram Alexander to say that government fi gures truly indicate hospital mishaps because they deal with the serious ones.

Nor is it adequate that a surgeons’ spokesman, Dr John Quinn, says an end to climbing rates of retained objects in patients since 2004 indicates that surgical staff are more aware of the problem.

They might be, but it is as obvious as one and one adding up to two that they are not yet taking their counting seriously enough.

Article from: Herald Sun

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Environmental Enclosures and Rooms http://www.environmental-enclosures.com - This site features two systems for environmental controlled rooms and enclosures:

The fi rst, Bowers Modular System, being of modular metal panel construction, where each panel element is a structural component contributing to the overall independent structural properties of the fi nished build. The integral properties, in terms of shielding and controlling the external and internal environment respectively, and application of use, are illustrated as an overview on the accompanying pages of the website.

The second, Wishbone, is a rapid deployment system of lightweight environmentally controlled enclosures (rooms/cells) and inter-connecting corridors creating, for example, a full medical facility in a disaster zone. Build time in less than 30 minutes by an experienced team, meaning that surgery, in the case of an operating theatre, can be performed in less than an hour. An overview of the design principles are also described and illustrated on the website.

Independent healthcare sector signs up to cleanyourhands

From 10 December independent healthcare providers in England and Wales will have access to expert guidance and award-winning materials designed to encourage healthcare staff to clean their hands in a bid to tackle infection rates.

This comes as the cleanyourhands campaign, an NHS initiative run by the National Patient Safety Agency (NPSA), extends its remit to the independent sector.

So far the cleanyourhands campaign has been taken up by all acute trusts in England and Wales, and the majority of primary care, mental health, care and ambulance trusts.

A Memorandum of Understanding was signed between the NPSA and the Independent Healthcare Advisory Services (IHAS) at Londons Princess Grace Hospital , allowing all members access to the campaign resources, including eye-catching posters, guidance booklets and DVDs.

Martin Fletcher, Chief Executive of the NPSA said:

The Memorandum of Understanding marks the fi rst time that the cleanyourhands campaign has been formally available to independent healthcare providers, thus refl ecting a positive commitment to infection control nationally. We hope this will ensure a continuity of support for both the healthcare staff and patients alike, as we know that they can move between the NHS and private settings for work or treatment.

Effective hand hygiene at the point of care has already been proven to be a step in the right direction for controlling the spread of preventable infections in the NHS, so we hope that independent healthcare providers will similarly maximise this opportunity to educate their staff and reassure their patients.

Sally Taber, Director of the IHAS said:

The Independent Healthcare Advisory Services Infection Control Group is delighted that the independent sector can at last have access to the cleanyourhands materials and looks forward to its close cooperation in the future with the NPSA.

The campaign aims to reduce the spread of preventable infections such as MRSA and Clostridium diffi cile by educating and prompting staff to clean their hands before and after treating each patient.

An independent evaluation of the campaign in NHS hospital settings last week revealed that the initiative has engaged well with institutions and facilitated sustained changes to hand hygiene behaviour with a three fold rise in the procurement and use of alcohol handrub, strongly liked with the fall in MRSA rates in the NHS.

Surgery is benefi cial for treatment of gastro-oesophageal refl ux

Research published by the National Institute for Health Research Health Technology Assessment (NIHR HTA) programme has found that early surgery is benefi cial for patients with chronic symptoms of gastro-oesophageal refl ux disease (GORD). Refl ux is a very common condition with 20 per cent of the population experiencing it at some point in their lives. Currently the management of people with GORD at the more severe end of the spectrum is primarily through the use of drugs in the form of tablets. Relatively few patients have surgical treatment, now performed using a key-hole procedure known as a laparoscopic fundoplication. However, GORD may be a lifelong condition, and so could require 20-30 years of medical therapy if a patient is young when diagnosed. A large team of researchers, led by Professor Adrian Grant from the University of Aberdeen, recruited 810 people from 21 hospitals across the UK to the £1.1 million trial, to compare the clinical effectiveness, cost-effectiveness, and safety of a policy of relatively early laparoscopic surgery compared with continued medical management. The results showed that surgical treatment was more effective than long-term drug therapy, especially in patients with the most troublesome symptoms, certainly up to one year after the procedure. A surgical policy is, however, more costly than medical management and it is uncertain whether it would be cost-effective in the long-term. Extending the use of laparoscopic fundoplication to people whose GORD symptoms require long-term medication would provide better quality of life. Like all surgery, fundoplication has some risks, but the more troublesome the symptoms, the greater the potential benefi t from the operation, says Professor Grant. We believe that our research can help to better inform the management of patients with chronic symptoms of GORD. The report published in Health Technol Assess 2008; Vol. 12:31. To view or download the full report visit www.hta.ac.uk/1134


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Department of Health and BSI British Standards to boost NHS resilience

Seeking ex Royal Army Medical Corps Operating Theatre Technicians (OTT)

Operating Department Assistants (ODA)Operating Department Practitioners (ODP)

Come and join OTT Reunited forNewsletters and Reunions, over 135 members worldwide.

Contact Ken Hannah at [email protected]

or telephone 01733 453462 for details

While the commitment of NHS staff can be relied upon in the time of a crisis, detailed and comprehensive planning is also vital if the most challenging situations are to be dealt with effectively. That is why emergency planning is one of the fi ve national priorities set out in this years Operating Framework for the NHS in England. Through its work with BSI, the NHS Resilience Project will help to guide and inform that planning to ensure that the NHS can be there for the patients who need it, whatever happens.

Mike Low, Director of BSI British Standards, said, We have already seen widespread enthusiasm across industry for the Business Continuity Management tools offered by BSI British Standards and I am pleased that the Department of Health will be encouraging its adoption amongst NHS trusts. This is a very positive step on the road towards achieving consistently high-quality Business Continuity Management throughout the NHS.

Following the implementation of BS 25999 Parts 1 and 2, the Department of Health and BSI British Standards will continue to collaborate to deliver a far-reaching and sophisticated approach to BCM, tailored to the needs of the NHS.

For further information about the NHS Resilience Project, and resources relating to its work, please visit http://www.dh.gov.uk/NHSResilience or email [email protected]

The Department of Health and BSI British Standards today announce a new initiative designed to increase resilience to major incidents and disruption across the National Health Service. This will begin with the implementation of BS 25999 Parts 1 and 2, BSI British Standards code of practice and specifi cation on Business Continuity Management.

The NHS has a good record of responding well to big-bang major incidents, which produce sudden infl uxes of casualties. However, it has more limited experience of dealing with rising tide incidents which develop over a longer period of time. For example, an infl uenza pandemic, fl ooding, or restricted energy and water supplies all have the potential to impact upon the NHS in terms of its ability to continue routine business, or maintain patient capacity and organisational infrastructure. Other threats to business continuity include staff shortages, limited access to premises, or failures in technology. Looking beyond NHS organizations own services and facilities, increasingly complex supply chains mean that the failure of key suppliers can also have signifi cant repercussions for patient care.

The NHS Resilience Project was set up in 2007 to ensure that NHS organisations are meeting their obligations to maintain effective business continuity management (BCM) plans under the 2004 Civil Contingencies Act. BS 25999-1 Code of Practice on Business Continuity Management and BS 25999-2 Specifi cation on Business Continuity Management provide practical guidelines and requirements for putting BCM arrangements in place. The Department of Health sees the BSI standard as an ideal benchmark against which organizations throughout the NHS can judge their business continuity measures, with widespread adoption promising higher and more consistent standards of resilience across the healthcare system.

Phil Storr, Head of the NHS Resilience Project at the Department of Health, said, Members of the public expect the NHS to be there for them when they need it, no matter what the circumstances.


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Sales experience is not essential, full training will be given. Instead we are looking for people with drive and enthusiasm, positive attitudes and looking for a new challenge in sales.

If you’re looking for a change of direction, please write to us, with your CV including current package details, and outlining what you could bring to the role:

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Alarm hazards top hospital tech problems

Dec. 24 2008 -- A patient-safety research group says alarm hazards, needle sticks and surgical fi res are among the top fi ve technology hazards in hospitals.

The ECRI Institute’s list is updated annually based on problems reported to, and investigated by, the group.

“Our list is based on serious technology safety concerns that can be prevented with appropriate attention and planning,” James P. Keller Jr., vice president of health technology evaluation and safety at the institute, said in a statement last week. “We hope that the list can help raise awareness about these problems, which should be on every hospital’s quality improvement agenda.”

Other items on the list included air embolisms from contrast media injectors, and surgical devices or fragments left in patients.

Source UPI.com

‘Youngest’ baby has brain glue op A UK baby has become one of the youngest in the world to undergo an operation using glue to reduce the size of a brain tumour.

Madison Quartarone was just a week old when the procedure was carried out at London’s Great Ormond Street Hospital. She was found to have a large, benign tumour, and glue was used to block the blood vessels supplying it, effectively starving it of nutrients.

The baby, from Bedford, is now said to be “doing well”. Neurosurgeon Dominic Thompson, who carried out the procedure, said he was not aware of any younger babies receiving it.

“If successful, it could be groundbreaking,” he told the Bedfordshire on Sunday newspaper. “Madison is not out of the woods yet but she does look remarkably well.”

Madison, who is now eight weeks old, was born with an obviously swollen head, which meant that the tumour could be spotted quickly.

Mr Thompson said that it was “very unusual” for tumours to present themselves so early in life.

During the procedure, a tube was guided into the blood vessels connected to the tumour, and the glue passed through it to seal them.Scans have suggested that the treatment was having an impact, starving the tumour of nutrients and oxygen, and causing it to shrink.

Madison’s grandfather Ian Chandler told the paper that she was now putting weight on, and the family was hopeful that the tumour would continue to reduce in size.

Source: BBC

Crossword - Hospital Mixed Answers 02, Issue 219

Solution failed to arrive by copy deadline.

Answers will be printed in next available edition.

Apologies for any inconvenience caused.


Patients Are Now Able To Learn About Their Hip And Knee Implants

A new website dedicated to provide independent information for patients undergoing hip and knee replacement surgery in the UK has opened last month. Uniquely, the website, www.hipandkneenetwork.co.uk boasts a panel of orthopaedic surgeons and was launched at the British Orthopaedic Association conference in Liverpool.

The Hip and Knee Network was part-funded by the EU and enables patients to access government data on the quality and take up of all hip and knee implants on the market. This is the fi rst time that this data has been presented in an easily accessible way to the public and the Hip and Knee Network has already had a lot of interest in this part of the site from patients undergoing this type of surgery.

A guiding principle of the website is that it is completely independent of the NHS, private medicine, and implant suppliers. All information on the site is produced and/or vetted by a panel of specialist orthopaedic surgeons. Therefore it is the only place on the Internet dedicated to providing high quality, impartial information on hip and knee replacement surgery.

Steve Young, one of the consultant orthopaedic surgeons behind the website explains, We felt that patients should be better informed, there is a lot of information out there but its either too fragmented or created by people with a vested interest in a particular product or service. We designed the site to present all the information in a straightforward, unbiased, ethical way which will support and compliment the work done by surgeons and physiotherapists with hip and knee replacement patients.

Other innovations on the site include the ability to search for a surgeon or a hospital conducting hip and knee replacement surgery anywhere in the UK, send in a question to the surgeon panel, and take a test to assess the likelihood of hip and knee surgery.

Mr David Stock, another member of the websites surgeon panel continues, This project is about creating a community for patients and surgeons involved in hip and knee replacement surgery.

Its diffi cult for Surgeons to fi nd the time to generate the sort of presence on the Internet that would help patients fi nd the right quality of information. By combining our efforts we can do more to help them.

The Hip and Knee Network has a secure area for orthopaedic surgeons to network and communicate with each other in private in addition to forums to enable professional debate.

Mr Jon Waite, the third member if the surgeon panel goes on to say, Its important to understand that this site is not just about the panel involved so far, we are inviting all of our surgical colleagues to get involved and contribute to the debate and discussion. It should become a powerful resource and a platform for new ways of interaction between patients and surgeons.

The founders hope that with the quality of information available on the Hip and Knee Network it is set to become the fi rst port of call on the Internet for those with an interest in hip and knee replacement surgery.

NHS pays to rectify cosmetic ops The NHS is having to pick up the tab for cosmetic surgery performed abroad that has gone wrong, doctors say.

The British Association of Plastic, Reconstructive and Aesthetic Surgeons said many patients were turning to the health service for follow-up care.

A poll of 203 NHS surgeons found that more than a third knew of cases where complications followed surgery abroad.

The government warned people that the NHS was only there to deal with emergency complications in such cases.

And it urged those thinking about going abroad for operations to be careful.

It is estimated that up to 100,000 people a year are heading abroad for cheap cosmetic surgery such as breast enlargements, tummy tucks and face-lifts.

BAPRAS said the growing demand was being fuelled by the availability of cheap fl ights, but warned that the trend was leading to problems.

It said its members had seen a range of complications including blood poisoning, wound infections and blood clots, as well as patients who were not happy with the results of the surgery.

And the association warned that the extra work being caused by having to see these patients could end up delaying other NHS work.

It said patients should be made to pay for rectifying treatment except where there was a life life-threatening situation or if the patient was suffering from acute pain.

Complications following UK-based cosmetic surgery is the responsibility of the private clinic.

BAPRAS spokesman Hamish Laing said the NHS should not be expected to “pick up the pieces” unless the complications were life-threatening.

“There are patients who are having operations they couldn’t normally have had on the NHS and we don’t think it’s right that we should be having to take up resources that should be used for reconstructive plastic surgery in the NHS to sort out these problems,” he said.

People should be aware of potential complications of operations abroad and be prepared to pay privately for follow-up surgery, he added.

Risks

But the British Medical Association said it was against patients being barred from NHS care.

Dr Vivienne Nathanson, head of ethics at the BMA, added: “It is essential that patients are warned about the potential risks of any surgery, and the specifi c risks of managing complications after having surgery overseas.

“What may seem like a bargain could cost them their health.”

Katherine Murphy, of the Patients Association, agreed it would be wrong to withhold treatment.

She said patients needed better information about treatment available abroad.

A spokesman for the Department of Health said it had already made clear that the NHS was only there to deal with emergencies in such cases.

The spokesman added: “People are free to have cosmetic or other private surgery abroad if they wish to.

“However, we strongly advise people to do their research and make sure that they are clear about prices, procedures, recovery times, aftercare and what happens in the event that the treatment goes wrong.”

Source: BBC Nick Triggle

the operating theatre journal

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