Greater efforts to recruit more surgical staff have been recommended as part of a new strategy for the emergency surgery sector that has been proposed by the Royal College of Surgeons (RCS).
Earlier this year the organisation published a policy briefing on emergency surgery that has called for a series of wide-ranging changes and reforms to the way services are planned and organised, in order to eliminate systemic flaws and guarantee a higher standard of care for all.
It is believed that making these changes could deliver a number of short and long-term benefits that would ensure surgery patients can receive the quality of treatment they require, no matter what part of the country they live in, while also making sure that staff are empowered to do their jobs as effectively as possible.
Issues with the current system
The RCS report noted that although surgical staff across the country are committed to providing the highest quality of care they can, organisational issues are creating a number of problems that need addressing sooner rather than later.
One of the most pressing of these is the wide variation in mortality rates that exists nationwide. Indeed, the UK Emergency Laparotomy Network found that mortality following emergency laparotomies varied from 3.6 per cent to 41.7 per cent across 35 hospitals.
Moreover, rising pressures on emergency services, growing A&E admission rates, inadequate readmission processes at some hospitals are all contributing to the issue, as well as the inescapable fact that the nature of healthcare provision - and the needs of patients - are changing with time.
As the average age of the UK population rises, the need for emergency surgeries will continue to increase, while the current era of information has opened up new and unexplored avenues for medical staff to exchange data with patients and each other.
Perhaps most importantly, the report indicated that none of these improvements can take place until more doctors are hired - particularly in terms of generalists who are able to deliver emergency surgical care, given the recent rise in the proportion of staff who are primarily trained to offer specialist care.
As such, the RCS, the College of Emergency Medicine and other medical royal colleges have developed a series of recommendations that could address these issues, including a number of potential solutions to the recruitment conundrum.
Health Education England has been urged to work with relevant professional bodies to create an attractive career structure for emergency medicine, while also reintroducing A&E training for all trainee surgeons and potentially other medical professionals.
Other key systemic changes include an increased separation of elective and emergency surgery to improve access to treatment, plus better regulatory oversight of emergency surgical procedures to generate more audit data for decision-making processes.
Patients, meanwhile, need to be provided with more information on which consultants are responsible for their care and clearer details on managing their own rehabilitation after surgery. Doctors have also been recommended to communicate more openly to resolve concerns or questions about a patient who has recently received surgical treatment, especially for vulnerable older people.
With 1.2 million patients requiring emergency surgical assessment or treatment each year, taking proactive steps in this field should be considered a key priority for healthcare decision-makers. It will be hoped that any changes that are forthcoming will help to stimulate recruitment and further enhance care quality in this vital sector.
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