Cardiac services at St George’s Hospital Trust

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9th August 2018
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16th August 2018

Cardiac services at St George’s Hospital Trust

Lower than expected survival rates after cardiac surgery, and a reported toxic environment, have led St George’s Hospital Trust to commission an independent review into their service at their Tooting hospital. The report, which the Trust published last week, aims to help the cardiac service improve. There has been lots of media attention about the report, including articles in the Times and BBC.

St George’s University Hospitals NHS Foundation Trust serves a population of 1.3 million across south west London, including patients from Lambeth. It is made up of Queen Mary’s Hospital in Roehampton, and St George’s Hospital in Tooting. St George’s hospital has 4 cardiac theatres, it deals with trauma cases, and has expertise in a number of specialities. The trust was known for its high quality of care, and was well regarded as a teaching centre for cardiac and thoracic surgeons. However, St George’s Hospital Trust was recently rated as ‘Requires Improvement‘ by the Care Quality Commission, leaving the hospital Trust in special measures.

In 2017 and again in 2018, the Trust received alerts regarding higher than average mortality rates in patients having cardiac surgery, 3.7% compared with 2% nationally. The Trust was also aware of deteriorating relationships between surgeons in the cardiac team. This led them to commission an independent report. Professor Mike Bewick and Dr Simon Haynes carried out the review between 11 June and 3 July 2018. They spoke with staff in the cardiac unit, visited theatres and wards,  and attended staff meetings.

The report stated that some staff, ‘felt that there was a persistent toxic atmosphere’ and that, ‘there was a ‘dark force’ in the unit.’ Many staff felt that poor mortality rates were inevitable because of the negative environment. You can read the full report here.

St George’s Hospital Trust has reported that it has made a number of changes to its service already:

  •  Moving all cardiac surgeons to a single specialty practice. As a result, both cardiac surgery and thoracic surgery at St George’s is now only undertaken by single specialty surgeons.
  •   Inviting Guy’s and St Thomas’ to provide us with on the ground, clinical leadership support. They agreed, and a cardiac surgeon from Guy’s and St Thomas’ has spent time in our cardiac surgery unit this week.
  • Addressing concerns about cardiac surgery data management and governance, with a new management structure introduced last week.
  • Advertising for an additional consultant cardiac surgeon to join the team.
  • Hiring a HR professional to focus on staff behaviours in the cardiac surgery unit.

Jacqueline Totterdell, Chief Executive and Professor Andrew Rhodes, Medical Director, St George’s, said:

“We would like to stress again that the cardiac surgery service at St George’s is safe. However, we also know the service needs to improve, and quickly – this is why we asked Professor Bewick to carry out his review, and this is the reason we are implementing his recommendations as quickly as we can. We would like to thank our patients and members of the public for their support, as well as our staff who are continuing to do their very best for patients every day.”

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