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NHS patients have cataract operations reviewed after private treatment NHS patients have cataract operations reviewed after private treatment
(7 months later)
Nineteen NHS patients have had the outcome of their cataract surgery reviewed after at least two had problems with their eyes following operations at a private hospital.Nineteen NHS patients have had the outcome of their cataract surgery reviewed after at least two had problems with their eyes following operations at a private hospital.
The private provider concerned has offered its "sincere apologies to all patients that suffered complications" from their operations – an incident that will intensify the political debate over outsourcing NHS services.The private provider concerned has offered its "sincere apologies to all patients that suffered complications" from their operations – an incident that will intensify the political debate over outsourcing NHS services.
The problems arising from a new contract between NHS and private hospitals in south Devon came just weeks after it emerged that dozens of people who underwent similar procedures at a private provider in Somerset in May had suffered complications following their operations.The problems arising from a new contract between NHS and private hospitals in south Devon came just weeks after it emerged that dozens of people who underwent similar procedures at a private provider in Somerset in May had suffered complications following their operations.
Although the hospital and private company involved this time are different, the incident involving operations at Mount Stuart hospital in Torquay, part of Ramsay Health Care, will reignite debate about the increasing use of private companies in the state health service.Although the hospital and private company involved this time are different, the incident involving operations at Mount Stuart hospital in Torquay, part of Ramsay Health Care, will reignite debate about the increasing use of private companies in the state health service.
The problems emerged on the first day of operations conducted under a contract to perform cataracts between the NHS's South Devon Healthcare Foundation trust, which runs Torbay hospital, and Mount Stuart.The problems emerged on the first day of operations conducted under a contract to perform cataracts between the NHS's South Devon Healthcare Foundation trust, which runs Torbay hospital, and Mount Stuart.
No further patients will be referred for such surgery while investigations continue into what happened on 26 July, when 19 NHS patients, including four who went via the NHS's 'choose and book' system, underwent operations.No further patients will be referred for such surgery while investigations continue into what happened on 26 July, when 19 NHS patients, including four who went via the NHS's 'choose and book' system, underwent operations.
No patients have yet required further corrective surgery but most cases are still being reviewed. Some involved in the initial follow-up appear to have recovered normally, according to the trust, which has had a relationship with Mount Stuart for 10 years. Over the past year some patients needing orthopaedic, urology or general surgery have had their operations at Mount Stuart.No patients have yet required further corrective surgery but most cases are still being reviewed. Some involved in the initial follow-up appear to have recovered normally, according to the trust, which has had a relationship with Mount Stuart for 10 years. Over the past year some patients needing orthopaedic, urology or general surgery have had their operations at Mount Stuart.
There is no easy way of comparing healthcare outcomes between the NHS's own surgery and treatments and those that are contracted out. Neither the Department of Health nor NHS bodies with national remits collect comparative statistics. Earlier this month, it was revealed a contract between Musgrove Park hospital, Taunton, and Vanguard Healthcare involving cataract operations had been terminated four days after half the 60 patients who had undergone the surgery had suffered complications. Cataract surgery is often regarded as one of the most routine procedures.There is no easy way of comparing healthcare outcomes between the NHS's own surgery and treatments and those that are contracted out. Neither the Department of Health nor NHS bodies with national remits collect comparative statistics. Earlier this month, it was revealed a contract between Musgrove Park hospital, Taunton, and Vanguard Healthcare involving cataract operations had been terminated four days after half the 60 patients who had undergone the surgery had suffered complications. Cataract surgery is often regarded as one of the most routine procedures.
The Spanish consultant concerned in south Devon has completed 4,537 operations for Ramsay since 2005 and has been registered as a doctor in Spain since 1989. He is said to have "excellent" clinical outcomes with a complication rate of less than 0.5% but will do no further work for Ramsay pending the outcome of the investigation. The Spanish consultant concerned in south Devon has completed 4,537 operations for Ramsay since 2005 and has been registered as a doctor in Spain since 1989. He is said to have "excellent" clinical outcomes with a complication rate of less than 0.5% but will do no further work for Ramsay pending the outcome of the investigation.
The General Medical Council, which registers doctors working in the UK, has been consulted over the incident, according to the company.The General Medical Council, which registers doctors working in the UK, has been consulted over the incident, according to the company.
Ramsay said in a statement: "Mount Stuart hospital would like to offer its sincere apologies to all patients that suffered complications following their cataracts appointment on 26 July. As soon as we realised that there was a potential problem all patients were recalled by Mount Stuart hospital and then by the trust." Ramsay said in a statement: "Mount Stuart hospital would like to offer its sincere apologies to all patients that suffered complications following their cataracts appointment on 26 July. As soon as we realised that there was a potential problem all patients were recalled by Mount Stuart hospital and then by the trust."
The hospital was working closely with the trust and its monitoring of the patients concerned, the company added. "All relevant bodies have been informed and we are working closely with commissioners and the CQC and are keeping them informed of our ongoing investigation." The hospital was working closely with the trust and its monitoring of the patients concerned, the company added. "All relevant bodies have been informed and we are working closely with commissioners and the CQC and are keeping them informed of our ongoing investigation."
Ramsay "has an excellent record of clinical outcomes and we take the delivery of this very seriously". said the company. "Across our organisation we have a very strict clinical governance framework in place to minimise clinical risk as much as possible."Ramsay "has an excellent record of clinical outcomes and we take the delivery of this very seriously". said the company. "Across our organisation we have a very strict clinical governance framework in place to minimise clinical risk as much as possible."
The trust told the Guardian that "within a few days" of their operation , two patients "came to A&E experiencing visual problems and our consultant realised that there may have been a problem with their cataract operations".The trust told the Guardian that "within a few days" of their operation , two patients "came to A&E experiencing visual problems and our consultant realised that there may have been a problem with their cataract operations".
A spokeswoman said: "As soon as we realised there was a potential issue, we alerted Mount Stuart and commissioners so that they could investigate, and that investigation is still ongoing. We also contacted all 19 patients, and asked them to come in for urgent clinical review and follow-up to their operation.A spokeswoman said: "As soon as we realised there was a potential issue, we alerted Mount Stuart and commissioners so that they could investigate, and that investigation is still ongoing. We also contacted all 19 patients, and asked them to come in for urgent clinical review and follow-up to their operation.
"Our opthalmologists have now seen all 19 patients who had their cataract surgery at Mount Stuart, and we will continue to keep them under review to establish whether there is any long-term impact on their eyesight. It seems that some patients have already recovered as expected from their surgery", the spokeswoman said. "Until the outcome of the investigation is known, we will not be referring any further patients to Mount Stuart for cataract surgery.""Our opthalmologists have now seen all 19 patients who had their cataract surgery at Mount Stuart, and we will continue to keep them under review to establish whether there is any long-term impact on their eyesight. It seems that some patients have already recovered as expected from their surgery", the spokeswoman said. "Until the outcome of the investigation is known, we will not be referring any further patients to Mount Stuart for cataract surgery."
She said the trust had an agreement with Mount Stuart requiring that patients received "the same quality of care that they would expect in our own hospital".She said the trust had an agreement with Mount Stuart requiring that patients received "the same quality of care that they would expect in our own hospital".
Laurence Vick, a partner of solicitors Michelmore's, said the firm was representing a woman in her 70s with distorted vision, which, he said, remained unresolved. He said: "Credit Mount Stuart and the trust for being open. We know there is a longstanding relationship between the two but it is significant this was the first batch of cataract patients."Laurence Vick, a partner of solicitors Michelmore's, said the firm was representing a woman in her 70s with distorted vision, which, he said, remained unresolved. He said: "Credit Mount Stuart and the trust for being open. We know there is a longstanding relationship between the two but it is significant this was the first batch of cataract patients."
There were still serious questions regarding outsourcing and the vetting and supervision of contracts, said Vick. "Cataract surgery is generally regarded as a low-risk procedure. There can be complications but in the cases we see, complications that have arisen have more often than not resulted from negligence."There were still serious questions regarding outsourcing and the vetting and supervision of contracts, said Vick. "Cataract surgery is generally regarded as a low-risk procedure. There can be complications but in the cases we see, complications that have arisen have more often than not resulted from negligence."
A Department of Health spokesperson said: "Patients deserve the safest and best care. If providers fail to meet these standards the NHS will hold them to account and reclaim costs on behalf of patients. All providers responsible for NHS treatment are subject to the same strict CQC regulatory regime."A Department of Health spokesperson said: "Patients deserve the safest and best care. If providers fail to meet these standards the NHS will hold them to account and reclaim costs on behalf of patients. All providers responsible for NHS treatment are subject to the same strict CQC regulatory regime."