Why specialist surgery must stay at QA

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QUEEN Alexandra Hospital stands to lose millions of pounds of income if expert surgeons are moved to Southampton.

The Cosham hospital receives about £4m a year for vascular surgery – which deals with the treatment of damaged and ruptured blood vessels.

But this income is under threat as regional health bosses are considering moving QA’s surgeons to Southampton General Hospital as part of plans to centralise care.

Today, as The News launches a ‘Keep it at QA’ campaign to stop regional NHS bosses moving vascular surgeons, health representatives say a drop in income would be devastating news for our hospital.

Gosport councillor Peter Edgar, who is one of the council of governors at QA and sits on both Portsmouth and Hampshire’s health overview and scrutiny committees, said: ‘The hospital has a big PFI to pay off and bills to pay and anything that undermines that puts the whole hospital operation at risk. It’s an extremely worrying scenario.

‘If the hospital is losing income, it could come to a point where it’s no longer able to pay its bills and will not be able to continue. The finances are an ongoing worry anyway, but the hospital has worked very, very hard to try and deal with that situation, but they will struggle to carry on if this happens.’

On top of the income QA could lose, it would also mean the 350 patients who need vascular surgery each year would have to travel further for surgery – much of which is emergency and involves a patient being rushed in by ambulance.

But hundreds more patients would also be affected as vascular surgeons do not just deal with surgery such as aneurysms – where blood vessels become enlarged and can burst – but also help with the day-to-day work at the hospital such as cancer surgery where vessels can become damaged.

And in addition to this, QA’s vascular surgeons also see thousands of patients who have vascular problems at clinics in the community – this service would also have to stop.

QA vascular surgeon Graham Sutton, said: ‘It’s not just 350 patients a year who would be affected by this. It would be the expertise lost in other surgery and the work we do in the community.

‘This could have a big knock-on effect and we don’t think the patients of Portsmouth will benefit from being moved to Southampton.’

NHS South Central – which is the regional health authority – decided to carry out a review of vascular services across the area following the Vascular Society of Great Britain making recommendations that it would be best to centralise care.

NHS South Central then decided to pursue this recommendation and carry out a review of vascular services at hospitals in the region.

It invited hospital trusts to bid to be the main provider of vascular surgery in the area.

Following this NHS South Central has made an interim decision that Southampton General Hospital should be the provider of the service in the south of the region,

It’s believed Southampton has initially been chosen over QA because of a difference in the mortality rates of aortic aneurysm surgery – which is just one aspect of vascular surgery. This specific surgery deals with swelling of the aorta, which is the largest artery in the body.

QA’s mortality rate for planned aortic aneurysm surgery is below the national average. But the hospital’s mortality rate for emergency aortic aneurysm surgery is higher than the national average. However this is believed to be because the emergency patients tend to have existing disorders or diseases and risk factors during surgery.

If aortic aneurysm surgery was moved to Southampton, and it achieved better than the national average results for mortality, local health experts believe only two to three lives would be saved a year. But by contrast, clinicians believe many more lives would be put at risk by QA no longer having vascular surgeons on site.

Meanwhile NHS South Central says clinicians are developing a range of proposals but no decisions have yet been made.

Simon Cook, associate director of acute care at the regional health authority, added: ‘Clinicians are looking at how clinical outcomes for vascular surgery patients can be improved on a sustainable basis.

‘Local people will be provided with clear information on each proposal once they have been developed.’

A public consultation will begin in the summer.

I’M SURE I WOULDN’T BE HERE NOW...

PENNY van Berkel owes her life to vascular surgeons at Queen Alexandra Hospital.

When the 50-year-old was involved in an horrific car accident she needed emergency treatment to repair a ruptured spleen, burst diaphragm and shattered pelvis.

She also needed the expertise of a vascular surgeon to help repair damaged blood vessels.

But Mrs van Berkel wonders if she’d be alive now if she had had to travel 40 miles further for treatment – which could be the case in the future for patients if QA’s vascular surgeons are moved to Southampton.

Mrs van Berkel, of Widley, featured in The News last year when she thanked QA staff –including the vascular surgeon involved in her care – for saving her life.

She is now joining a raft of people speaking out against the proposals to move surgeons and is urging the public to get behind the ‘Keep it at QA’ campaign.

She said: ‘If they move surgeons to Southampton, I think there will be people who are not around as a result of it. If I’d had to go to Southampton, I’m fairly sure I wouldn’t be here now.

‘Time is definitely of the essence in an emergency and having to travel further would not have helped at all.’

She added: ‘I certainly don’t want to see surgeons moved to Southampton. That kind of expertise should remain in big hospital like QA.’

While 350 patients have vascular surgery at QA every year – when they have specifically gone in because of a problem with a blood vessel – many hundreds more, like Mrs van Berkel, require the expertise of vascular surgeons during other surgical procedures.

This is where the main concern lies with moving surgeons at QA.

QA vascular surgeon Graham Sutton, who was involved in Mrs van Berkel’s care, said: ‘As well as vascular surgery, we’re on hand to help colleagues in surgery such as cancer surgery. With vascular surgeons at QA now, a cancer surgeon would have to wait two minutes for them to come and help, but would have to wait an hour if the surgeon had to come from Southampton.

‘Clinicians would not feel happy about taking on cases without a vascular surgeon next door.’

VITAL WORK OF CASCULAR EXPERTS

WE ALL know what a cancer surgeon does, but not everyone will know the important role of a vascular surgeon.

Vascular surgery is the treatment and repair of blood vessels.

These are the key things a vascular surgeon does:

· Treat aneurysms: An aneurysm is a bulge in a blood vessel caused by a weakness in the vessel’s wall. If it grows too big it can burst and be fatal. Aneurysms commonly occur in the arteries at the base of the brain and in the aorta – the artery leading from the heart to the abdomen. A vascular surgeon will treat aneurysms which have burst and treat those which have been detected during screening, but have not yet ruptured.

· Clear out arteries leading to the brain in stroke patients: A stroke is caused by a disturbance in blood flow to the brain. A vascular surgeon will rectify the problem and help prevent further strokes.

· ‘Replumb’ arteries in the legs: In some patients, commonly diabetics, the circulation in their legs becomes so bad they are at risk of losing the limb. A vascular surgeon will treat the problem and save the patient’s leg.

· Offer expertise and assistance during other surgery: A vascular surgeon will help when blood vessels are damaged in other surgery, such as cancer surgery.

SURGEONS’ ROLE

VASCULAR surgeons play a vital role at Queen Alexandra Hospital.

Without them, lives will be put at risk.

Clinicians, GPs, health representatives and patient groups are all against QA’s surgeons moving to Southampton General Hospital – and The News is too.

That is why we have launched the ‘Keep it at QA’ campaign, to send a strong message to regional health bosses that we want vascular surgeons to stay at our hospital.

And members of the public can help back this campaign by having their say.

We want as many of you as possible to write to us and tell us what you think about the proposal to move surgeons to Southampton.

Whether you’ve had vascular surgery, you work in the health service, or you are just someone who thinks this is the wrong move for our hospital – we want to hear from you.

To get in contact you can either email keepit@thenews.co.uk, or write to Keep it at QA, Editorial, The News, The News Centre, Hilsea, Portsmouth, PO2 9SX.

If you would like to speak to a reporter about this, call Rachel Hawthorn on (023) 9262 2169.

Then when NHS South Central, which has proposed moving surgeons, launch their consultation in the summer, we’ll be ready with a dossier to present to them to show the strength of feeling in our area.

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