LEGAL claims brought by public patients against the Orthopaedic Department over their care have cost the government £600,000 over the past three years, a new report has revealed.
The cost of litigation, brought between 2021 and 2023, was highlighted in a report by the Royal National Orthopaedic Council which has been published by the government. Formally reviewing such cases – to determine where patient care could be improved – is one of 36 recommendations made to help make the General Hospital “an exemplar hospital” for the Island.
Other recommendations focus on reducing waiting times and giving more patients the option to be treated locally.
The report recommends that:
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Operating theatres should remain open longer.
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Simpler procedures should be moved into day-care facilities.
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Standby waiting lists should be created to cope with cancellations.
It states: “These changes will improve the resilience of elective surgery throughout the year, including in the winter months… this will have a positive impact on reducing waiting times for patients in both outpatients and for those patients requiring admission for orthopaedic services.”
The report forms part of the Getting It Right First Time initiative, a national programme designed to improve patient care, by reducing unwarranted variations in clinical practice between hospitals.
One of its authors, Professor Tim Briggs, chairman of the GIRFT programme, said that Health and Community Services staff had been “open and honest” about the challenges they faced and had highlighted opportunities to improve services during interviews conducted in April this year.
The report adds: “We saw excellent facilities, with many examples of good practice. This confirms our view that the General Hospital has an opportunity to become an exemplar hospital, which will improve care for all patients and encourage additional private patients to use the facilities. We have identified opportunities for – and areas of change to – practice that will increase activity by maximising the use of existing resources and assets.”
A focus of the report is optimising use of the hospital’s operating theatres, which it says should run for 48 weeks of the year, for 2.5 sessions a day on six days a week, with staff rotas adjusted to avoid the need for breaks over the lunch-time period. It also identified opportunities to create more space in current theatre schedules.
“There are procedures that should be performed in an outpatient procedure room by default, not inpatient theatres, which would bring the General Hospital into line with GIRFT’s ‘Right procedure, right place’ approach,” said Mr Briggs.
The report also addressed a wide range of other issues relating to the Hospital’s culture, including an over-reliance on locum practitioners; the need to monitor the performance of surgeons through appraisals; giving middle-grade doctors the opportunity to conduct more operations to improve morale and prevent deskilling of staff; and remedying inconsistencies in contracts, so that physiotherapy and occupational therapy teams can be deployed seven days per week.
The report repeated concerns raised at the Health Advisory Board about ageing equipment in the Radiology Department, recommending a review and upgrade, noting concerns that it is currently not possible to screen for prostate cancer using existing MRI scanner software.
Commenting on the GRIFT report, Health Minister Tom Binet said: “In the past, a report of this nature would not normally be released. However, having discussed with senior officers, we are all of the opinion that it would be helpful for you to have sight of the work that is being undertaken to ensure the best long-term use of public funds.”
