Non-surgeon removed gall bladders at hospital

The Royal College of Surgeons has expressed alarm that a non-surgeon has removed patients’ gall bladders at Walsall Manor Hospital.

It said that Surgical Care Practitioners (SCPs) - the staff who play a support role during procedures - should not be performing laparoscopic cholecystectomies with or without supervision.

The comments follow the publication of a research paper showing that 175 surgeries were carried out by an SCP at the hospital during a four-year period.

Walsall Healthcare Trust said it was reviewing the comments.

The Council of the Royal College of Surgeons said there were serious risks to safety posed by such practice, plus issues to do with consent and medical negligence litigation should anything go wrong.

It added the framework for SCPs did not support them actually undertaking the operation.

The council also expressed concern that if SCPs were doing operations, it was taking away training opportunities from trainee surgeons.

The research paper, published in the annals of the Royal College of Surgery, said that a former nurse had qualified as an SCP in 2006, with her skills developing over the next 10 years as she was mentored by the surgical team.

The SCP progressed from minor surgery to hernia repairs and, after assisting with major keyhole surgery procedures, it was decided she should develop her skills further.

In total, according to the paper, she was involved in 53 laparoscopic cholecystectomies assisted by a consultant, 110 by a specialist or associate specialist grade, and seven by a second-year surgical trainee between 2015 and 2019.

The report stated there were no major complications. However, five patients, it said, had to be readmitted to hospital - three with pain and two with portal infections.

Professor Shafi Ahmed, chief of surgery at the Royal London Hospital, said such an approach to the procedure was playing with patients’ lives

“A laparascopic cholecystectomy is a major operation with significant major potential complications, including mortality," he said.

"Even as consultants there is a great deal of scrutiny on the number of cases and the complication rates.”

He said trainees had normally been through five years at medical school and then in surgery for three to four years before they were allowed to perform the procedure.

He said of the actions at Walsall: “This is unsafe and dangerous and needs to be stopped immediately."

Walsall Healthcare NHS Trust did not respond to specific questions from the BBC regarding consent and medical negligence insurance.

Ned Hobbs, deputy chief executive, said: “As a trust, we are in support of additional roles in the NHS such as the nationally recognised SCP along with a commitment to high-quality training for doctors and other healthcare professionals.

“We have received the response from the Royal College of Surgeons regarding laparoscopic cholecystectomies undertaken by an SCP in the trust and are reviewing the comments raised.”

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