Health chiefs apologise after children injured during ops

CARDIFF and Vale University Health Board have apologised following a review which found children suffered injuries during surgery – but also insisted services are safe.

The Royal College of Surgeons investigated 18 paediatric surgical cases between 2013 and 2017 which identified similar concerns through hospitals’ complaints processes.

It came after a number of complaints about cultural and behavioural issues in the department and concerns from other departments such as radiology and the paediatric intensive care unit.

The cases involved a number of different paediatric surgeons including locum and experienced consultants.

The RCS investigation highlighted concerns in six of the 18 cases.

No child died in any of the cases highlighted.

In two of these, Cardiff and Vale University Health Board was already in the Putting Things Right process for managing concerns, having already identified it “did not give optimum care” and had apologised to the families involved, a board meeting last Thursday was told.

In the third case the review found that although closer post-operative management was needed, the outcome for the child involved would not have changed.

The RCS asked the health board to carry out further reviews on three children – in two cases it found the care provided was reasonable.

But in one case the board “did feel we had failed that child and their family” – who are now in a Putting Things Right process, executive nurse director Ruth Walker told the meeting.

Mrs Walker has said paediatric surgical services at the University Hospital of Wales (UHW) in Heath, Cardiff, have been reviewed following the findings, and are safe.

The board said it had been in contact with all families where harm had been identified.

Between 2013 and 2017 more than 5,200 children had surgery at UHW – which meant these cases represent 0.3% of the total number of children who were operated on in this time period.

She said: “We would like to reassure families, patients and the public that there is no need to be concerned with the paediatric surgery at the University Hospital of Wales and that our services are safe.

“In line with good governance we identified a cluster of concerns with similar themes through our staff speaking up and our incident, complaints and claims process within paediatric surgery.

“This led to a request that the Royal College of Surgeons independently review 18 paediatric surgical cases that had taken place between 2013 and 2017.

“All families and/or their representatives have been contacted under Welsh Government’s Putting Things Right [protocol] and there is no reason to believe this issue is wider than the cases identified.

“We have accepted the report and the recommendations and have worked hard to improve processes to reduce the risks raised.”

The RCS report highlighted issues around lack of consultant reviews which contributed to failures to manage postoperative complications which also led to unnecessary delays.

There were also concerns about handovers and joint working between the paediatric surgeons and paediatric gastroenterology departments.

In response, the health board says it has implemented a number of recommendations made by the RCS, including hiring six new paediatric surgeons, with plans to appoint a seventh in November, designating time for handovers in consultant rotas and improving relationships between departments.

Paediatric surgery is now no longer doing elective work while running an emergency on call service, as recommended in the report.

The RCS in March 2018 told the board they are “satisfied and assured” improvements are being made.

Maria Battle, chairwoman of Cardiff and Vale University Health Board, apologised to the families involved at Thursday’s meeting.

She said: “We apologise to those children who have suffered harm. We have ensured that the services are safe.

“It’s an opportunity to learn where issues have been raised for quite some time.”