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Provision of vascular surgery in England in 2012
P Grewal1, M Davis, G Hamilton
1Department of Surgery, Queen Alexandra Hospital, Portsmouth, UK. Perbinder@yahoo.com
Insights
Eighty English trusts provide acute and elective arterial and aortic surgery, with 48 centralized vascular hubs. Integrated vascular services are recommended for improved patient care and clinical standards in vascular surgery.
Area of Science:
- Vascular Surgery
- Health Services Research
Background:
- The Vascular Society of Great Britain and Ireland set a 2013 target to halve UK elective Abdominal Aortic Aneurysm surgery mortality.
- Vascular Surgery was officially recognized as a specialty in the UK in March 2012.
- This study evaluates the current state of vascular surgery provision in English acute trusts.
Purpose of the Study:
- To assess the provision of vascular surgery services across acute trusts in England.
- To identify the number of trusts offering acute and elective arterial and aortic surgery.
- To determine the distribution of specialized vascular hubs and supporting networks.
Main Methods:
- A survey was conducted via email with 169 acute trusts in England, identified from Department of Health data.
- The survey was administered under the Freedom of Information Act.
- A response rate of 98.8% was achieved.
Main Results:
- Currently, 80 out of 169 trusts provide acute and elective arterial and aortic surgery.
- Of these, 48 trusts function as specialized vascular hubs, with 32 offering local networks or under review.
- Vascular hubs have an average of 4.8 consultants and 3.75 middle-grade surgeons, with on-call rotas typically 1 in 6.
Conclusions:
- The study confirms that 80 trusts in England offer acute and elective arterial and aortic surgery, with 48 centralized complex vascular services.
- An integrated vascular service model is proposed to enhance the quality of care.
- Centralization and integration are expected to advance surgical techniques and elevate clinical standards in vascular surgery.
Introduction:
In 2009 the Vascular Society of Great Britain and Ireland reported its recommendations for The Provision of Vascular Services for Patients with Vascular Disease. The objective is to halve the UK elective surgery mortality rate for Abdominal Aortic Aneurysm to 3.5% by 2013. From 16th March 2012, statutory approval has been given by Parliament to recognise Vascular Surgery as a Specialty in the UK. This study assesses the provision of vascular surgery in acute trusts across England.
Method:
From the Department of Health, 169 acute trusts were identified in England and each acute trust was emailed under the Freedom of Information Act.
Results:
There was a 98.8% response rate. There are currently 80 trusts in England providing acute and elective arterial and aortic surgery, with 48 vascular hubs and 32 trusts which either provide a local on call network or are currently under review. Within the 48 vascular hubs there are a mean of 4.8 consultants and 3.75 middle grades. The on call rota was on average a 1 in 6.
Conclusion:
This study has shown that currently 80 trusts in England provide acute and elective arterial and aortic surgery with 48 centralised complex and arterial vascular services. An integrated vascular service will provide the best quality of care, develop the latest techniques and improve clinical standards.
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