Two teams of clinicians at University Hospital Southampton NHS Foundation Trust have been shortlisted for prestigious national medical awards for their “inspiring and pioneering” teamwork.
Professor Tim Underwood and his upper gastrointestinal (upper GI) colleagues are in the running for surgical care team of the year and the joint obstetric cardiac team for the cardiology team of the year at The BMJ Awards 2017.
The awards received 290 entries across 14 categories and winners from the 74 shortlisted projects – selected by an expert judging panel which includes patient representatives – will be named at a ceremony in London in May.
The upper GI team’s enhanced recovery after oesophagogastric surgery (EROS) programme, which was developed at UHS and introduced in 2013, is tailored to the needs of patients who have undergone major and complex stomach surgery.
It involves bespoke pre-operative oral and written information for patients and carers, early mobilisation with the support of physiotherapists and occupational therapists and personalised fluid and food intake plans directed by dietitians.
As a result, major complications following surgery fell from 19.8% to 11% and length of stay in hospital decreased from 12 to nine days. Since its introduction in 2013, EROS has saved approximately 582 bed days, which equates to a cost saving of more than £230,000.
“Previously published results for enhanced recovery after oesophageal surgery have shown modest improvements, possibly due to reluctance by the clinical teams to progress patients quickly for fear of significant, life-threatening complications,” explained Prof Underwood, a consultant surgeon at UHS and professor of gastrointestinal surgery at the University of Southampton.
“This study demonstrated that EROS could be applied to all patients who underwent major upper GI surgery with good outcomes. It is now the standard of care at UHS and we have shared our protocol with other NHS cancer centres.”
The joint obstetric cardiac team at UHS, which consists of consultants in fetal and maternal medicine (Mr David Howe, Dr Raji Parasuraman), consultant adult congenital cardiologists (Dr Aisling Carroll, Dr Sam Fitzsimmons), consultant anaesthetists (Dr Poppy Mackie, Dr Andy Curry), specialist midwife (Jackie Kerr) and specialist cardiac nurse (Lynda Tellett), provides a regional service for women with heart disease during pregnancy to deliver care more safely and effectively.
Cardiac disease has been the leading cause of maternal mortality in the UK since 2000, with the most recent national report highlighting a cardiovascular cause in a quarter of women who died during or up to six weeks after pregnancy.
Rather than being seen in separate clinics by cardiologists, obstetricians and anaesthetists, pregnant women with cardiac conditions are seen in a single clinic for shared assessment and planning of their care.
This includes an electronic plan for delivery which is always up to date and immediately accessible and similar electronic plans are now used for other mothers requiring complex care at delivery.
"The provision of joint care is not new but providing it in a single shared clinic reduces unnecessary visits for patients to different clinics, improves the quality of communication and care and is more cost-effective due to an overall reduction in the number of clinic attendances," said Dr Parasuraman.
Dr Fiona Godlee, The BMJ’s editor in chief, said: “Anyone in any doubt that clinicians are pushing the boundaries of innovation despite pressures engulfing the NHS need look no further than The BMJ Awards finalists for 2017. The shortlisted entries represent inspiring and pioneering teamwork with patient outcomes at their core.”
Posted on Wednesday 15 March 2017