Select Committee on Health Written Evidence


APPENDIX 1

TRENT AND PENINSULA ISTC'S: CLINICAL OUTCOMES: 22 MARCH 2004-30 JANUARY 2006


Patients operated and
discharged (excluding
re-admissions)
Percentage of
operated and
discharged

Total Surgery
7,617
Hip Replacements
1,693
22.22%
Hip Revisions
  (Part of Minimum Take)
11
0.14%
Knee Replacements
2,149
28.13%
Knee Revisions (Part of Minimum Take)
5
0.06%
Minor surgery
3,759
49.35%
DNA Say Surgery
28
0.74%
DNA In-Patients
17
0.44%
Surgery Cancelled for Clinical Reasons
121
1.58%
Surgery Cancelled for Non-Clinical Reasons
21
0.27%

1.  REASONS FOR CLINICAL CANCELLATIONS (SUMMARISED)

Cancelled after Outpatient Assessment

    —  Require further diagnostics

    —  Cardiac Problems

    —  Hypertension

    —  COAD

    —  Circulatory Problems

    —  Require ITU Facilities

    —  Other Procedure Required

    —  No Surgery Required

    —  Urinary Tract Infection X-Rays not available

    —  Circulatory Problems

2.  CANCELLED AFTER SURGERY HAS BEEN BOOKED

Clinical Reasons

    —  Unforeseen other surgery

    —  Hypertension

    —  Septic Lesion

    —  Flu

    —  MRSA Positive

    —  Persistent Urinary

    —  Tract Infection/Blood in Urine Prolapsed Uterus

    —  LowHB

    —  Swollen Leg

    —  Medication/Aspirin

    —  High CRP

    —  Abnormal Egg

Non Clinical Reasons

    —  Patient Choice

    —  X-Ray not available

    —  Social Problems

CLINICAL OUTCOMES

1.  Returned to theatre for unforeseen procedure


Patients Operated and Discharged
Return to Theatre
%

7,617
159
2.08%





Reasons Return to Theatre (Summarised)

Manipulation under anaesthetic (knee)
17
Dislocation
14
Wound Inspection and Debridement
34
Secondary Suturing
2
Prosthetic Component Replacement/Revision
5
Insertion/Removal of Drain
2
Removal of Pin
2
Removal of K-Wire
1


2.  Transferred to another provider for treatment


Patients Operated and Discharged
Transferred
%

7,617
25
0.32%




Reasons Transferred (Summarised)

Cardiac Arrest
2
Dislocation—Admired QMC
1
Uncontrolled Hypertension
2
Pneumonia
1
Stroke
1
Bowel Obstruction
1
Urinary Retention
2
Chronic Diarrhoea
1
Respiratory Arrest
1
Ischemic Changes on ECCT
4
Peptic Bleeding Gastric Ulcers
1
on-Procedure related incident (Car Accident)
1
DVT
2


3.  Re-admission within 29 days after discharge


Patients Operated and Discharged
Re-admitted
%

7,617
174
2.28%




Reasons Re-admitted

Returned to theatre (Re-admitted)
72 (5 In-hospital returns, before discharge)
Pain Management
12
Oozing Wound
8
Suspected DVT
7
Fall at home
5
Blisters/cellulites
3
Swollen Leg/Feet
3
Haematoma
2
Social Reasons
2


4.  Clinical outcomes


Patients Operated and Discharged
Re-admitted
%

Total patients
%
Nosocomial Infection
32
0.4
Community acquired infection
19
0.24
Unexpected admission to HDU/ITU
9
0.11
Hemorrhage
3
0.03
Adverse incidents
92
1.20
Allergic reaction
9
0.11
Deep Vein Thrombosis
5
0.06
Pulmonary Embolism
2
0.02
Death
4
0.05
Transfer to NHS Trust Hospital
23
0.30

Patient satisfaction based on survey—at least 10% of Patients




Patients
%

Total patients seen
9,982
Total Responses
4,790
47.9
Overall Patient Satisfaction
95

Rate of patient complaints as % of all patients Referred




Patients
%

Total patients referred
9,982
Total number of complaints
163
1.63





 
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Prepared 25 July 2006