A “BLATANT rejection” of clinical evidence means vascular services for Bucks patients are heading for disaster, the House of Commons heard last night.
MP Steve Baker secured a late Parliamentary debate on the plight of Wycombe Hospital yesterday – raising further concerns around the loss of complex vascular surgery to Oxford.
The NHS shake-up, recommended by the South Central Cardiovascular Network, is aimed at creating a specialist centre at the John Radcliffe Hospital [JRH], benefitting from increased consultant cover and expertise.
But the changes were questioned several times last year by the Bucks Free Press and Mr Baker, who yesterday produced “clear clinical evidence” that Wycombe outperforms the JRH.
Diseases of the arteries and veins used to be treated by traditional surgery only, but problems can now be dealt with by using a more modern, less invasive procedure called endovascular surgery.
This involves using imaging techniques to see inside the body while a narrow tube [catheter] is guided to the site of the problem through the blood vessels, which generally means less risk, less pain and shorter recovery times for patients.
Last year an independent review of the changes found vascular services at Oxford are “ten to fifteen years behind the best”, while surrounding hospitals "probably provide a better endovascular service" (see related links).
And yesterday, Mr Baker said he had obtained data which shows Wycombe achieved eight vascular interventions for each amputation during the first half of 2012/13, compared with just 4.5 at the JRH.
He said “this shows a considerably greater degree of success in maintaining people’s limbs in very difficult circumstances”.
And the Conservative MP for Wycombe added: “Vascular services in Wycombe are not some ditch and gatepost operation to be salvaged by the great Oxford University hospitals, as Wycombe outperforms them with a smaller team. In this regard, it is the John Radcliffe that needs saving...
“Vascular services in the Thames Valley appear to be not so much sleepwalking into disaster as positively driving towards it.”
Despite detailing a series of problems, including the resignation of a senior surgeon, last year’s independent review said the changes should still go ahead on the basis that vascular services should be co-located alongside Oxford’s major trauma unit.
But Mr Baker says this was “a blatant rejection of the principle that is constantly used to justify centralising services away: clear clinical evidence”.
Certain vascular procedures, such as Carotid Surgery, are set to remain in Wycombe until 2014 at least, though the review said this is unsustainable in the long term (see related links).
And the likely loss of carotid surgery from Wycombe Hospital has raised concern that this could in turn threaten its critical care, coronary and hyper-acute stroke units.
In response to Mr Baker, health minister Dr Daniel Poulter noted the importance of vascular services to Wycombe, which has large Asian population, among whom there is a higher rate of cardiovascular disease.
However, he said changes to front-line health services are a matter for the local NHS, and evidence on a wider scale indicates that centralisation of vascular services achieves better outcomes.
He added: “Generally speaking, all surgeons need to do a minimum number of procedures in order to maintain regular competency, and to maintain continually high and good outcomes for patients...
“That is the reason for the service reconfiguration. The argument can be made, as my hon. Friend has done, that Wycombe should continue to provide those services, but we know that the national data and best evidence point to the fact that the services are best provided at specialist centres.”
See related links for a video of the debate and Friday's Bucks Free Press for a full report.