The deaths of 200 to 250 patients who died following heart surgery at a scandal-hit NHS trust are to be reviewed, it has been announced.
All the patients were treated in the cardiac unit at St George’s University Hospitals NHS Foundation Trust in Tooting, south-west London.
The hospital suspended complex heart operations last year after a leaked report suggested poor relationships between surgeons were risking patient safety.
There had been a years-long ‘toxic’ feud between staff which escalated to the point one surgeon was sent a dead animal in the post.
The new review was commissioned by NHS Improvement and will consider all heart surgery patients who died, whether they are the subject of specific concerns or not.
St George’s Hospital in South West London will come under scrutiny in a new review of the circumstances surrounding the deaths of more than 200 heart surgery patients, the NHS says
Jacqueline Totterdell, chief executive at St George’s, said: ‘It is absolutely essential that patients and their families have full confidence in the care our cardiac surgery team provide – and this review of past deaths will be a key part of that process.’
The NHS today announced the review would be carried out by a panel of independent cardiac surgery, cardiology and anaesthesia experts.
They will revisit the details of all patients who died following heart surgery at the trust between April 2013 and September 2018.
Patients’ medical records and details of any internal investigations into their deaths will be taken into account in the review, which could last up to a year.
St George’s hit headlines last year when it was revealed surgeons at the trust had been locked in a ‘toxic’ feud with one another for years.
WHAT WAS THE FEUD BETWEEN SURGEONS AT ST GEORGE’S?
Health inspectors at the Care Quality Commission (CQC) last year reported issues of weak leadership and internal unrest as part of the problems affecting St George’s Hospital cardiac surgery unit.
Some felt there was a persistent toxic atmosphere and a ‘dark force’ in the unit, the report said.
Investigations found the unit had a cardiac surgery mortality rate of 3.7 per cent in recent years, compared with a national average of 2 per cent. It has since improved.
The CQC report said problems in the unit go back more than eight years.
It said the unit’s ‘defensive approach’ to the death rate was wrong.
From September 2018, the most complex surgery cases were temporarily diverted to other hospitals – about 100 people were said to be affected.
Senior leadership attempts to address the cultural issues between surgeons has not improved the situation, the report said.
Marjan Jahangiri, the first female professor of cardiac surgery in Europe, claimed the hospital was more interested in ‘cover-ups and petty vendettas than patient welfare’.
She believed she was targeted because of ‘envy at her success’, with a package containing a dead animal and a decapitated doll sent anonymously to her home.
‘Tribal’ surgeons were said to be risking patients’ health by refusing to work together amid a row which saw one sent a dead animal and decapitated doll in the post.
Care Quality Commission inspectors said last year: ‘Consultants did not work collaboratively, share responsibility or resolve conflict in a constructive and timely manner.
‘There were high levels of mistrust amongst clinical colleagues which contributed to the poor culture within the service.’
In September it was announced the most complex heart surgeries at St George’s would be diverted to other hospitals until improvements had been made.
During the period covered by the review the hospital trust, which also runs Queen Mary’s hospital in Roehampton, had a cardiac surgery death rate almost double the national average.
Some 3.7 per cent of patients having heart surgery died compared to an NHS-wide average of two percent, according to the National Institute for Cardiovascular Outcomes Research.
The review period will cover surgeries carried out while the trust was on ‘alert’ status over the number of patients dying after heart ops.
Deceased patients’ families may be contacted if there are concerns about the care they received.
The review only applies to cardiac surgery at St George’s, and does not include other associated specialities such as cardiology.
The hospital has reassured patients ‘the cardiac surgery service at St George’s is safe’ and said improvement measures are still being monitored by an NHS panel.
The Bewick review, leaked in July 2018, had already warned the hospital about ‘deep dysfunction’ in its cardiac surgery department, the Health Service Journal reported.
It said the hospital’s leadership needed to repair rifts in its cardiac surgery department or face it being closed down altogether.