Serious failings found in hospital's surgery unit

A review into a hospital rated as the worst performing in England has found serious failings in its surgical care including a toxic culture that risks patient safety.

The Queen Elizabeth Hospital (QEH) NHS Foundation Trust based in King's Lynn, Norfolk, requested a review of its general surgery service by the Royal College of Surgeons after concerns were raised by whistleblowers in 2023 and 2024.

The review did not find evidence of widespread patient harm, but stated some cases were "unacceptable", with delays in spotting complications and questions over surgical competence.

The hospital has apologised and paused its robotic surgery programme.

The review of 17 surgery cases was carried out between 30 April and 2 May.

In eight cases inspectors found "the quality and safety of surgical care were considered to have been unacceptable", and in two cases "there was room for improvement in the care provided".

In three cases "the review team queried whether the operating surgeons had sufficient competencies to perform the surgeries undertaken".

The review team said it was "particularly concerned" by some of the surgery performed by a locum consultant surgeon and found an absence of feeding back to agencies on the "unacceptable quality of surgical care provided".

Issues were also found with delays to post-operative care complications in four cases, which "likely resulted in delays in these patients being returned to theatre", the report said.

The atmosphere in staff meetings was described as "unpleasant" and patient deaths were not discussed openly.

The review noted a lack of formalised handover of a patient from one consultant to another, which was a concern first raised in December 2024.

The report said an audited process for patient handovers was needed and called for a review into the hospital's electronic system "to ensure that it holds up-to-date information regarding which consultant is responsible for managing a patient's care".

The review also found the surgical leadership at the hospital "was not respected or valued by the service" and was considered by those interviewed to have been "poor".

The review said it was critical the toxic culture and the "ongoing dysfunction between the consultant surgeons is resolved" as any "continued dysfunction would lead to service deterioration".

It suggested the trust considered implementing behavioural contracts, with the threat of disciplinary action to tackle this issue.

The trust was advised by the review it should "introduce effective leadership" to the surgical unit and support the roles with training and mentoring.

The Royal College of Surgeons said a focus on safety was essential to restore confidence at the unit.

In response to the report, Prof Lesley Dwyer, the chief executive of Norfolk and Waveney University Hospitals Group which oversees QEH, said the trust "accepted the serious concerns raised".

She added it had now brought in leaders from the Norfolk and Norwich University Hospital to help it improve the unit and make it "as safe as we would wish it to be".

Prof Dwyer added "with the systems we have put in place with the amount of oversight, I am confident we have been able to ensure that they will get safe care".

She added the trust had set up a helpline for those who have had surgery and have any concerns.

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