Morriston cardiac surgeons accused of bullying and abuse
A HARD-HITTING review of cardiac surgery at Morriston Hospital has accused surgeons of bullying and abuse.
Both nurses and anaesthetists pointed the finger at surgeons, while anaesthetists were also accused of disruptive behaviour, with bosses at Abertawe Bro Morgannwg University (ABMU) Health Board claiming they were “held to ransom” by them.
Surgeons, meanwhile, told the independent panel who wrote the review that they were aggrieved by some aspects of their pay arrangements and did not feel ABMU bosses wanted to resolve this.
The review team interviewed dozens of staff and said, despite the warring factions, that the cardiac surgery service “appears to offer good quality care and outcomes with mortality rates (post surgery) being comparatively low”.
But the report branded the “significant” numbers of patients who died while waiting for surgery — 57 over the last five years — as a “major deficiency” as well as a tragedy for those concerned and their families.
The report also said that the lack of teamwork led to huge decisions about patients’ lives being reversed. For example, seriously ill patients who had been put on what is known as an end-of-life care pathway had this decision overturned.
“We heard from several sources that this is quite common,” said the report. “Futile treatment was pursued in patients who all subsequently died. This is completely unacceptable and must be ended immediately.”
Damning words also flowed from nurses. The report said: “The nurses both on CITU (cardiac intensive care unit) and elsewhere feel very strongly about the behaviour of the cardiac surgeons and have vividly described receiving wholly unacceptable abuse, lack of respect, blame, bullying and arrogance from the surgeons.”
Low morale, added the report, had also festered from “inequitable” payment arrangements between the varying staff, with theatre clinicians getting extra pay as part of a six-day working system — subsequently changed — while theatre staff were on basic rates.
The report went on: “There is a perception that cases delayed during the working week might be delivered as a waiting list activity at the weekend, which the higher rates of pay attracted.”
The review team also found “too many examples of staff, especially surgeons, not complying with hand hygiene regulations”.
At times, patient waiting times for surgery have frequently exceeded 36 weeks — the national target’s uppermost limit — but to tackle this, the overall waiting list has rocketed to a four-year high of 394.
Surgeons did, however, enjoy a good working relationship with cardiologists — and have since written to report author Stephen Ramsden saying they welcomed the review and were very keen to “work collaboratively” for the better.
Morriston’s cardiac surgery service treats approximately 700 patients per year, who undergo procedures including bypasses and valve replacements. In March this year, it was ranked eight out of 40 among similar departments for the period between 2008 and 2011 by the Society for Cardiothoracic Surgery in Great Britain and Ireland.
The findings of the review were discussed at an ABMU board meeting yesterday.
Mr Roberts said: “It was very clear to me that there were quite a lot of deep issues. Staff have faced unacceptable conditions when they came to work, including the behaviour of some colleagues. As a board, we will not and cannot tolerate that sort of behaviour.”