NHS deaths could be halved, say doctors

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/08/26/nhs126.xml

More than 10,000 people are dying needlessly each year after being denied intensive care treatment, according to senior doctors.

	Andrew Lansley: 'We have chronically poor levels of intensive care compared with elsewhere'

They have written to the Health Secretary Alan Johnson, warning that many patients are dying after routine surgery because of a failure to identify them as "high-risk" cases.

The result is that they are not monitored closely enough, causing at least 20,000 deaths each year.

But consultants say that figure could be halved if high-risk cases were properly identified and transferred to intensive care. They say the number of critical care beds devoted to post-operative patients should be tripled from the 30,000 currently provided, while 50 per cent of patients should receive extra care.

Shadow health secretary Andrew Lansley said: "This is a really critical issue for this country. We have chronically poor levels of intensive care compared with elsewhere."

In the letter to Mr Johnson, seen by this newspaper, 17 eminent anaesthetists demand an overhaul of NHS surgical practices, warning that four times as many patients die in Britain after surgery as in the United States.

The doctors say the health service has failed to introduce simple tests to identify high-risk patients and challenge the health secretary as to why technology proven to cut deaths is used in a fraction of NHS operations.

One of the co-signatories, David Bennett, Emeritus Professor of Intensive Care Medicine at St George's Hospital in London, said: "There are at least 20,000 patients dying after surgery across the UK - that is a very conservative estimate.

"We think we could halve the numbers dying, and save at least 10,000 lives a year, if patients were given the right support.

"This is a political decision. There aren't many interventions that could have such a dramatic effect." In-creased use of intensive care, combined with better monitoring, could save money by cutting patients' time in hospital and preventing emergency re-admissions, he said.

Prof Bennett said that most hospitals had failed to invest in equipment such as fitness bikes, which help to assess the patient's health prior to surgery, and blood-flow monitors, which maintain fluid levels and cardiac output during an operation.

Despite backing from NHS rationing body the National Institute for Health and Clinical Excellence, blood -flow monitors are used on less than 10 per cent of patients.

Dr Bruce Taylor, honorary secretary of The Intensive Care Society said more patients should be monitored by intensive care before they became seriously ill. But he said there was "no slack at all in the existing system" to take on more patients without a substantial rise in funds.

Britain has 0.6 critical care beds per 10,000 population compared to 4.4 per 10,000 in the US.

"There are not enough beds and we regularly struggle to meet -demand," Dr Taylor said.

A spokesman for the Department of Health said the Government was doing all it could to ensure hospitals provided efficient surgical care.