Chronic underfunding of post-surgical care is adversely affecting recovery times and patients’ quality of life, says surgeon
One of Britain’s leading surgeons has spoken out against the “chronic underfunding” of post-surgical care services in the NHS, which is leaving stroke victims and head injury patients at serious risk of failing to recover.
Jake Timothy, a neurosurgeon based at Leeds Teaching Hospital Trust, has said the erosion of physiotherapy, nursing care and occupational therapy positions was directly affecting recovery times and leaving patients’ quality of life at risk.
Timothy told the Observer the problem was “an endemic issue within the NHS”. His claims were backed up last night by Phil Gray, chief executive of the Chartered Society of Physiotherapy (CSP), who said cuts to physiotherapy services meant patients were forced to recuperate longer in hospital, leaving them at risk of developing “serious longterm problems”.
A fellow of the Royal College of Surgeons, Timothy called for more investment in rehabilitation services to shorten “expensive inpatient care”.
He said: “There is no point in performing life-saving surgery if there are not the resources to help patients rehabilitate from the acute episode and eventually back into society. Neurological injury has a major impact on both the patient, families and society.
“It would be far more cost-effective for the taxpayer and hospital administrators to invest in the rehabilitative services which will hasten recovery and shorten the expensive inpatient care, especially in times of such financial constraints. This would enable us to treat more patients.
“Unfortunately, the Trust needs to make difficult decisions regarding funding due to financial constraints, but within neurosurgery these cuts have major implications to the quality of life for our patients.”Gray said the CSP had been receiving reports of cuts to physiotherapy services because of financial pressures. He added: “We know of reduced staff numbers in physiotherapy departments and are hearing that physiotherapists with expertise in key or specialist areas are being replaced by staff with lower skill levels in order to cut costs. This may have a negative impact on the quality of the service provided to patients and long term it will not result in savings. Cuts to physiotherapy services mean many patients have to stay in hospital for longer than they should. Early access to physiotherapy is essential in helping patients to make a quick recovery, which in turn can free up hospital beds. Physiotherapy can also prevent patients from developing serious longterm problems.
“Thankfully, many hospitals are recognising the value of physiotherapy and have expanded the number of physiotherapists they employ. We hope more will follow and adopt this approach.”
Timothy, who is currently pioneering techniques in spinal repair and minimally invasive surgery to reduce patient recovery time, voiced his concerns after discovering that one of his patients, 56-year-old John Armstrong, had remained in ward 25 of the Trust’s Leeds General Infirmary several months after suffering from bleeding on the brain in the early hours of 15 March. Armstrong’s wife, Liz Meenan, wrote to Timothy expressing disbelief at her husband’s perceived lack of post-surgical care, and launched a campaign to fight for adequate physiotherapy.
She has now succeeded in securing extra care for John and other patients. But she believes the lack of treatment following his operation as a result of cuts to post-surgical care services has directly affected his quality of life, with her husband frequently becoming depressed and agitated at the slowness of his recovery.
Timothy wrote to Meenan, saying he agreed with her concerns regarding the provision of inpatient physiotherapy. He said: “There has been a chronic underfunding of what is such an important service, particularly in neuro-rehabilitation.”
He said the reality at the LGI, the regional head injury unit, meant that provisions for head trauma patients were now “inadequate” due to funding cuts. Timothy said he was troubled by this, given that the Trust may become a major trauma unit and see an increase in the number of patients who need such care.
“Although the focus of the Trust’s work is to look at the acute management, I am concerned that the rehabilitation side will be neglected,” he told the Observer.
In a series of meetings in June and July with hospital staff, Meenan was told that problems with the depletion of physiotherapy services existed before Armstrong was admitted and “should have been picked up and acted upon sooner”, according to minutes seen by the Observer.
At one meeting, medical staff acknowledged the “shortage of physiotherapists and physiotherapy sessions, the shortage of occupational therapy sessions … and the impact on Mr Armstrong’s rehabilitation and the inadequate seating opportunities for Mr Armstrong”.
Every staff member present apologised “on behalf of the system” and sympathised with Meenan’s position.
Meenan, 57, said: “The hospital has now agreed a package for John, and for other patients too. I have never wanted John to be a special case or for him to jump the queue.” Her campaign is being supported by her MP, Rachel Reeves, shadow chief secretary to the treasury. Reeves has written to Meenan on several occasions, saying how disappointed she was to hear about her husband’s case. She wrote in early July to health secretary Andrew Lansley, urging him to investigate. Last week Reeves received a response from a minister in Lansley’s department advising Meenan to complain to the hospital.
A spokesman for Leeds Teaching Hospitals said: “We have had extensive discussions with Mrs Meenan about her concerns regarding the complex needs of Mr Armstrong. Three additional physiotherapy staff have been made available to support the service delivered to the ward in question and there have been significant improvements to the frequency of interventions.” The Patient Advice and Liaison Service (PALS) is investigating Armstrong’s case after receiving a formal complaint, and has said it will report back on 31 August.