Annual Report and Accounts 2012/13 - Royal Devon & Exeter Hospital

28 2. Progress on our
2012/13 Priorities
Royal Devon and Exeter NHS Foundation Trust
Quality Report 2012/13
CASE STUDY
Safety, clinical effectiveness and
patient experience
Patient story, as told by Stephen Dinniss
"After thinking I was
cured, after seven
years clear, I was
diagnosed with a
recurrence of bowel
cancer in March 2011.
Following further
chemo-radiotherapy the tumour
was felt to not be curable and
no surgical options were felt
to be appropriate. However,
following a chance meeting
between several clinicians
whose opinions I had sought,
and the publication of an
article in a surgical journal from
Denmark describing a more
radical approach to surgery, I
was offered the opportunity to
consider a hemipelvectomy to
treat the cancer. The operation
would mean the amputation of
my right leg and removal of the
right hip as well as many of the
pelvic organs. It had never been
undertaken in the UK before,
with just twelve described in the
Danish article.
I understood it represented a huge
challenge and dilemma for both
myself and the hospital and required
significant consideration and planning.
I was therefore given the opportunity
to meet with the main clinicians
involved to aid in making the decision
and once we had decided to proceed,
we were kept abreast of ongoing
developments and planning. We were
aware of meetings between managers
and clinicians as well as involvement
of Commissioners and the PCT. As a
result we were asked to meet with the
Medical Director to ensure we fully
understood the significance of our
decision; and on his suggestion it was
arranged for a surgeon from Denmark,
with experience of the operation, to
be brought to Exeter to be involved.
We also met most of the seven
surgeons and anaesthetists, as well as
physios and occupational therapists,
who would be involved, and had the
opportunity to ensure all our questions
were answered in advance.
The operation itself I remember
nothing of, and little of the following
period. I was aware, though, that
many decisions about where my
care was based, and who would
lead it were made before the
operation. I subsequently felt secure
in understanding the plan to remain
on ITU before moving to the plastic
surgical ward.
I remained in hospital for around
five weeks and throughout that
time my care was well co-ordinated
and delivered, a testament to the