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

2. Progress on our
2012/13 Priorities
Royal Devon and Exeter NHS Foundation Trust
Quality Report 2012/13
29
The Surgeon’s story, as told by Mr Ian Daniels, Colo-rectal surgeon
planning that had occurred prior to
the operation. A discharge planning
meeting, involving community services
both from the local mobility centre and
the district nurses, was held on the
ward to ensure the seamless transition
from inpatient to outpatient care. A
further opportunity was also given to
both myself and my wife to debrief
and discuss any concerns we had
about our experiences with the clinical
team prior to discharge. We struggled
to identify areas within which my care
could be improved.
Overall, my experience, on this most
difficult challenge I have ever faced,
was made significantly easier by the
excellent planning and co-ordination
of my care prior to and during my time
in hospital. Now as I plan my return to
work on my new prosthesis, six months
since the operation, I would like to
take the opportunity once again to
thank all Members of the staff involved
and encourage them to consider
applying aspects of my experience to
the care of all patients.”
“This was a truly exceptional example
of multi-disciplinary team-working
across organisational boundaries.
Managers worked in support of
clinically driven leadership; the
surgeons, anaesthetists, nurses,
physiotherapists, occupational
therapists from all the different
specialties worked as a single team and
everyone was focussed on achieving
the best care for Stephen.
As a surgeon, I felt a huge
responsibility seeing Stephen walk into
the operating theatre, knowing the
enormity of what lay ahead for him
and our responsibility. The surgery itself
was the largest single operation we’ve
ever carried out at the RD&E. The
team of people involved on the day
was easily more than 20; but in total
probably 70 or 80 health professionals
were involved.
It’s highly intensive and complex
surgery and not undertaken lightly. In
fact, we’re not aware of it ever having
been carried out in the UK previously
for recurrent rectal cancer. It required
precision planning because there are so
many specialties involved.
As this was a surgical first for the team,
I consulted with the Danish colleagues
throughout the planning, and arranged
for one of the surgeons to attend and
advise during the procedure itself.
In this case, we had to ensure
Mr Dinniss and his family were
psychologically prepared; not just
for what the operation and aftercare
would involve, but also how it would
impact the rest of his life. We had to
gain consent and funding from our
GP commissioners and tremendous
work was done by our planners and
governance team. Delivering all the
aspects of his care was done with
almost military precision. His operation,
lasting over 11 hours and involving
consultants from six different specialties,
was supported by the theatre team
who worked tirelessly with the surgeons
during the operation.
The payback for us has been tremendous.
Not only is Stephen now free from the
intractable pain he was experiencing,
his quality of life is also greatly improved.
Within weeks he was driving his car
and playing football on crutches with
his children. He is living as full a life as
any of us and that’s a great outcome.
He will remain under continued
follow-up and assessment, but already
is attending rehabilitation to fit a
prosthesis. Overall I feel very proud
seeing the efforts of so many staff
here in Exeter support Stephen and his
family through a very difficult time and
to demonstrate true multi-disciplinary
care.”
"We're not aware of
this surgery ever having
been carried out in the
UK before for recurrent
rectal cancer."