News Feature


21,273 operations cancelled before start of ‘winter pressures’


Single dose of antibiotic reduces mothers’ risk of death during childbirth


A single dose of the antibiotic azithromycin can help protect mothers from dangerous sepsis infections and death during vaginal childbirth, a new study has found. Infections, particularly sepsis, are responsible for 10% of maternal deaths shortly before, during and after childbirth, putting such infections in the top five causes of maternal mortality worldwide. “A single dose of the antibiotic azithromycin


NHS figures show 21,273 operations were cancelled at the last minute in the three months to the end of December 2022, with hospitals feeling ‘winter pressures’ well before the winter had officially started. The data also shows 4,593 patients were not treated within 28 days of their cancellation, in a breach of the standard. The data highlights the scale of operations that were cancelled at the last minute for non-clinical reasons. A last-minute cancellation is one that occurs on the day the patient was due to arrive, after they have arrived in hospital or on the day of their operation. NHS England’s monthly Referral to Treatment


(RTT) statistics also report the total number of people waiting for consultant-led NHS hospital treatment has seen a small increase on November 2022, with 7.20 million on the list in December 2022. Despite the huge efforts of NHS staff, the number of patients waiting more than 18 months has started to increase again. In November 2022 it was 48,961 and has now increased to 54,882 patients waiting 18 months (78 weeks) or more in December 2022 for consultant-led hospital treatment. The Government’s Elective Recovery Plan has a target to eliminate NHS waits of over 18 months (78 weeks), by April 2023. The most common long waits seen were for


Trauma and Orthopaedic treatment – such as hip and knee replacements (797,630); ear, nose and throat treatment (549,656); or general surgery – such as gallbladder removals and hernia operations (442,948). Mr Tim Mitchell, vice president of the Royal College of Surgeons of England, said: “NHS staff have worked incredibly hard to make sure the longest waits for surgery have been dramatically reduced over the last year. “However, the data show that too many patients


are still suffering the distress of having their operations cancelled at the last minute. Their lives, and sometimes livelihoods, remain on hold while they wait for a new date and the relief from pain that surgery will bring. In some areas, surgeons are telling us that they are dealing with more complex cases, more frequently, as patients’ conditions deteriorate while on long waiting lists. “No surgeon wants to be in the position of telling a patient their surgery has to be cancelled but the very high demand we have seen in emergency departments since the summer, and problems discharging patients who are ready to leave hospital when there is a lack of social care, mean this is too often what has to happen. Gaps in the workforce also play a huge part. Often there will be a surgeon available to operate, but no theatre nurses or anaesthetists.” NHS England has announced 37 new surgical


hubs, ten expanded existing hubs and 81 new theatres dedicated to planned care, in an effort to speed up the recovery of waiting lists. Commenting on the new hubs and extra theatre


capacity, Mr Mitchell added: “These new surgical hubs will go a good way to helping bring down waiting lists. It is excellent news for patients and positive news for surgeons who have shared with us their frustration at not being able to get patients in for their operations due to a lack of theatre capacity. But there is more to be done. “We would like to see surgical hubs established


in every area of the country with a particular focus on those areas that are underserved and struggling to bring down waiting times. All of this will also mean nothing in the long term unless we have a resilient workforce to staff hubs. The Government’s much anticipated workforce plan couldn’t come soon enough.”


decreased sepsis and death by half in women in labour,” said researcher William A. Petri Jr., MD, PhD, of the University of Virginia School of Medicine’s Division of Infectious Diseases and International Health. “The simplicity of this intervention should allow its institution around the globe to protect mothers during childbirth.” More than 29,000 women in low- and middle- income countries volunteered to take part in a randomised trial; half were given azithromycin and half were given a harmless placebo. Among the 14,637 women who received the


placebo, 2.4% developed sepsis or died within six weeks; that’s compared with only 1.6% of the 14,526 women who received azithromycin. The difference was clear enough that the researchers stopped the trial early. The antibiotic is already recommended for Caesarean births in the US and elsewhere. The findings are published in the New England Journal of Medicine.


Urgent need for platelet donors


New figures reveal that 1,800 new platelet donors are needed this year to help provide life-saving treatments for cancer patients. NHS Blood and Transplant is urging blood donors who have blood types A negative, A positive and AB negative to consider switching to donating platelets. Platelets help blood to clot and one donation can help up to three adults or 12 children. Most donations help people with cancer who are undergoing chemotherapy to avoid blood-loss, but transfusions also help people who’ve lost a lot of blood after an accident, organ transplant or surgery. Platelets last just seven days after donation.


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