News
Complications from ‘health tourism’ puts pressure on NHS
Patients travelling overseas for cosmetic limb lengthening can face serious complications that place additional pressure on NHS services, according to new research published in The Annals of the Royal College of Surgeons of England. The study, led by specialist limb reconstruction
surgeons, examined patients presenting to a specialist limb reconstruction service at the Royal National Orthopaedic Hospital, following limb lengthening surgery undertaken abroad, and found several had experienced serious complications requiring further treatment, rehabilitation and, in some cases, complex corrective surgery. Complications documented in the study included implant failure, poor bone healing, severe joint stiffness and deformity. Researchers found patients frequently required multiple hospital contacts and physiotherapy, with some needing significant surgical intervention to manage problems arising after their original procedure. The study also highlights the impact on NHS
resources when complications from surgery abroad are treated back in the UK. The authors identified a net financial burden to the NHS of more than £36,000 across the cases reviewed, with the two patients requiring corrective surgery accounting for the largest share of costs, alongside pressure on specialist limb reconstruction services. The findings add to wider concerns about the
impact of surgery abroad on patients and NHS services. RCS England has been calling for the NHS to collect data on patients requiring treatment for complications after undergoing surgery abroad; to better understand the scale of complications and the pressures they place on NHS services. The authors say a broader national picture is needed to understand the full extent of the issue. The study documented major complications in multiple patients following limb lengthening
International declaration for perioperative care
Leading international medical organisations have united behind a shared vision for the future of perioperative care. Initially developed at the 2025 Evidence Based Perioperative Medicine (EBPOM) World Congress, the London Declaration aims to highlight the value and impact of good perioperative care. It sets out a shared vision for how this can
surgery abroad, with only one patient returning to the original provider for corrective treatment. Patients had a median of 10 hospital contacts
each, with all requiring physiotherapy and some needing extensive follow-up care. Cost and availability were the main reasons patients chose surgery abroad. None of the patients had undergone pre-travel consultations, raising concerns about informed consent and patient preparation. Some patients had hidden their procedures from their families. Mr Peter Calder, lead author and Consultant
Paediatric and Limb Reconstruction Surgeon, said: “Limb lengthening involves complex surgical techniques, with pre- and post-operative involvement of multidisciplinary teams, to ensure optimal surgical and functional outcomes. “Anecdotally, we have seen an increase in
patients presenting to our hospital following lengthening surgery abroad. All required intensive physiotherapy and, in many cases, surgical intervention for serious complications. This resulted in both an increase in burden on staff and financial costs for the NHS.” For further information, visit: https://publishing.
rcseng.ac.uk/doi/10.1308/rcsann.2026.0040
Celebrating excellence in SSI prevention
The OneTogether UK Expert Conference 2026 brought together healthcare professionals and system leaders to share learning, collaboration and innovation focused on reducing surgical site infections (SSIs). Delivered in partnership with the Infection Prevention Society, Central Sterilising Club, Association for Perioperative Practice, College of Operating Department Practitioners and Solventum, the conference explored the latest evidence, strategies and real-world practice to improve patient outcomes across the surgical pathway. The conference also celebrated excellence
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www.clinicalservicesjournal.com I July 2026
through the OneTogether Awards 2025. The award winners announced included: King’s Global Health Partnerships DRC SSI Team and The West of England PreCiSSIon Collaborative, whose impactful projects are driving measurable reductions in SSI both nationally and internationally. Both teams shared insights from their
award-winning initiatives during dedicated conference sessions, inspiring delegates with practical approaches to improving surgical safety. To enter next year’s awards visit: https://
onetogether.org.uk/onetogether-awards/
be achieved through collaboration across borders, empowering patients, investing in a skilled multi-professional workforce and building partnerships and pathways that improve outcomes for patients. The Royal College of Anaesthetists (RCoA) and the Centre for Perioperative Care (CPOC) are proud to be founding signatories, alongside six international partner organisations. 1. Australian and New Zealand College of Anaesthetists (ANZCA)
2. European Society of Anaesthesiology and Intensive Care (ESAIC)
3. American Society of Anesthesiologists - Center for Perioperative Medicine (ASA- CPMed)
4. American Society for Enhanced Recovery and Perioperative Medicine (ASER-PM)
5. Evidence Based Perioperative Medicine (EBPOM)
6. Perioperative Quality Initiative (POQI)
Dr. Claire Shannon, President of the RCoA, commented: “I am delighted to sign this declaration on behalf of the RCoA and welcome this vision for international perioperative care, shared with our partners. I am grateful to everyone who worked to develop this declaration and the commitment from all involved in working together to transforming our shared vision into reality.” Visit:
https://cpoc.org.uk/about-cpoc-
strategy-and-vision/london-declaration-2026
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