The Musgrove/Vanguard contract – list of specific failures and concerns

  • As discussed in Laurence Vick’s NHS Outsourcing article, these are the key concerns raised re. the surgery Vanguard performed for Musgrove Park Hospital:
  • Possible poor surgical technique – but this was not the only explanation; patients had suffered different complications from both of the two surgeons employed by The Practice;
  • “Pressure of operating on 20 patients each day may have contributed to the possible deterioration of surgical quality and reduction in patient experience” – one patient commented he had felt ‘rushed’ when compared with his previous experience of undergoing cataract surgery carried out by the NHS ophthalmic team at Musgrove;
  • Several patients reported experiencing pain at the time of the procedure;
  • some patients said the surgery had been very painful irrespective of whether they had suffered complications – this was thought to have resulted from inadequate drops of local anaesthetic; another potential cause of the pain suffered was damage to the iris, evidenced in a number of patients in the review;
  • Some patients had been “shouted at” for not keeping still during their procedures;
  • problems with the dilution of the saline solution;
  • Problems with the phacoemulsification machine supplied by Kestrel which had just returned from being serviced – a representative from Kestrel had been in attendance for the first day of operations to familiarise the two surgeons with this particular model;
  • Nurses reported the phacoemulsification machine cutting out and the timings recorded by the surgeons were longer than those usually seen at Musgrove;
  • multiple microscopic metallic fragments found in the anterior iris surface of at least four patients, probably thought to have arisen from the phacoemulsification machine;
  • Two patients experienced burns to the eye from the phacoemulsification machine;
  • arrangements for planned follow-up of patients had not been finalised when the contract commenced.