Provision of a vascular service in a district general hospital

• Published in: Annals of the Royal College of Surgeons of England Vol. 78; no. 5 Suppl; pp. 228 - 229
• Main Authors: Whiston, R J, Hedges, A R
• Format: Journal Article
• Language: English
• Published: England 01.09.1996
• Subjects: Hospitals, District - organization & administration; Hospitals, General - organization & administration; Humans; Prospective Studies; Vascular Surgical Procedures - manpower; Wales; Workload; Wales
• ISSN: 0035-8843; 1478-7083

The effect of the appointment of a vascular interest surgeon (VIS) on the provision of a local vascular service has been analysed with regard to change in workload, over the 2.5 years before and after appointment. During the period analysed (1989-1994), there was an increase in elective vascular surgery: aorto/iliac reconstructions (11 v 58) and femoro-distal reconstructions (5 v 34). Carotid/subclavian, femorocrural and endoscopic cervical sympathectomy were introduced. There was a reduction in tertiary referrals (14 v 34). An associated increase in arteriography (196 v 280), angioplasty (38 v 74) and chemical sympathectomies (12 v 27) was observed. Major amputations, however, decreased (64 v 49). There was a decrease in emergency vascular operations performed; ruptured aneurysms (23 v 15), embolectomy (17 v 10). 50 per cent of these operations were performed by the VIS. The appointment of a vascular surgeon increases surgical, radiological and anaesthetic workload but there are still problems in the provision of a local vascular service.