BAPRAS calls for greater patient access to plastic surgeons

30th November 2011

 

As BAPRAS opens the UK’s biggest ever meeting on plastic surgery, it is calling for greater access to plastic surgeons as part of multi-disciplinary NHS teams. The UK currently has a third of the number of plastic surgeons per capita than the USA which is disadvantaging patients and compromising NHS efficiency.

The BAPRAS Winter Meeting, which is being held in London from 30 November to 2 December, will discuss the latest innovations in reconstructive surgery from across the world.  It will highlight exemplary work carried out in 2011 and show how plastic surgery techniques are helping patients overcome medical problems of both form and function.

However, as plastic surgery becomes increasingly specialised, the chances that patients are unable to benefit from these techniques is also increasing.  BAPRAS believes that the insufficient numbers of plastic surgeons, alongside a lack of knowledge amongst healthcare commissioners about the benefits of new plastic surgery procedures, is putting patient quality of life in jeopardy.

BAPRAS President Tim Goodacre, says "as highlighted by the BAPRAS Winter Meeting, the UK has world class plastic surgeons who are transforming NHS patients’ lives: from improved breast and skin cancer recovery; to rebuilding burns victims; to groundbreaking cases such as the craniopagus twins separated this September at Great Ormond Street Hospital. Plastic surgery was created in the First World War as a result of medical innovation at a time of dire need, and this focus on continual improvement is still driving us today.

Despite plastic surgery now being a central part of the NHS, not everyone has access to plastic surgeons when they need them. We have more experience than any other healthcare professional of working in partnership with other experts and, as the future shape of our health service continues to be debated, we urge commissioners to place plastic surgeons at the heart of multi-disciplinary teams. This will ensure our specialisms can complement the skills of others, and patients can receive top quality outcomes safely and efficiently”.

Data on the complications in breast reconstruction surgery will be presented today, 30 November.  

Findings from the Mastectomy and Breast Reconstruction Audit shows that there are differences in patient satisfaction depending on which type of breast reconstruction the patient chooses, highlighting the necessity of patient choice. Where microsurgical ‘flap-based’ reconstructions carried out by plastic surgeons after mastectomy are suitable, it is shown to provide  one of  the highest satisfaction rates for patients and some of the lowest risk of complications of any other method currently available, in spite of the complexity of surgery.

Despite the evidence supporting plastic surgery techniques for reconstruction nearly half (46 percent) of GPs are currently unaware of the National Institute for Health and Clinical Excellence (NICE) recommendations that all patients undergoing a mastectomy should be offered immediate breast reconstruction.

Large regional variations in breast reconstruction rates highlight the issues for patients in receiving balanced advice; in some locations rates for breast reconstruction are as low as nine percent, but in the private sector and other locations the rate rises to above 40 percent.  Only 21 percent of GPs know that the highest patient satisfaction was achieved following complex flap-based reconstructions2..

Tim Goodacre continued:

“Access to reconstruction led by a plastic surgeon is now a proven part of a speedy and satisfactory recovery from mastectomy. There are over 16,000 mastectomies carried out in the UK each year, but numbers of reconstructions vary far too much depending on location and this must change.”

On Thursday 1 December, BAPRAS member David Dunaway, consultant plastic surgeon running the Craniofacial unit at Great Ormond Street Hospital, will lead a presentation on a two-month follow up of the pioneering separation of craniopagus twins. Plastic surgeons played a key role in the multi-disciplinary team carrying out the separation and plastic surgery techniques were crucial to the success of the separation, encouraging a staged approach to the procedures which enabled tissue regeneration.

On the final day of the meeting, Mark Soldin, BAPRAS consultant plastic surgeon at Kingston and St Georges University Teaching Hospitals, will lead an afternoon focusing on body contouring following massive weight loss. He will be joined by Dennis Hurwitz from the US and Alexander Stoff from Germany who will showcase pioneering body contouring techniques.

Tim Goodacre concluded “Obesity concerns are well documented and bariatric procedures are becoming an increasing part of the weight loss solution.  It is critical that both physical and mental implications of rapid weight loss are considered and ways of enabling patient access to body contouring are identified. We look forward to a lively discussion on Friday.”

 

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