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Meeting 6 Part 1: Surgical Services

The sixth Stakeholder Reference Group (SRG) for the Moving Forward Together (MFT) Programme took place on Wednesday 21st of February. The Group of 16 patient, service user and carer representatives (details at the end) heard two presentations and engaged in discussion about; how surgical services have and are continuously changing; and how long-term conditions could be managed differently using a cross system approach.

The Chair, Dr Ian Ritchie, opened the meeting by welcoming the group and introducing the presenters; Mr Mike McKirdy, a Consultant General Surgeon with a specialist interest in Breast Disease, at the Royal Alexandra Hospital, Paisley; and Pamela Vaughn, an advanced respiratory physiotherapist at the Glasgow Royal Infirmary.

Mike McKirdy spoke about the changes he had seen across surgical services in the time that he had been practising and what he thought the future might be like and illustrated this using examples. Much of this had and will be driven by changes in technology, techniques equipment and access to information and evidence. This had led to specialist teams who became the experts in certain procedures and this had without a doubt improved safety, outcomes and the patient experience.

He spoke about the idea of the right surgery at the right site and that to provide this specialised care would mean that there would be fewer sites able to provide it. Also that for some highly specialise procedures this can only happen in one site for the whole of Scotland – this is the only way that the person carrying this out can do so in the number required to develop the expertise. He said that people might have to travel further but from a clinical point of view it was the right thing to do and that modern approaches minimise the overall disruption to patients and their families.

The group then asked questions and led discussion looking at whether the cost of investing in new technology and increasing specialisation had contributed to longer waiting lists for some procedures. However, everyone recognised that this had also led to much better outcomes and that if informed about this then people would be more accepting of having to travel slightly further to access services. Even though they agreed that the new approach was positive, they also said that there needs to be investment in community and voluntary sector services that enable and support people.

They said that informing the wider public about the improvements such as fewer complications before, during and after surgery and improved survival rates was vital. However, it wasn’t only about the physical aspects but that there was also more support available and the overall patient experience had improved as a result. They recognised that there were similarities within cancer care where people from across the West of Scotland widely accepted that in order to get the best treatment they had to travel to the Beatson and that this could not be delivered in multiple sites.