Southmead Hospital bosses act after 203 patients were harmed by needless bowel operations

Surgeon Tony Dixon was sacked by the trust three years ago.

Southmead Hospital and Surgeon Tony Dixon

Bristol hospital bosses have tightened how patients’ consent is obtained, and new medical procedures are approved after more than two hundred people were harmed from unnecessary bowel surgery. Last week, a report to North Bristol NHS Trust, which runs Southmead Hospital, revealed dozens of people were left in severe pain after consultant colorectal surgeon Tony Dixon gave them pelvic floor surgery using synthetic mesh.

The review concluded there were 203 cases from the 387 investigated where the patient should have been offered an alternative, less invasive treatment and was considered to have come to harm. However, the operation was conducted satisfactorily. Lives had been “ruined,” a trust board meeting heard.

Mr Dixon, suspended when concerns were first raised in 2017 and sacked by North Bristol NHS Trust two years later, pioneered the use of synthetic mesh to lift prolapsed bowels, a technique known as Laparoscopic Ventral Mesh Rectopexy, which can result from childbirth. He performed the operations between 2007 and 2017 at Southmead and the Spire Hospital, a private facility where NHS patients overseen by North Bristol NHS Trust were regularly referred.

Trust medical director Tim Whittlestone told the board on Thursday, May 26th, that the patients who first raised concerns were “courageous”. He said: “We acted at once on those concerns and launched several investigations, some of them about an individual surgeon, but more importantly about a review of patients who had undergone this procedure.

“On behalf of the trust, I’m extremely sorry to patients who have subsequently discovered were harmed due to undergoing an operation under our care.” Mr Whittlestone apologised that the “overly complex and thorough” review and recall of patients had taken so long but had been “one of the largest ever” clinical reassessments in the UK.

He said many patients had accepted the trust’s offer of psychological support but needed further corrective treatment in other hospitals because North Bristol NHS Trust lacked the ability. "We have learned a lot of lessons. We have taken some essential steps in governance within this organisation,” Mr Whittlestone said.

“Clinical governance, the question of consent and the approval of new procedures is the core, fundamental principles of good medical practice. We have pioneered a unique way of consenting patients in shared decision-making. So, we set up a group, including university representatives, as we want to collect as much data as possible to look at a unique way of consenting patients and to ensure they are fully informed before surgery.

“We also took steps to improve our multidisciplinary team meetings to ensure that they are quality appraised and are of exceptionally high calibre, that no one individual or no one procedure or no one perceived wisdom can influence the recommended outcome for patients, and I am confident we have made great strides. We have increased the speed between realising that we have a recall and communicating with patients.

“It is regrettable that some patients were waiting many months and up to several years to hear the outcome of their recall and review process. We have ensured there are processes to supply an ongoing narrative to patients in the future, should such events ever need to be repeated.

“On behalf of the board, we want to express our regret and deep sorrow to these patients.” He said it was a “very frightening time” for those who had undergone surgery.

“Some have had significant complications from surgery despite the procedure being carried out correctly,” Mr Whittlestone said. "Rectal Prolapse is a debilitating and awful condition to start with, and some of the surgery is highly complex, and the potential complications of some of these operations are terrible.

“Some patients have had their lives ruined by complications from this surgery. Unfortunately, we cannot yet fully remove the mesh and supply full reconstruction, and for those patients, we have to support them in their ongoing NHS care in London and on the South Coast.”

North Bristol NHS Trust chair Michele Romaine said: “It is essential that we learn, but if you are one of these patients, which is only of limited comfort. If you have had your life turned upside down, you want to know if the organisation has learned the lessons, but also you were on the receiving end of this.

“What is important is that we are brave enough when we get things wrong to put our hands up and say we got things wrong. On behalf of the board, I want to say we are sorry, we did not get it right, we have learned from that, and we hope we have supplied the support necessary to the people we harmed.”

Patients who have spoken out include customer services manager Mandy Giltrow, 49, from Bristol, who still suffers frequent stomach and bowel pain, recurrent urinary infections, and a hernia near her surgery scars.