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Patient Choice How Can I choose my Surgeon? From April 2004, the British Government and Department of Health have set targets for how long patients should wait for an operation. This includes operations for varicose veins. In the past, your GP (family doctor) chose who the surgeon was for you to see. Now it is increasingly common for GPs to refer you to the hospital and the administrators ( not the doctors) choose who you will see. From January 2005 your GP should offer you a choice of 4 hospitals in which you can be treated. You will not be able to choose your NHS surgeon although you can request to be seen by one. You may have to wait longer to see a specific surgeon. If you want to see a surgeon as a private patient then you can choose who, where and often when. In the NHS it is planned that you can choose only where and possibly when! Once you have been seen by an NHS surgeon, you may be put on a waiting list for your vein operation. Hopefully you will have an operation within six months, done by the surgeon or under the care of the surgeon you saw in clinic. If you have been waiting more then six months to have an operation on your varicose veins then you may be able to have your operation done in a private rather than an NHS hospital. When you have waited six months for an operation then you should be contacted by your hospital (the one that had arranged to do your operation). The hospital administrators should ask you if you still want the operation. If you do, and they cannot arrange for your operation to be done, then you are entitled to have your operation done in another hospital. In some areas of the country, the people responsible for providing your treatment (Primary Care Trust or PCT), may have contracts with one or more private hospitals to perform your operation. If this is the case, then the consultant surgeon that you first saw may be able to do your operation as originally planned but in a private hospital rather than the NHS hospital. In some areas, your operation might be done by a different but similarly experienced surgeon who is an NHS consultant. All NHS consultants have been specially trained and examined over many years. They are also required to maintain their knowledge and standards. Some NHS Consultant Surgeons have expressed concern that patients may be asked to go to hospitals staffed by surgeons that have not had the same training and who do not have the same experience as Consultants who work in the NHS. In the past these surgeons visit the United Kingdom for a few days to do the operations and then leave. They may not be available if there are problems with the operation. With these warnings in mind, the following may help you if you have waited more than six months for an operation: I have not been contacted by my local hospital. What should I do? Consider writing to the Surgical Business Manager ( an administrator, not normally a doctor) in your local hospital and ask them what they are planning for your operation. The hospital patient liaison officer or the switchboard operators should know who they are. I have been asked to go to my local private hospital but I do not know who will do my operation. When you receive a letter from the private hospital, contact them to ask who will be doing the operation. In most cases you should be given the opportunity to see the surgeon, who will operate on you, a week or so before the operation. At this meeting, you might be asked to complete a consent form and should be offered the opportunity to discuss your operation. I would prefer to have my operation done by the surgeon I saw first. You would need to contact the business manager at you local hospital to tell them of your preference. I am happy to have another surgeon perform my operation but how do I know how experienced they are? All Consultant Surgeons trained in the United Kingdom should be happy and experienced enough to perform operations on people with varicose veins. Some may not be familiar with the latest techniques like VNUS, TRIVEX, EVLT or Varicofoam. I have been asked to have my operation done by a surgeon who has not been an NHS consultant. What should I do? You should consider asking the surgeon what their experience is: Most Consultant Vascular Surgeons in the United Kingdom perform between 50 and 100 varicose vein operations per year. In addition, they should be familiar with the latest developments in venous surgery and they should have access to a vascular laboratory for the investigation of varicose veins. You might wish to ask the surgeon you have been sent to see how many varicose vein operations they have done in the last year. Ask them how many of their patients have had a wound infection, how many are happy with the result of surgery and how many have developed numb patches on their skin. Their answers may give you some idea of their experience. Ask the surgeon if you need a duplex scan of your veins before the operation. If you need a cut in the groin for your vein operation, ask them whether they remove the long saphenous vein by stripping or some other method. Most vascular surgeons now recommend that the long sapheous vein is removed to reduce the chance of recurrence of the varicose veins. In some cases it is not necessary to remove the long saphenous vein. You might want to ask to talk to someone on whom the surgeon has already done a varicose vein operation. They would be able to give you an idea of the surgeon's performance. |