01 Aug 2014

Volume 2 Issue 3


In this issue we have focused on patient safety.  At the recent London EFORT/BOA meeting, David Stanley presented “Today’s Challenges in Patient Safety” as his Sir Robert Jones Memorial Lecture, we enclose a summary of his excellent presentation on page 20.  John Machin and Prof Tim Briggs present an extensive overview of litigation as it affects orthopaedics in the NHS on page 39.  We have taken these two key articles as our theme and various Specialist Societies have added detail in the more specific areas of their practice.  Generic issues relating to infection and consent are also covered.  Nick Welch (Chair of the BOA Patient Liaison Group) gives us his view on patient safety, reminding us that care and safety is a culture not a tick box process (and the theme for the cover!).

We heard from our president, Prof Tim Briggs, on the “Getting it Right First Time” (GIRFT) initiative in the last edition.  John Nolan from Norwich gives us his perspective of GIRFT following a recent visit from Prof Briggs (page 21).

The Trainee section this issue is written by its current Editor, Jeya Palan about the Shape of Training Report (SHoT) from a trainee’s viewpoint (page 22).  More of this at our Brighton meeting.

We have introduced a “How I Do…” piece, which can be found on page 56.  This is the first of a series of these articles submitted by members of the Orthopaedic Trauma Society (OTS).

We also pay tribute to a really nice man and Past President of the BOA; Tony Ratliff who encompassed all the ideals we ascribe to (page 60).

Alongside these articles you will find many news updates from the BOA and beyond.


Colin Howie – BOA Vice President


Reference Lists


Litigation in Trauma and Orthopaedic Surgery

1. No authors listed. Opinions of The Lords of Appeal for Judgement in the cause Chester (Respondent) v. Afshar (Apellant): Chester v Afshar. United Kingdom Parliament Web site. www.publications.parliament.uk/pa/ld200304/ldjudgmt/jd041014/cheste-1.htm (date last accessed 5 December 2013).

2. No authors listed. NHS Litigation Authority Report and accounts 2011/12. The NHS Litigation Authority Annual Report 2011-12, www.nhsla.com/AboutUs/Documents/NHSLA Annual Report and Accounts 2012.pdf (date last accessed 5 December 2013).

3. Taragin MI, Sonnenberg FA, Karns ME, Trout R, Shaprio S, Carson JL. Does physician performance explain interspecialty differences in malpractice claim rates? Med Care. 1994;32:661–667.

4. Roberts K. Managing risk in orthopaedics. Independent Practitioner. July 2007

5. Briggs TWR. Getting It Right First Time. www.timbriggs-gettingitrightfirsttime.com (date last accessed 5 December 2013)

6. No authors listed. Bones of contention – claims in orthopaedic surgery. MDU Services Limited. 2013

7. Atrey A, Gupte CM, Corbett SA. Review of successful litigation against english health trusts in the treatment of adults with orthopaedic pathology: clinical governance lessons learned. J Bone Joint Surg Am. 2010 Dec 15;92(18):e36

8. McWilliams AB, Douglas SL, Redmond AC, Grainger AJ, O'Connor PJ, Stewart TD, Stone MH. Litigation after hip and knee replacement in the National Health Service. Bone Joint J. 2013 Jan;95-B(1):122-6.

9. Khan IH, Jamil W, Lynn SM, Khan OH, Markland K, Giddins G. Analysis of NHSLA claims in orthopedic surgery. Orthopedics. 2012 May;35(5):e726-31

10. Quraishi NA, Hammett TC, Todd DB, Bhutta MA, Kapoor V. Malpractice litigation and the spine: the NHS perspective on 235 successful claims in England. Eur Spine J. 2012 May;21 Suppl 2:S196-9.

11. No authors listed. Hospital Episode Statistics. www.hscic.gov.uk/hes (date last accessed 5 December 2013)

12. No authors listed. Health Committee - Second Report. The Spending Review settlement for healthcare. www.publications.parliament.uk/pa/cm201011/cmselect/cmhealth/512/51208.htm (date last accessed 5 December 2013)

13. No authors listed. Primary Hip Replacement Surgery. http://info.wirral.nhs.uk/document_uploads/evidencereviews/PrimaryHipreplacement.pdf (date last accessed 5 December 2013)

14. No authors listed. Primary Knee Replacement Surgery. http://info.wirral.nhs.uk/document_uploads/evidencereviews/Kneereplacement.pdf (date last accessed 5 December 2013)

15. Matsen FA 3rd, Stephens L, Jette JL, Warme WJ, Posner KL. Lessons regarding the safety of orthopaedic patient care: an analysis of four hundred and sixty-four closed malpractice claims. J Bone Joint Surg Am. 2013 Feb 20;95(4)

16. Hettrich CM, Mather RC, Sethi MK, Nunley RM, Jahangir AA. The cost of defensive medicine. AAOS Now 2010;4

17. McGrory BJ, Bal BS, York S, Macaulay W, McConnell DB. Surgeon demographics and medical malpractice in adult reconstruction. Clin Orthop Relat Res. 2009 Feb;467(2):358-66.  

18. Jena AB, Seabury S, Lakdawalla D, Chandra A. Malpractice risk according to physician specialty. N Engl J Med. 2011 Aug 18;365(7):629-36.