Coroner reports on death after hip surgery wait

Anne Rowland, a care home resident in Oxted, died in East Surrey Hospital after inflammation and infection of the lungs following surgery

The death of a woman after a five day wait for hip surgery has prompted a coroner to raise concerns a hospital may be putting patients at risk.

Anne Rowland, an Oxted care home resident, died in East Surrey Hospital on 31 March 2023 after inflammation and infection of the lungs following surgery.

Coroner Anna Crawford found there was “no clinical reason” for the surgery not taking place until five days after Ms Rowland injured herself in a fall.

Surrey and Sussex Healthcare NHS Trust said it was "profoundly sorry for the delay" and offered its "deepest sympathies" to Ms Rowland's family.

Ms Rowland broke her hip following a collision with another care home resident who was partially sighted on 27 February 2023.

She was taken to East Surrey Hospital the same day.

In a Prevention of Future Deaths report, Ms Crawford concluded that outstanding infrastructure repairs and the use of different guidelines from the National Institute for Health and Care Excellence (NICE) that the Surrey and Sussex Healthcare NHS Trust was “placing patients at risk of early death”.

East Surrey Hospital uses a metric of 48 hours within which to conduct such surgery and does not use the NICE timeframe, which says it should take place on the day of the injury or the day after.

Although the hospital has a dedicated operating theatre for trauma patients, on some occasions demand outweighs capacity.

The court heard evidence Mrs Rowland was clinically fit for surgery but it did not take place "because other trauma patients were prioritised ahead of her based upon their relative clinical need".

'Monitoring performance'

The coroner concluded that waiting for her operation “caused” Mrs Rowland to develop dementia and immobility.

This “contributed” to her developing aspiration pneumonia following surgery.

The trust said it had since “significantly” reduced delays in hip fracture surgery.

Its chief medical officer, Ed Cetti, told the Local Democracy Reporting Service: “We always strive to perform surgeries of this nature as soon as possible and monitor our performance against the 36-hour time window identified by NICE guidance. We also monitor against a 48-hour window.

“Recognising that not all patients are medically well enough for surgery within 36 hours, we are working on improving our performance further.”