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Study reveals surgeons need to improve how they communicate with patients about new procedures

Published: 20 August 2023

A new study funded by NIHR has found that patients who are being offered new surgical procedures are not given enough information about their treatment. They are not given enough detail on possible uncertainties or the potential risks when deciding whether to go ahead with the surgery.

The study was funded by NIHR's Bristol Biomedical Research Centre and published in the Annals of Surgery. It is one of the first studies to examine exactly what patients are told about innovative surgical procedures.

Developing new ways to do surgery is crucial to improving outcomes for patients. But an independent safety review led by Baroness Cumberlege highlighted that patients may not be getting all the information they need before being treated using new procedures. The current guidance says that patients need to be given enough information to fully consider the risks and benefits of a new procedure.

Listening to surgeons’ and patients’ conversations

To find out more about this issue, the study team looked at conversations between surgeons and patients about new procedures. They focused on seven procedures that were being introduced in five NHS hospitals. These included techniques such as robotic surgery. Nine clinicians carrying out innovative procedures were also interviewed. There were asked what they wanted to tell patients.

The clinicians said they fully intended to discuss the innovative nature of the procedures. However, they admitted these conversations could be difficult.

Recordings of conversations between clinicians and patients showed that most clinicians did not explicitly mention that the procedures were new. Most also did not mention their limited experience, and the lack of evidence and uncertainty of what the outcome would be. The study also showed that all the clinicians were optimistic about the benefits of the new procedures. They often did not discuss the potential risks.

Thirty interviews were also conducted with patients after surgery. Researchers did this to understand what patients thought about the information they had been given. Patients said they had a strong sense of trust in their clinicians and felt reassured by their confident attitude. They also picked up on the enthusiasm of clinicians towards procedures that they considered ‘the future’. Many patients thought the procedures were more established than they actually were. They felt that they were not told about potential disadvantages.

Communicating the benefits and uncertainties of new procedures

Dr Daisy Elliott, lead author, said: “This study provides important insights into the communication process surrounding innovative surgical procedures and devices. Despite the clinicians’ best intentions, many patients weren’t fully informed about innovative procedures. Whilst there is often a belief that ‘new is better’, this research highlights that clinicians can find it difficult to provide neutral and balanced information in this context. A major focus of our work at the Bristol BRC will be to work with clinicians to provide support and training, so that patients can make well informed decisions about undergoing new procedures”. 

Founder of Rectopexy Mesh Victims and Support and ambassador for Mesh UK, Paula Goss said: “Fully informed consent discussions are crucial for patient safety for all procedures. Consultants and nurses should speak to patients thoroughly and transparently, allow recording of the consultations for patients to think about the information provided, and patients should be able to continue a dialogue to ask any question before any procedure. This should be a mandatory requirement for all hospitals and healthcare settings. Thorough in-depth patient involvement at every stage is the only way to provide and correct the issue of lack of trust that arises commonly with patients about to undergo any procedure.”


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