General Surgery

General surgery is a large specialty that is provided in the majority of NHS hospitals. With around 1.8 million episodes of inpatient care each year, general surgery provides treatment for patients with complex surgical conditions of the gastrointestinal tract, breast, kidney, pancreas and liver.

Many instances of inpatient care require surgical procedures – with 1.35 million general surgery procedures performed in 2015/16.

Through improvements to both emergency and elective surgical practice, the GIRFT report outlined the considerable benefits to patients and commissioners in reducing length of hospital stay to support bed capacity.

GIRFT’s general surgery clinical lead is Mark Cheetham, consultant in general and colorectal surgery at Shrewsbury and Telford NHS Hospital Trust (SaTH). The report was authored by John Abercrombie, a general and colorectal surgeon at Queen’s Medical Centre, Nottingham, and our previous general surgery clinical lead.

Mark Cheetham

Clinical Lead for General Surgery

Consultant in general and colorectal surgery at Shrewsbury and Telford NHS Hospital Trust (SaTH)

Mark has been a consultant in general and colorectal surgery at SaTH since 2005. He has particular interests in the surgery of inflammatory bowel disease, proctology, abdominal wall reconstruction and emergency surgery.

He is a fellow of the Royal College of Surgeons of England and a member of the Association of Surgeons of Great Britain and Ireland, the Association of Coloproctology of Great Britain and Ireland and the International Society of Surgery. He is an editorial board member of the World Journal of Surgery and co-editor of Schein’s Common-sense Emergency Abdominal Surgery.

Mark has a keen interest in clinical leadership and quality improvement and was divisional medical director between 2013 and 2022. He was awarded a Generation Q Fellowship by the Health Foundation in 2015 and is an affiliate at the Centre for Health and Care Leadership in Birmingham University.

John Abercrombie

Author of GIRFT national report for general surgery

General and colorectal surgeon at Queen’s Medical Centre, Nottingham,

John has been a general and colorectal surgeon at Queen’s Medical Centre, Nottingham, since 1998. His particular interests are complex inflammatory bowel disease, intestinal failure, and abdominal wall reconstruction, and he is also a screening colonoscopist.

John led the GIRFT general surgery workstream as clinical lead and was the author of the specialty national report, which was published in August 2017, but has since left the programme.

Changing general surgery procedures could improve care for patients

The NHS could see a significant reduction in the amount of people unnecessarily admitted for emergency general surgery if more acute hospitals introduced consultant-led surgical assessments at their ‘front door’.

Analysis by the Getting It Right First Time Programme (GIRFT) shows this change could lead to up to 30% fewer general surgery emergency admissions a year where no operation is delivered.

Examples of clinical improvements explored fully within the report include increasing the amount of day-surgery for some procedures (so patients can return home more quickly), better use of data (to reduce variation in general surgery performance) and increasing use of perioperative medicine (to address ‘reversible risk factors’ prior to non-urgent procedures).