Education And Debate

Organisation of vascular surgical services: evolution or revolution?

BMJ 1994; 309 doi: (Published 06 August 1994) Cite this as: BMJ 1994;309:387
  1. J A Michaels,
  2. R B Galland,
  3. P J Morris
  1. Nuffield Department of Surgery, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU
  2. Royal Berkshire Hospital, Reading RG1 5AN
  1. Correspondence to: Mr Michaels.
  • Accepted 11 April 1994

The trend towards subspecialisation in hospital services is likely to lead to the development of vascular surgery as a separate specialty. If vascular surgry is to emerge as a high quality service then vascular emergencies - a substantial component of the workload - should be dealt with by surgeons with adequate training, and all patients should have equal access to the service. A specialist vascular surgical unit would have to be large enough to make efficient use of other services that it needs, such as radiology, and so may require the amalgamation of smaller health district units. Because of the differing local degrees of subspecialisation, national or regional strategies for vascular surgery must be developed.

The increase in subspecialisation in hospital services may create organisational problems for providers of health care. In general surgery an increasing number of posts are advertised with a special interest, subspecialist training is being developed,1 and many trainees intend to pursue a career in a subspecialty.2 If the trend in Britain follows the trend in other countries vascular surgery looks likely to emerge as a separate specialty over the next few years. The results of a recent audit of vascular surgery in Oxford Regional Health Authority show that …

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