Project title
Peer support for surgeons after adverse events – the Royal College of Surgeons of England’s Surgeon Peer-led Post-incident Response Teams (SUPPORT) Improvement Collaborative
Country
UK
Background
Adverse events are an inevitable aspect of surgical care. When things go wrong in surgery, surgeons are profoundly affected – personally, professionally, and psychologically. While this is true of all healthcare professionals, surgeons are worthy of particular focus. This is because existing supporting mechanisms simply don’t work for surgeons – either because the support isn’t right, or because surgeons choose not to access it.
For example, surgeons account for only 4.3% of medically qualified users of the NHS Practitioner Health programme – which provides mental health support to NHS staff – even though 11% of UK medical practitioners are surgeons. Similarly, 43% of surgeons don’t talk to anyone at all about the impact that an adverse event has had on them.
Ensuring that surgeons are supported after adverse events makes financial sense – impaired surgeons are not productive surgeons. In 2003, the costs of excluding a doctor from work were calculated as £188,000. Undoubtedly, this number will be much greater now.
Peer support has shown to be an effective model for supporting surgeons after adverse events if it is delivered by surgeons. Two such initiatives exist in the USA, but there are none in the UK, and details about the implementation and outcomes are limited.
Summary
Since 2016, the Royal College of Surgeons of England has developed a strong record of improving surgical care in multiple UK hospitals by running quality improvement (QI) collaboratives. QI work to date has focused on proving the hypothesis that surgical care teams can improve an aspect of patient care in their hospitals by using the Institute of Healthcare Improvement’s (IHI) QI Collaborative Model and applying it to improve patient care in response to a particular clinical condition.
The SUPPORT Improvement Collaborative aims to help participating sites design, deliver, sustain, and evaluate a peer support programme for surgeons. SUPPORT launched in January 2024, and there are currently 12 trusts enrolled across the UK and Republic of Ireland. Most participating sites have formally launched SUPPORT in their trust and trained a cohort of peer supporters.
The project will remain ‘live’ until March 2025, after which the evaluation and analysis phase will commence. Data capture includes pre- and post-project survey data to assess the impact of the project on the support available to surgeons after adverse events. Semi-structured interviews will be carried out with project site team members to develop a richer understanding of the practicalities of introducing such an initiative, and importantly the barriers and facilitators to its implementation. Feedback will also be collected from supported surgeons, as well as peer supporters, to assess their experiences.
Outcome
The aim of SUPPORT is to improve the peer support available to surgeons after adverse events, and to reduce the number of surgeons who are doubtlessly suffering in silence in the aftermath. We aim to reduce the psychological and financial burden of adverse events to improve outcomes for everyone – surgeons who are looked after will in turn be better equipped to look after their patients. We are also carrying out novel qualitative research to develop our understanding of the practicalities of implementing the programme. In the longer term, we hope to contribute to a wider cultural shift in which support systems and the need to access them are normalised and embedded into routine surgical practice.
The Royal College of Surgeons of England has already committed to the next iteration of the project, SUPPORT2, which recruitment is now open for. For more information, please visit our website: The RCS England SUPPORT Improvement Collaborative – Royal College of Surgeons