Prashant Kadam

[Iswanto Sucandy MD @IswantoSucandy]

We just completed ORSI Academy Robotic Hepatobiliary 2025 Course directed by Drs Iswanto Sucandy and Mathieu Dhondt. Patient selection, technical steps of standard hepatectomy, Klatskin surgery, up to Robotic liver transplant recipient were discussed. Gratitude to all faculties!

[Matthew Armstrong 💙 @Drfattyliver]

⁦@uhbtrust⁩ ⁦@Bham_HPB_LTx⁩ ⁦@BridgetoLifeLTD⁩ ⁦@NeilRajJ1⁩ ⁦@UHB_HPB⁩ 2nd UK National HOPE meeting. George Clark pc the evolution of machine perfusion in #livertransplant ⁦@uhbtrust⁩. Game changer with lack of DBD offers nationally

[Matthew Armstrong 💙 @Drfattyliver]

⁦@LondonMarathon⁩ atmosphere was truly amazing! The huge crowds and their support were a credit to the UK. The local communities were amazing. Not too late to sponsor for ⁦@PancreaticCanUK⁩ https://t.co/Qo9m5ogUqI

[Cami Sotomayor @cdsotomayorl]

We are thrilled to share our latest publication!

Successful Reuse of a Liver Graft in Transplantation: First Reported Case in Chile https://t.co/GGy0Yc7wzP

@ErwinBuckel @IHPBA @AHPBA #OrganDonation #LiverTransplant

[Robert Sutcliffe @liveRPancSurg]

Really pleased to see our 1st output from a global collaboration of 46 centers including >1700 patients with pheochromocytoma. Thanks to all contributors, esp amazing work by Alessandro Parente & @KevinVerhoeffMD @EurUrolFocus

https://t.co/vzwJ5wILO0

[Syed A. Ahmad @SyedAAhmad5]

Factors Associated with and Impact of Open Conversion in Laparoscopic and Robotic Minor Liver Resections: An International Multicenter Study of 10,541 Patients ⁦@AnnSurgOncol⁩ https://t.co/JAgUnBWHAJ

[David Bartlett @DaveCBartlett]

Great to see so much participation from the Birmingham HPB surgical team during the HPB sessions at #AUGIS2024! @Augishealth @uhbtrust @Bham_HPB_LTx @UHB_HPB @liveRPancSurg

[Prashant Kadam @djRueil]

Congratulations to Professor Ferguson and Professor Armstrong on their recent appointments! You both deserve all the recognition. Best wishes for a brilliant future!

[Neil Rajoriya @NeilRajJ1]

The Birmingham liver unit become a happier place today with the news of appointments of Professors Ferguson & Armstrong. So well deserved. In daily awe of your amazing clinical/research skills along with your patient focussed care. @jfergus75 @Drfattyliver @uhbtrust

[Shivan Sivakumar @ShivanSivakumar]

Some early media coverage of the QE recruiting the first patient in Europe to a high profile pancreatic cancer vaccine trial! Gives hope to patients! @UHB_HPB @UHBCancer @unibirmingham @PancreaticCanUK

https://t.co/mko0LBXIqE

[HPD (HPB and Liver Transplant Surgery Padova) @HPDsurgery]

Proudly part of this massive effort!

Check out 🤓 “Propensity Score-matched Analysis Comparing Robotic Versus Laparoscopic Minor Liver Resections of the Anterolateral Segments 🤖 📺

An International Multi-center Study of 10,517 Cases !!! In @AnnalsofSurgery

[Robert Sutcliffe @liveRPancSurg]

It’s been a long time coming, but finally all my hard work over the years has been worthwhile!

[Chris Johnston @cjcjohnston]

After 3 recent consultant appointments, the Edinburgh Transplant / HPB Surgery fellowship is recruiting - Senior Clinical Fellow, LAT and Specialty Doctor (CESR support, permanent contract).

Comprehensive training in liver, kidney, pancreas transplantation, NRP and resectional HPB surgery.

Two successful CESR applications over the last 12 months and both candidates have since been appointed as substantive consultant transplant surgeons.

For informal discussion before the application deadline, please get in touch.

@DalmauMar @khaledAmmar53 @Asherief @ProfW_edinsurg

https://t.co/8VeABpHe0N

[Robert Sutcliffe @liveRPancSurg]

@HalletJulie @AAFretland @MarcBesselink @ILLS_LAPLIVER @EAHPBA @AHPBA @IHPBA @SAGES_Updates @CDTzeng @Giammatwit @cutitoutPODCAS1 Blinding patients was interesting. Many patients guessed wrongly whether they had open or lap. Some still didn’t know after the scar was revealed!!! Modest short term benefits and no ⬆️ morbidity means that it is reasonable to offer lap if patient wishes but selection is 🔑

[Swati Garekar @swatigar]

Yet another farewell photo for our departing nurses .

We got to do better in retaining nurses.

Patients are the ones who lose the most, here.

[Prof Keith Roberts @UHB_HPB]

@DrSfpb presenting her research on novel diagnostic test in PEI. Very exciting data after lots of hard work. Absolute pleasure to have supervised her PhD. Thank you

[J. P. Jonas @TELL_JPJONAS]

What an honor: fellowship graduation amongst the ISLS faculty during the #isls2023 in #zurich 🤩

[APHPBA2023 @APHPBA2023]

“Dealing with Complex Iatrogenic Biliary Injury”, a Keynote presentation by Dr. Darius Mirza from UK @EAHPBA

[Neil Rajoriya @NeilRajJ1]

Usual masterclass from @aelsharkawy75 …. With increasing testing and cases let alone treatment options and imminent changes to guideline - a massively expanding field

[Liver Transplantation Journal (LTxJournal) @LTxJournal]

Long-term outcomes (beyond 5 years) of liver transplant recipients - a transatlantic multicentre study by @navpalani @ADAravinthan et al

https://t.co/ztQbPAIXwa

#livertwitter @bswhealth_DFW

[Prof Shafi Ahmed PhD FRCS @ShafiAhmed5]

Lucy Letbe has been found guilty of murdering 7 babies and attempted murder of another 6 babies in the neonatal unit of Countess of Chester Hospital, making her the biggest killer of children in modern British history.

I have been thinking of this constantly over the last 24hrs and my heart goes out to the babies and poor families. I am trying to understand how this was allowed to happen and try to make some sense of this horrific case.

In my clinical experience this case sadly doesn't suprise me. There have been many recent cases that have similar underlying causes.

A few thoughts:

Whistleblowing

Although the @NHS openly encourages openness, transparency, a duty of candour and whistleblowing in various directives. Whistleblowing is including in the documents NHS Improvements raising concerns (whistleblowning) policy for NHS staff and Freedom to Speak Up.

However, in practice whistleblowing is actively discouraged. Whistleblowers are marginalised, bullied and isolated. It's a common finding and was obvious in this case. Sadly concerns raised by the clinicians in this case were dismissed. The doctors were brave yet not listened to and I am full of admiration to all of them in particular Dr Ravi Jayaram.

Internal reviews

The knee jerk reaction is for the leadership usually the Chief Executive , Medical Director and Chief Nurse to order internal reviews. In my experience the terms of reference for these reviews are limited and designed to protect the hospital and it's reputation rather than deal appropriately with the problem. Also the selection of the reviewers is biased by the leadership and the review itself is often compromised by direction from the leadership team. The reviewers often have undue pressure from the leadership.

External reviews

These are usually better but also can be compromised by the choice of reviewers and again there is often limited terms of reference and pressure on protecting the organisation.

The 2 external reviews in this case were not designed to examine whether Lucy Letby or any other member of staff, was responsible for the deaths and both recommended that several deaths be investigated further. Unbelievably the Chief Executive instructed senior doctors to write a letter of apology to Letby on for repeatedly raising concerns about her.

Non Exective Board

I am not sure how the board in this case could oversee this case and not raise suspicion and hold the leadership and CEO to account better.

Toxic Culture and Incompetence

There is a serious lack of good and effective leadership in the NHS with appropriate experience and qualities to run the service and deal with these difficult problems. In addition there is a well recognised toxic culture that percolates throughout the NHS.

Reward for failure

Despite overseeing this case the CEO, Director of Nursing went on to get further senior positions in the NHS. The medical director remained in post to "oversee" the case.

The NHS has a habit of rewarding bad leadership with promotion.

We have ALL failed the babies and families in their case.

I have never felt more ashamed and saddened of working in the NHS and am seriously now thinking about leaving.