OBJECTIVES:To establish the incidence, costs and causes of medical negligence claims in relation to vascular surgery in the UK's NHS. METHODS:All claims related to vascular surgery reported to the NHS Litigation Authority from April 1995 to April 2007 were included in the study. Data was subsequently reviewed, coded and analysed. RESULTS:395 claims were identified (mean: 49/year over last 5 years) of which 303 had been settled. Damage compensation was given in 160 cases, with overall litigation costs of approximately 17 million pounds (21 million euros). The main complaint reasons in successful claims were intra-operative problems (50%), failure/delay of treatment (14%) and failure/delay of diagnosis (11%). Varicose vein (VV) surgery was involved in 48% of successful claims, with intra-operative nerve and vessel damage being the major causes. Peripheral vascular disease (PVD) and abdominal aortic aneurysm (AAA) disease were the next two types of disease/procedures involved in successful claims with 21% and 6% respectively. CONCLUSIONS:The number of claims related to vascular surgery has remained stable over the past 5 years. Improved consenting and higher surgical skill levels especially in relation to VV surgery and increased diagnostic vigilance in PVD, AAA disease and infections are potential areas for future improvement.

Background: Vitamin D deficiency is a chronic condition which contributes to general ill health and seems to be re-emerging in our catchment area since funding of vitamin D supplementation by Primary Care Trusts ceased. This study aims to verify this situation and to assess the cost effectiveness of reintroducing vitamin D supplementation in the Burnley Health Care NHS Trust.Methods: Vitamin D deficient patients presenting between January 1994 and May 2005 were identified and data retrospectively collected from their case notes. The cost of treatment and the theoretical cost of primary prevention for the Trust population were calculated using previous and current DoH guidelines.Results: Fourteen patients were identified, of whom 86% presented in the last 5 years and 93% were of Asian origin. The incidence of vitamin D deficiency for our population is 1 in 923 children overall and 1 in 117 in children of Asian origin. The average cost of treatment for each such child is 2500 pound, while the theoretical cost of prevention of vitamin D deficiency in the Asian population through primary prevention according to COMA guidance is 2400 pound per case.Conclusions: Vitamin D deficiency is re-emerging in our Trust. The overwhelming majority of our patients are of Asian origin. The cost of primary prevention for this high risk population compares favourably both medically and financially with treatment of established disease. We suggest that Primary Care Trusts provide funds for vitamin D supplementation of Asian children for at least the first 2 years of life.