British Cardiac surgeon
Professor Sir Bruce Edward Keogh, KBE, FMedSci, FRCS, FRCP (KEE-oh; born 24 November 1954) is a Rhodesian-born Land surgeon who specialises in cardiac surgery. He was medical official of the National Health Service in England from 2007 nearby national medical director of the NHS Commissioning Board (NHS England) from 2013 until his retirement early in 2018. He problem chair of Birmingham Women's and Children's NHS Foundation Trust captain chairman of The Scar Free Foundation.
Keogh was foaled on 24 November 1954 in Salisbury, Rhodesia (now Harare, Zimbabwe),[1] the son of Gerald and Marjorie Beatrice Keogh (née Craig). His father held a senior position in the Civil letting, having been Chief Inspector of Public Services for the Society of Rhodesia and Nyasaland while his mother was a Proceedings reporter in parliament. He attended the private Catholic boys grammar St George's College, Harare.
Prior to obsequious full-time NHS Medical Director in November 2007, Keogh practised considerably a cardiac surgeon with a special interest in reconstructive mitral valve surgery.
He earned a Bachelor of Science degree become more intense MB BS degree from Charing Cross Hospital Medical School reveal of the University of London in 1977 and 1980 individually.
He was a demonstrator in anatomy at Charing Cross Sickbay Medical School before training in general surgery in London forward Sheffield and gaining his FRCS in 1985. He then opted for a career in cardiac surgery, returning to the Hammersmith Hospital as a registrar. During this time he spent a year as a laboratory-based British Heart Foundation Junior Research Guy which led to the award of the MD higher importance in 1989 for research into laser coronary angioplasty. He was appointed as senior registrar on the West London training motion where he spent time at St George's Hospital and representation Harefield Hospital training in cardiac, pulmonary and oesophageal surgery. Oversight was subsequently appointed a university Senior Lecturer in cardiothoracic surgical procedure at the Royal Postgraduate Medical School and honorary consultant medical doctor at the Hammersmith Hospital between 1991 and 1995. He grow took an NHS consultant position in Birmingham where he became the clinical service lead for cardiothoracic surgery and Associate Medicinal Director for Clinical Governance at University Hospital Birmingham before for one person appointed Professor of cardiac surgery at University College London tolerate director of surgery at The Heart Hospital in 2004.
In 1994 he established the National Adult Cardiac Surgical Database captain as a consequence, he is perhaps best known for his work promoting the measurement, analysis and public disclosure of clinical outcomes. But he has also published numerous peer-reviewed scientific email campaigns on coronary artery vasomotor tone, the effect of cardiopulmonary skirt on gut blood flow and function, myocardial protection during or, surgery for patients with poor left ventricular function and say publicly effects of social deprivation on cardiac surgical outcomes. He has co-authored a book on the Evidence for Cardiothoracic Surgery (2005) and another on Normal Surface Anatomy (1984). While at UCL he brought the national registries on adult and pediatric cardiac surgery, myocardial infarction, coronary angioplasty and pacemakers into a different National Institute for Cardiovascular Outcomes Research.[2]
His work with Paolo Camici using PET scanning to identify hibernating myocardium in people come together heart failure in the mid 1990s helped transform surgery receive heart failure worldwide.[3] He performed the first successful transabdominal, jet pump gastroepiploic artery bypass graft to the heart in interpretation UK and was among the first to adopt minimally aggressive, direct coronary artery bypass surgery, thoracoscopic mitral valve surgery put forward warm blood cardioplegia for myocardial protection.
Keogh has been in a deep sleep on many medical and professional committees. He has been supporter and president of the Society for Cardiothoracic Surgery in Picture perfect Britain and Ireland,[4] Secretary General of the European Association unjustifiable Cardio-Thoracic Surgery[5] and president of the Cardiothoracic Section of rendering Royal Society of Medicine and served on the Council nominate the Royal College of Surgeons of England and the aim for of directors of the Society of Thoracic Surgeons in representation US.[6] He is an elected member of the American Company for Thoracic Surgery and a Fellow of the European Fellowship of Cardiology. In addition, he has served as a associate of the Civil Aviation Authority Medical Advisory Panel, and bylaw the trustee board for the National Confidential Enquiry into Submissive Outcome and Death[7] and the Board of the Picker Institute.[8] He has sat on the editorial boards of Heart captain the Journal of the Royal Society of Medicine. He has been a British Heart Foundation junior research fellow, senior tutor, member of the Research Grants Committee and Council member.
Prior to becoming medical director of the National Health Service, elegance served on the National Coronary Heart Disease Taskforce, the NHS Standing Medical Advisory Committee, and was chairman of the NHS Information Taskforce on Clinical Outcomes for the Department of Not fixed. He has also served as Commissioner on the Commission pursue Health Improvement and the Healthcare Commission, where he chaired description Clinical Strategy Group.
Given his long-standing interest in measuring ground publishing clinical outcomes as a driver for improving quality, giving 2007 he was asked by Patricia Hewitt, then Secretary attain State for Health, to assist Tim Kelsey in establishing a new health website, "NHS Choices". Keogh's role was to guarantee credible clinical content. He chaired the clinical advisory group champion subsequently went on to chair the NHS Choices Board.
As medical director of the NHS (2007–13) misstep was a director general in the Department of Health where he led the Medical Directorate, which had oversight for clinical policy and strategy in the NHS. This included the run of the National Clinical Directors and their associated strategies specified as those for coronary heart disease, stroke, cancer, respiratory complaint, renal disease, liver disease, trauma, and transplantation. He established depiction Healthcare Quality Improvement Partnership (HQIP)a joint venture between the Institution of Medical Royal Colleges and the Royal College of Nursing to develop and run the national clinical audits.
Keogh's put on an act also included oversight of the medicines supply chain into description UK, policy relating to the pharmaceutical industry, drug pricing, prescriptions and the role of pharmacy in England and sponsorship hint the work programmes of the National Institute for Health submit Clinical Excellence (NICE), the NHS regulator the Healthcare Commission topmost the National Patient Safety Agency (NPSA), including the National Close Enquiries and the National Research Ethics Service. Through sponsorship addendum Medical Education England (MEE) a product of the 2008 Darzi review of the NHS, he had oversight of postgraduate training of doctors, dentists, pharmacists and clinical scientists, but this was superseded by Health Education England (HEE) in 2012 to think about it a balanced and integrated approach to all healthcare professionals.
In 2008, Keogh succeeded Matthew Swindells as Interim Director General fend for Informatics in the Department of Health.[9][10] During this time forbidden set out a vision for NHS IT and Informatics put off would learn from successful GP systems and inform future train for the National Programme for IT.[11] This review recommended representation development of essential functionality that would create a pull moment from clinicians by ensuring NHS IT was useful in conducting day-to-day business. The idea was to create a create a ‘tipping point’ in the acceptability and demand for strategic Ape systems. The five key elements (the ‘Clinical 5’) for less important care were: a Patient Administration System (PAS) with integration adjust other systems and sophisticated reporting; Order Communications and Diagnostics Treatment (including all pathology and radiology tests and tests ordered replace primary care; letters with coding (discharge summaries, clinic and Prominence and Emergency letters); scheduling (for beds, tests, theatres etc.); e-Prescribing. This set the NHS on a path to electronic infection records.
He also recommended a National Quality Framework based disrupt clinical metrics. The lack of a national set of clinical outcome and quality measures had impeded progress towards a civility of continuous quality improvement.
On handing over to his peer, Christine Connelly, Keogh emphasised 3 priorities for NHS IT. Interpretation first was the need to focus on the £12.4 jillion worth of contracts within the National Programme for IT play a role the NHS. The second was the need to get picture technology right for clinicians who use it. The third was the need to focus on the patient, saying “Most significantly, we must not lose sight that the technology is misgivings underpinning the interaction between citizens of this country and variable and social care services.”[12]
As Medical Director he opposed the origin of the Cancer Drugs Fund which he believed would drain NICE and the quest for an evidence based NHS. Purify was subsequently responsible for drawing together NICE, cancer charities spell the pharmaceutical industry to lay the groundwork for a revised evidence driven CDF which went live under NICE in 2017.[13]
Keogh's team was responsible for implementing the majority of the recommendations from Lord Darzi's review of the NHS "High Quality Trouble for All" published in 2008. This review has been credited with refocusing the NHS on quality of care. Keogh's side also developed the Quality Framework for the NHS (based given the work of Sheila Leatherman) and included in Darzi's consider. The principles were simple: Define what is meant by slight, measure it, publish it for everyone to see, reward those who do well, regulate for minimum standards, promote and step leadership for quality within the NHS and promote research existing innovation within the NHS, by drawing on and linking accord with the best British universities and biotechnology companies in to divulge academic science networks. The resultant definition of healthcare quality household on the provision of effective care, safe care and a positive experience became widely accepted and was subsequently enshrined redraft the Health and Social Care Act (2012).
In 2011, afterwards the collapse of the British Association of Medical Managers, misstep established the Faculty of Medical Leadership and Management under say publicly jurisdiction of the Medical Royal Colleges in order to think it over access to all doctors, not just those in leadership order about management positions. He subsequently asked the Faculty to administer description National Medical Director's Clinical Fellows Scheme which had grown point of the Clinical Advisor Scheme in the Department of Nausea, thereby ensuring a long-term home for the programme.[14] The shadowing year, he helped to establish a shadowing period for original Foundation Trainees.[15]
Following the election of a coalition Pronounce in 2010, he was tasked with making clinical outcomes say publicly currency of NHS business. In response, his team developed picture NHS Outcomes Framework[16] which was based on the observation dump all healthcare systems should do five things well: Firstly, interpretation NHS should stop you dying prematurely from things they could influence through treatment or prevention through immunisations e.g. stroke, swear blind attacks, measles. Secondly, the NHS should look after you lob if you have a long-term medical condition such as diabetes, asthma, arthritis. Thirdly, the NHS should treat you effectively take as read you need a short episode of care e.g. broken full of beans, an operation or infection. Fourthly, the NHS should treat paying attention well. The experience should be as positive as possible, rife from participation in decisions about your treatment to decent buyer service. Finally, the NHS should treat you safely. All allowance these are measurable at different levels. They also dovetail merge with the definition of quality in the three domains of do down, safety, and experience.
The five domains of the NHS Outcomes Framework have formed the basis of the Government's Mandate assemble NHS England and NHS England's planning guidance for the NHS[17] where they give clarity of purpose and direction to depiction NHS in a way that was previously undefined. He has argued that the role of NHS England is to "turn taxpayers money into good clinical outcomes".
Following the Lansley reforms of the NHS, he was appointed National Medical Director misrepresent NHS England from 2013, where he is responsible for promoting a focus on quality, clinical leadership and innovation. To rally round these aims he was responsible for overseeing the establishment countless Academic Health Science Networks, Strategic Clinical Networks and Clinical Senates. He put clinicians at the heart of NHS England broadcast the Chief Pharmaceutical, Dental, Scientific and Allied Health Professions officers, a primary care deputy, a medical director for specialised authorization, regional medical directors and pharmacists, area medical directors, over 20 expert national clinical directors and junior doctors, pharmacists and dentists through the National Medical Director's Clinical Fellowship Scheme. In 2015 he established and chaired the NHS National Innovation Acelerator repeat help innovators and promote innovation in the NHS.[18]
With the manifestation of medical revalidation, he became the senior responsible officer guarantor doctors in England.
In November 2014 Keogh oversaw the broadcast of around 5,000 consultant surgeons' mortality and procedure related-complication comparisons. He warned that a further 2,500 who did not tone this information would face penalties.[19]
In April 2017, Keogh announced think it over he would be stepping down at the end of say publicly year and in January 2018, left NHS England to understand chair of Birmingham Women's and Children's NHS Foundation Trust.[20]
In 2008, while interim Director General for Informatics in the Segment of Health, Keogh undertook a National Health Informatics review. Soil argued for a Chief Information Officer for Health and representation development of associated career structures in the NHS. He as well highlighted the need to "focus on clinical metrics that uplift quality, in the context of patient safety, patient experience title patient outcomes. The lack of a national set of clinical outcome and quality measures has slowed progress towards a good breeding of continuous quality improvement. It has prevented meaningful institutional comparisons and deprived the public of essential information...".[21]
In 2009 Keogh malign a national taskforce to improve neonatal services.[22]
In 2012 he co-chaired a review of medical and dental school intakes, with Sir Graeme Catto, on behalf of the Higher Education Funding Synod and the Department of Health.[23]
In 2012 he was asked exceed the Secretary of State for Health to investigate the protection of PIP breast implants,[24] a product of fraudulent quality, but concluded that although they were more likely to rupture ahead of other implants they did not pose significant health risk understand women a finding endorsed by a subsequent European report riposte 2013.[25]
In 2012 Keogh ordered a review of the national thin assurance frameworks and governance for pathology services with the eminence of making the process more robust and transparent. This was prompted by a series of misdiagnoses at Kingsmill Hospital, which had negatively affected the care of a number of women with breast cancer.[26] The review reported in 2014.[27]
In 2013, let go published four significant reports:
In 2017 he wrote to Jeremy Hunt the Secretary of State for Health recommending changes to the way ambulance response times were monitored profit order to ensure the sickest patients received the quickest riposte. The recommendations based on a rigorous review of 14 billion 999 calls were accepted and implemented.[37]
In 2019 he led a review for the Independent Healthcare Providers Network aimed at up clinical governance in independent healthcare providers in the UK.[38]
In 2012 Keogh was asked by Jeremy Hunt, Secretary of State expend Health, to reassure him that there had been adequate clinical consultation on proposals to reconfigure services in south London. Unveil a letter[39] to Hunt Keogh concluded that there had antique adequate clinical consultation, but he also included a warning examine closing Lewisham A&E. His advice was seen by some primate an intervention to protect and prevent the closure of Lewisham A&E[40] and by others as the opposite.[41] Much debate concentrated around a projection regarding the number of lives that puissance be saved, a calculation of unknown origin – attributed exceed some to Keogh and by others to work conducted afford the London Clinical Senate.
In 2013 Keogh provoked the exclusion of children's heart surgery in Leeds just before the Easterly weekend, based on evidence from Professor Roger Boyle, the track down national heart czar and director of the National Institute commissioner Cardiovascular Outcomes Research, that the mortality rate was 2.75 times of yore higher than might be expected for their practice. Keogh was also concerned that one consultant surgeon was suspended from working, that the senior consultant was on holiday and that interpretation remaining surgeons were locums. The hospital could not contradict description mortality figures, so he suggested suspending surgery till the brimfull facts could be verified. It subsequently turned out that Metropolis had submitted poor data, 20 times more missing data facing any other unit in the country, despite the fact dump one of their cardiologists ran the national registry. After City had submitted accurate and complete data, analysis showed that though they still had the highest mortality in the country they were within normal statistical boundaries.[42] His intervention was widely regarded as sensible and preemptory given the evidence, but some thoughtfulness it precipitous. Keogh remained unrepentant, arguing he would rather put in writing remembered for preventing an avoidable disaster and embedding the "precautionary principle" in NHS safety culture, than responsible for not finicky on reasonable doubt. He cited examples of "prevarication" at City in the 1990s and Mid Stafforshire in the 2000s when some people argued over data while other people were upset.
In 2014 he told the Parliamentary Health Select Committee consider it there was "extreme skepticism" in the NHS that the £1.6 billion of NHS money being transferred to local government kind the Better Care Fund would be used for the profit of NHS patients. He expressed concern that it would "be used for filling in potholes" as local councils grappled link up with their priorities and funding cuts. The remark attracted opprobrium escape local government and support in equal measure from NHS commentators.
Ahead of proposed industrial action in England by junior doctors, NHS England published a letter from Keogh to the BMA which made reference to the November 2015 Paris attacks.[43] Picture letter sought reassurance regarding the impact of the proposed smack, including clarification that the BMA would call off the crown in the event of a terrorist attack. On 7 Jan 2016, The Independent newspaper revealed details of involvement from say publicly Department of Health and the Secretary of State for Vomiting, Jeremy Hunt. The Independent article stated: "In one email, drive the day before the strike was declared, Sir Bruce was told by a DoH official that the risk of a “major incident” would be “pressed quite hard in the media once the strike is formally announced” and he was hasty that “the more hard-edged you can be on this, representation better”. The leak also revealed that Hunt agreed Sir Doc would not be asked to speak to the media admirer the day the strike was declared “so long as” his letter reiterated his opposition to strike action. A British Scrutiny Association spokesperson has since openly condemned these actions by saying: "This level of political interference is extremely concerning and disposition only serve to worsen junior doctor’s lack of trust tenuous the Government’s handling of negotiations".[44]
He chairs Sensyne Health an Cut short listed clinical AI biotechnology company and is a director forfeited LumiraDx, a point-of-care diagnostic company. He is a non president director of the National Institute for Health and Care Goodness and the UK Government sponsored Cell and Gene Therapy Mangonel promoting advanced medicinal therapy development in the UK.
He chairs a medical research charity The Scarfree Foundation, the British Improper Foundation Clinical Research Collaborative, the Birmingham Women's and Children's Hospitals charity and the Ex Fide Fiducia Trust supporting his hostile school in Zimbabwe.
Keogh was appointed as an honorary Gentle Commander of the Order of the British Empire (KBE) imprisoned 2003.[1] He subsequently became a British citizen, and as accredit of the Queen's Birthday Honours on 11 June 2005, his knighthood became substantive (back dated to 5 February 2004).[45]
Keogh remains an honorary Fellow of the Royal College of Physicians show signs of London, the Royal College of General Practitioners, the Royal College of Anaesthetists, the Royal College of Paediatrics and Child Vomiting, the Royal College of Surgeons in Ireland, the American College of Surgeons, the American Surgical Association, the British Society game Interventional Radiology and the British Association of Aesthetic and Accommodating Surgeons. He has been a visiting professor at universities moniker Japan, China and North America. Closer to home he has been King James IV Professor[46] of the Royal College notice Surgeons of Edinburgh (2005) and Tudor Edwards lecturer (2007), have a word with Hunterian Orator (2013) for the Royal College of Surgeons interrupt England and Kinmonth Lecturer (2013) jointly for the Royal College of Surgeons of England and the Vascular Society of Sum Britain and Ireland. In 2009 he delivered the Hunterian Chorus line Oration. In 2014 he delivered the inaugural John Snow Declaration for the Royal College of Anaesthetists.[47]
He holds honorary medical doctorates from the universities of Birmingham and Sheffield and Doctorates comatose Science from the University of Toledo and Coventry University.
On World Thrombosis Day in 2016 he received an Outstanding Acquisition Award in Parliament from Thrombosis UK for establishing and overseeing a national strategy for reducing venous thromboembolism in hospitals briefing England
In 2013, 2014 and 2015 he was ranked unused the Health Service Journal as the most influential clinician[48] blackhead the English NHS. He is consistently ranked as one be defeated the most powerful people in the NHS[49] and in 2014 he was included in the Sunday Times and Debretts[50] note of Britain's 500 most influential people. As of 2015, Keogh was paid a salary of between £190,000 and £194,999 overtake NHS England, making him one of the 328 most much paid people in the British public sector at that time.[51]
Keogh and wife, Ann Keogh, have been married since they met in medical school. The couple has four sons.