Charing Cross Hospital Medical School Professor Sir Bruce Edward Keogh, KBE, FMedSci, FRCS, FRCP (/ˈkjoʊ/ KEE-oh; born 24 November 1954) is a Rhodesian-born British surgeon who specialises in cardiac surgery.
Prior to becoming full-time NHS Medical Director in November 2007, Keogh practised as a cardiac surgeon with a special interest in reconstructive mitral valve surgery.
He was a demonstrator in anatomy at Charing Cross Hospital Medical School before training in general surgery in London and Sheffield and gaining his FRCS in 1985.
He was subsequently appointed a university Senior Lecturer in cardiothoracic surgery at the Royal Postgraduate Medical School and honorary consultant surgeon at the Hammersmith Hospital between 1991 and 1995.
In 1994 he established the National Adult Cardiac Surgical Database and 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 articles on coronary artery vasomotor tone, the effect of cardiopulmonary bypass on gut blood flow and function, myocardial protection during surgery, surgery for patients with poor left ventricular function and the effects of social deprivation on cardiac surgical outcomes.
[3] He performed the first successful transabdominal, off pump gastroepiploic artery bypass graft to the heart in the UK and was among the first to adopt minimally invasive, direct coronary artery bypass surgery, thoracoscopic mitral valve surgery and warm blood cardioplegia for myocardial protection.
[9][10] During this time he set out a vision for NHS IT and Informatics that would learn from successful GP systems and inform future direction for the National Programme for IT.
[11] This review recommended the development of essential functionality that would create a pull effect from clinicians by ensuring NHS IT was useful in conducting day-to-day business.
The third was the need to focus on the patient, saying “Most importantly, we must not lose sight that the technology is about underpinning the interaction between citizens of this country and health and social care services.”[12] As Medical Director he opposed the establishment of the Cancer Drugs Fund which he believed would undermine NICE and the quest for an evidence based NHS.
[13] Keogh's team was responsible for implementing the majority of the recommendations from Lord Darzi's review of the NHS "High Quality Care for All" published in 2008.
Keogh's team also developed the Quality Framework for the NHS (based on the work of Sheila Leatherman) and included in Darzi's review.
The principles were simple: Define what is meant by quality, measure it, publish it for everyone to see, reward those who do well, regulate for minimum standards, promote and develop leadership for quality within the NHS and promote research and innovation within the NHS, by drawing on and linking with the best British universities and biotechnology companies in to form academic science networks.
[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 Council and the Department of Health.
[25] In 2012 Keogh ordered a review of the national quality assurance frameworks and governance for pathology services with the aim 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.
[38] In 2012 Keogh was asked by Jeremy Hunt, Secretary of State for Health, to reassure him that there had been adequate clinical consultation on proposals to reconfigure services in south London.
In a letter[39] to Hunt Keogh concluded that there had been adequate clinical consultation, but he also included a warning about closing Lewisham A&E.
[41] Much debate centred around a projection regarding the number of lives that might be saved, a calculation of unknown origin – attributed by some to Keogh and by others to work conducted by the London Clinical Senate.
In 2013 Keogh provoked the suspension of children's heart surgery in Leeds just before the Easter weekend, based on evidence from Professor Roger Boyle, the former national heart czar and director of the National Institute for Cardiovascular Outcomes Research, that the mortality rate was 2.75 times higher than might be expected for their practice.
The hospital could not contradict the mortality figures, so he suggested suspending surgery till the full facts could be verified.
After Leeds had submitted accurate and complete data, analysis showed that although they still had the highest mortality in the country they were within normal statistical boundaries.
Keogh remained unrepentant, arguing he would rather be remembered for preventing an avoidable disaster and embedding the "precautionary principle" in NHS safety culture, than responsible for not acting on reasonable doubt.
A British Medical Association spokesperson has since openly condemned these actions by saying: "This level of political interference is extremely concerning and will only serve to worsen junior doctor’s lack of trust in the Government’s handling of negotiations".
[1] He subsequently became a British citizen, and as part of the Queen's Birthday Honours on 11 June 2005, his knighthood became substantive (back dated to 5 February 2004).