A ‘united’ approach to orthopaedics

Trauma and orthopaedics at ULHT has made great strides over the last year since beginning a trial which has revolutionised the service.

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Trauma and orthopaedics at ULHT has made great strides over the last year since beginning a trial which has revolutionised the service.

More than 31,000 patients each year across Lincolnshire are treated within ULHT for injuries and problems involving musculoskeletal system (bones, joints, ligaments, tendons, muscles and nerves).

The team is made up of 32 consultants and a range of supporting middle grade and junior medical staff as well as advanced clinical practitioners, who collectively cover specialist interests involving the arms and legs within orthopaedics and trauma. They are supported by trauma nurse coordinators and a multi-disciplinary team including physiotherapists and occupational therapists. There is also a team of administrative staff working to support the service.

In August 2018, the Trust changed how each of its hospitals contributed to the trauma and orthopaedic service, as part of a revolutionary trial.

Following a huge piece of work across ULHT, the service moved to a Trustwide working model. This includes having ‘hot’ sites where trauma (emergency orthopaedic) surgery is carried out and ‘cold’ sites where elective (planned) surgery takes place. This means that the majority of patients requiring emergency or urgent treatment for trauma (broken bones and soft tissue injuries) will go to Lincoln and Boston, with some of this care given at Grantham and Louth too. Those having elective/planned orthopaedic surgery go to Grantham if they require an overnight stay as an inpatient, or Louth if they are able to go home on the same day. All fractured neck of femur (broken hip) surgery is carried out at Lincoln and Pilgrim in line with nationally agreed best practice.

Following the introduction of the hot and cold sites as well as protected orthopaedic beds on each site, the previously high cancellation rates have dropped. Before the trial, an average of nine patients a month had their surgery cancelled due to no beds being available. Since the trial has begun, the majority of the orthopaedic elective surgery takes place at Grantham and no patients have had their surgery cancelled due to bed pressures. The waiting time for first appointments and any required surgery also continues to reduce.

Clinical Lead Vel Sakthivel said: “This trial has allowed our entire service to transform in a way that has benefitted patients massively. The team has worked so hard to improve what we offer for orthopaedic patients, and while there are still improvements to be made, we now have a service we can all be proud of.

“Our patients either come through the emergency departments or are referred from their GPs. For anyone needing elective orthopaedic surgery, I would definitely encourage them to choose ULHT for their surgery. Since the trial began, we have only had positive feedback from our patients even though some have had to travel further for their procedure.

“As one of eight Trusts in the country involved in this trial, we are confident that our hospitals are now leading the way in orthopaedic care.”

The trial is being run in partnership with the Getting It Right First Time (GIRFT) initiative, a national programme which helps to improve the quality of care within the NHS by bringing efficiencies and improvements and reducing variation in practice.