Ambitious trial unveiled to transform orthopaedic surgery across the county

United Lincolnshire Hospitals NHS Trust (ULHT) has ambitious plans to transform orthopaedic surgery across the county, with a vision to make Grantham and District Hospital an orthopaedic centre of excellence and one of the top five performing sites in the country for the number of joint replacements.

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A six month trial which is due to start on Monday 20 August, aims to improve the experience and outcomes for orthopaedic surgery patients across the county by dramatically reducing the number of cancelled operations.

ULHT has been learning from some of the top performing Trusts in the country who are able to offer a better service by separating their elective and emergency orthopaedic surgery, resulting in better outcomes for patients.

As well as enabling many patients to have their surgery sooner, the trial will also reduce the length of hospital stays for patients, increase the likelihood for patients to see the same consultant throughout their care and will still have their outpatient, pre and post-op appointments locally.

The Trust has listened and responded to public opinion gathered during recent engagement sessions where the vast majority of people said they would be happy to travel to a centre of excellence for their planned operations, as long as they could still have their other pre and post-op care locally.

Trauma and emergency care will continue at Lincoln, Boston and Grantham. However a small number of trauma patients with a broken hip (anticipated to be approximately 40 patients during the length of the trial), will be cared for at Lincoln or Pilgrim instead of Grantham. This will enable the teams to better care for our hip fracture patients in line with national best practice.

The Trust’s Chief Operating Officer Mark Brassington said: “The current model of all of the Trust’s sites at Boston, Grantham, Louth and Lincoln, doing everything for all patients is struggling at times to cope with the increasing demand. We have been learning from the best performing NHS trusts in the country which provide more dedicated teams and facilities so increasing the quality of patient outcomes.

“The pilot will see all of the Trust’s sites working together, with each one focussing on elements of care that will help to improve the overall patient experience.

“Last year we had high cancellation rates, with 900 patients having their orthopaedic operations cancelled. The unprecedented demand over winter was a significant contributor to this, however it is not acceptable and with this trial we can stop this from happening again and provide a much better service to the people of Lincolnshire.

“By starting the trial next week, it means it will be established in time to help us with our preparations and plans for winter.”

ULHT’s Clinical Director for Orthopaedics at Pilgrim hospital, Prabhakar Motkur, said: “This is fantastic news for our patients. The whole surgical team are really excited about this as none of us want to see our patients having their operations cancelled. We have been waiting for this for some time and the motivation is there for us to make this work for the benefit of our patients.”

Key points:

  • All inpatient and day case patients will continue to be able to see consultants at their local hospital or a hospital of their choice for all of their pre and post-op appointments. Outpatient appointments will not change.
  • Grantham will become a hub for planned inpatient care, more than trebling the volume of cases it takes now. The changes will dramatically reduce the number of operations and procedures that are cancelled within the Trust. The vision is for the hospital to become an orthopaedic centre of excellence. The additional inpatients will come from the Trust’s other sites and their care will run alongside the hospital’s existing day case workload. If the pilot is successful, the plan will be to secure a multi-million pound investment in theatres at Grantham hospital, with bold visions to make it one of the top performing hospitals in the country for joint replacements.
  • At Grantham the number of surgical patients will rise by 60%.
  • By protecting and ring-fencing orthopaedic and inpatient beds at Grantham, there will no longer be the need to cancel planned surgery due to emergencies. This will be good news for those patients who have waited and planned ahead for their routine surgery.
  • As inpatient care will be covered by Grantham, the plan is to almost double the day case workload at Louth to around 1,080 cases each year.
  • Trauma and emergency care will continue at Lincoln, Boston and Grantham.
  • The plans will enable Lincoln and Pilgrim hospitals to focus on complex and emergency orthopaedic care and paediatrics. Critical care arrangements will remain unchanged.
  • To help ease some of the pressure in A&E at Lincoln and Boston, trauma assessment units will be established at both sites, enabling these patients to bypass the ED department.
  • By launching the pilot in late summer it will be established in time to help us with our preparations and plans for winter.

Mark added: “This is an exciting plan with big ambitions to provide our patients with the first class service that we want and know we can deliver and more importantly it is the level of service that they deserve.”