Grantham day case surgery proving ‘hip’ with patients and staff

Patient Tony Smith said he was delighted to be the very first person to have a day case hip replacement at Grantham and District Hospital.

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Thanks to an innovative new way of working, some patients needing planned hip replacements can now be operated on and return home the same day.

The ground breaking procedure is part of United Lincolnshire Hospitals NHS Trust’s (ULHT) trailblazing trauma and orthopaedic ‘hot and cold’ site trial – with emergency/unplanned (hot) orthopaedic surgery carried out on one hospital site and elective/planned (cold) orthopaedic surgery on another.

Mr Smith, from Market Rasen, had been suffering pain in his left hip during the night and was struggling to walk pain free. Having already tried injections and physiotherapy, the operation was discussed and decided upon.

“I didn’t feel a thing, the care I’ve received has been very professional and the whole process has been great,” said Mr Smith.

“Instead of me taking up a bed, it means that more people will be able to be seen and treated and speeds the whole thing up.

“I thought I’d be here for a few days but it’s been very easy and relaxed, no stress no strain.”

Mr Smith was admitted for surgery at 7.30am and discharged home just over 12 hours later.

Carried out by Consultant Surgeon Mr Rohit Rambani, the hip replacement procedure took just over half an hour to carry out and the patient was back on the ward soon after for assessment by the physiotherapy team and supported home with an appropriate care package by early evening.

Mr Rambani said he hoped that more day case surgery could now be carried out after this successful first operation.

“Our aim is to be the best performing hospital in the country for length of stay for patients and we’re starting with hips for day case procedures first which are slightly easier,” said Mr Rambani.

“The operation started at 9.45am and I was finished just after 10.15am, we got the patient up and about as soon as possible and home in the evening.

“It’s a real team work ethos and needs to be the right type of patient and everybody from theatre, physios and nursing staff working together.

“Hospital isn’t always the best place for our patients, they’d rather be at home sleeping in their own beds so if they can come for surgery with minimal disruption and stress and get back home as soon as possible it’s ideal.”

Day case surgery of this kind is dramatically reducing the overall length of stay for patients at Grantham, resulting in improved efficiency, better use of hospital resources and most importantly, better patient experience.

ULHT’s trauma and orthopaedic trial was launched just over a year ago, initiated by the Getting It Right First Time (GIRFT), national clinical improvement programme, which works with NHS trusts to tackle unwarranted variation in the way services are delivered.

In addition to reduced lengths of hospital stay, other benefits to separating emergency and planned procedures in this way include improved infection rates and less pressure on emergency beds.

Chloe Scruton, Deputy General Manager for Trauma and Orthopaedic Surgery at ULHT said: “We continue to push the boundaries, striving towards becoming a centre of excellence for orthopaedic surgery.

“One of our many successes is the reduction in length of stay for total hip replacements by 2.5 days and we have been able to push ourselves even further now, to achieve our first day case hip replacement, providing an excellent patient experience.

“None of this could have been achieved without the fantastic ’can do’ approach demonstrated by all of our Trust wide orthopaedic team members.”

This first day case hip procedure at Grantham follows similar operations launched at Pilgrim hospital last year, where some ankle replacement surgery can now be carried out as day cases.