NHS Lanarkshire board announces its plans for orthopaedic trauma

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The board of NHS Lanarkshire have set out their plans for the future of orthopaedic trauma services in the area.

At its meeting on Thursday, July 14 the board agreed changes to the service with a view to delivering improved outcomes for patients, reduced time in hospital following surgery, better waiting times and improved staff recruitment.

The board also promises that 98 per cent of all patients attending Monklands A&E, and 95 per cent of trauma patients, will continue to be treated there.

NHS Lanarkshire has also pledged that each of its three district general hospitals will retain their consultant led emergency departments. Plans to replace Monklands Hospital with a new healthcare facility with around 500 beds are also continuing.

Dr Jane Burns is NHS Lanarkshire’s divisional medical director of acute services. She said: “Our review included two stakeholder events which featured representation from service users, carers, clinical staff and public partnership forums. These events considered the available options and the favoured proposal was for a two site model with a mix of trauma and orthopaedic work at Wishaw General and Hairmyres Hospital as part of phase one.

“The ultimate aim is to have a two site centre of excellence model with one hospital providing all operative trauma services and the other providing effective orthopaedic services.

“It is this model for trauma and orthopaedics which NHS Lanarkshire will be consulting on as part of our Healthcare Strategy consultation which is due to get underway on August 1 which everyone will be able to give a view on.”

Dr Burns continued: “Maintaining the status quo is neither a sustainable option, nor will it address the safety and quality issues raised in the 2013 HIS Rapid Review report and visits by the General Medical Council and NHS Education for Scotland.

“This view is shared by the Academy of Medical Royal Colleges and Faculties in Scotland (AoMRC) which has welcomed this development of a shared vision for orthopaedic services.

“The National Clinical Strategy for Scotland 2016 has also cited evidence that a surgeon doing hip replacement operations should do at least 35 operations per year as at that level the occurrence of complications falls to around the minimum level.

“It is set out in the GIRFT report that outcomes for patients in Lanarkshire were likely to be variable and that measures to address this should be put in place as soon as possible. The steps we are taking will help achieve this.

“There were also considerable pressures on trauma and orthopaedic services last winter and the Board would be negligent if it failed to act now as there is a real risk of services collapsing this coming winter without this change.”

The change has the support of staff side (trade union) representatives as well the Lanarkshire review team, Mr Ian Ritchie said: “The Academy is in agreement with the findings of both the HIS and GIRFT Peer Review reports that the current model of trauma and orthopaedic services in NHS Lanarkshire must be improved to ensure safe and sustainable services for patients.

“Our report makes it clear that the best solution is a two centre model with a trauma unit on one site and elective services on one other.”
The Academy recognises that there may be constraints in moving to the trauma unit one site model in one step and therefore accepts the argument that a two-step service change will be necessary.

“The Academy will support and interim step if it clear and explicit that this is part of a journey to a single site for trauma.

“NHS Lanarkshire and regional planning colleagues reviews the implications of moving to a single centre model for trauma and considered that managing the transition would require mode detailed planning.

“However based on feedback and reports the Lanarkshire NHS Board agreed to move to the interim two site position as soon as possible in order to secure the necessary more immediate improvements in quality and safety of care.”

The trust estimates that three or four people per day who need a trauma or orthopaedic hospital admission will be affected by these changes, but that their quality of care will be improved.

NHS Lanarkshire also plans to invest £1.5 million in a new hospital lead Rapid Assessment Team at Monklands Hospital’s emergency department led by a senior member of clinical staff to improve patient flow and safety.

They also plan improvements at Monklands’ Day Surgery and Same Day Assessment units to more than double the number of patients seen, in addition to continuing towards a completely new hospital replacing Monklands.