Press Release
15
July 2016
Lanarkshire NHS Board
agrees to trauma and orthopaedic service improvements
NHS Lanarkshire is
improving patient safety and quality of care in a two phased restructuring of
its trauma and orthopaedics service.
The improvements are
being made following feedback from Healthcare Improvement Scotland (HIS), the
Scottish Government Peer Review process Getting It Right First Time (GIRFT),
the General Medical Council (GMC) and NHS Education for Scotland (NES) which
led to NHS Lanarkshire carrying out a detailed review of its trauma and
orthopaedic services from which these proposals have been developed.
The Lanarkshire NHS
Board agreed at its meeting on Thursday, 14 July to changes to the
service which will help to:
- deliver
improved and more consistent outcomes for patients
- reduce
the time patients spend in hospital after surgery
- improve
waiting times
- help
with recruitment and provide a sustainable, specialist workforce.
Following
the changes, around 98 per cent of patients attending Monklands
Hospital emergency department (ED/A&E) and 95 per cent of trauma
patients attending Monklands Hospital will continue to do so.
NHS Lanarkshire has also given a clear commitment to the continued provision of three district general hospitals (DGH) each with consultant led emergency departments (ED) which will each have access to emergency surgery and medicine, with support from; critical care, diagnostics and outpatients. It also reiterated its commitment to Monklands Hospital with on-going plans for a major new hospital development to replace the existing Monklands Hospital which will have 450-500 beds.
NHS Lanarkshire has also given a clear commitment to the continued provision of three district general hospitals (DGH) each with consultant led emergency departments (ED) which will each have access to emergency surgery and medicine, with support from; critical care, diagnostics and outpatients. It also reiterated its commitment to Monklands Hospital with on-going plans for a major new hospital development to replace the existing Monklands Hospital which will have 450-500 beds.
Dr Jane Burns, NHS
Lanarkshire divisional medical director of acute services, 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 elective 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 1 August
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 in the visits by the GMC and NES.
“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 as
the Lanarkshire Area Clinical Forum, a body representing a wide range of
health professionals.
Speaking in support of
NHS Lanarkshire’s move, leader of the AoMRC NHS 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 an interim step if it is clear and explicit that this is part of a
journey to a single site for trauma.”
Dr Burns continued:
“NHS Lanarkshire and regional planning colleagues reviewed the implications of
moving to a single centre model for trauma and considered that managing the
transition would require more detailed planning.
“However based on
feedback and reports from HIS, GMC, NES and the Academy, 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 changes will only
affect those patients who would have accessed trauma and orthopaedic inpatient
and day case care at Monklands Hospital. All three Lanarkshire
acute hospitals will continue to see and treat
orthopaedic out-patients.
For the vast majority
of patients who currently access emergency services at Monklands Hospital –
over 98 per cent – there will be no change. If Monklands Hospital is your local
Emergency Department (ED-A&E), you should continue to go for exactly the
same conditions as you would at the moment.
An average
of three or four people per day who require a trauma or
orthopaedic hospital admission will be affected by these changes. But they
will receive an improved quality of care.
The changes will also
enable NHS Lanarkshire to invest £1.5 million in a new consultant led Rapid
Assessment Team at Monklands Hospital’s ED which will see a senior clinical
decision maker at the start of the initial patient assessment process which
will improve patient flow and patient safety within the ED.
There are also plans to
increase capacity at Monklands’ Day Surgery Unit and make improvements to the
Same Day Assessment unit which will more than double the number of patients
seen.
This will be in
addition to the on-going plans to build a major new high quality acute
Monklands Hospital development to replace the existing hospital which will
require 450-500 beds.
For
the vast majority of patients who currently access emergency services at
Monklands Hospital – over 98 per cent – there will be no change
If Monklands Hospital is someone’s local A&E, they should continue to go for exactly the same conditions as they would at the moment. This is not changing now or in the future.
NHS Lanarkshire will continue to have three consultant-led accident emergency departments.
NHS Lanarkshire is acting on independent expert advice from the AoMRC (see attached AoMRC letter).
All three Lanarkshire acute hospitals will continue to see and treat orthopaedic out-patients.