Orthopaedic services are used by people with injuries and diseases affecting their muscles, skeleton and related tissues including the spine, joints, tendons and nerves. They include both planned (also known as ‘elective’) procedures such as hip and knee replacements, and also unplanned procedures caused by major traumas such as a road traffic or industrial accident.
Currently these services are provided by separate teams at both Aintree University Hospital NHS Foundation Trust and the Royal Liverpool and Broadgreen University Hospitals NHS Trust.
NHS Liverpool Clinical Commissioning Group (CCG), the organisation which is responsible for planning NHS care in the city, has been working closely with both Trusts to explore different ways to improve these orthopaedic services as part of its Healthy Liverpool programme.
Orthopaedics specialists at the two hospitals believe that in the future they should operate as part of a single Liverpool Orthopaedic and Trauma Service, with two dedicated centres.
The proposed plans would help ensure that local services meet new national standards for orthopaedic care, while also reducing patient waiting times and the length of hospital stays.
Dr Fiona Lemmens, Clinical Director for the Healthy Liverpool Hospitals programme, said:
“Hospitals are a key part of the local health service, and making sure that people have access to the very best hospital services - wherever they live, or are treated in the city - is central to Healthy Liverpool.
“We’ve been working with local orthopaedics doctors to look at how services could be improved, which has led to proposals for a single, city-wide service. We believe this way of working offers real benefits for patient care, making it easier for hospitals to share expertise and training, attract the most talented staff, and meet the highest clinical standards.
“However, it’s important to stress that no decisions have been made at this stage. Any changes would be set out in a public consultation, asking people for their views, which we hope will take place during the summer.”
Working as a single, city-wide service would mean individual doctors could focus on specific areas of orthopaedics, and treat a greater number of patients with the same condition, than they do under current arrangements. There is strong evidence that patient care improves when clinicians carry out particular procedures more frequently.
Daniel Brown, Consultant Orthopaedic Surgeon at the Royal Liverpool Hospital, said:
“There have been several major new national directives in the way that we are expected to manage both orthopaedics and trauma recently. These are all designed to improve patient safety, experience and outcomes. However, the current system in Merseyside does not allow us to deliver these changes. By combining the orthopaedic and trauma services at Aintree, Royal Liverpool and Broadgreen hospitals into a single service, working together we have the opportunity to not only meet these directives, but also to become a national centre of excellence for orthopaedic and trauma care. There is 100% support from the orthopaedic consultants across the city for these plans, and we are very excited about this project.”
Paul Carter, Consultant Orthopaedic Surgeon at Aintree University Hospital NHS Foundation Trust, said:
“By changing the way we deliver orthopaedic services and concentrating our resources we can achieve greater continuity of care and better outcomes for patients. The potential solution would also enable us to bring access to best practice to every patient in a way that can’t be achieved through separate services.”
The case for changing services will be put to Liverpool City Council’s Social Care and Health Select Committee today (Tuesday 31 January). The CCG is planning to hold a full public consultation during the summer, in which it will ask people for their views, to help to shape and refine plans.
Orthopaedics is one of a number of areas being considered for single, city-wide services as part of Healthy Liverpool. Other areas include cardiology, cancer services, emergency care, and stroke. In 2015 it was proposed that blood cancer services currently delivered at both the Royal Liverpool Hospital and Aintree Hospital, should come together as a single service based at the new Clatterbridge Cancer Centre, which is set to open in 2019.
There is an over reliance on radiology to diagnose arthritis. Patients need to be empowered to loose weight and exercise more. The city needs more hydrotherapy pools and sauna/ heat rooms ( in light of research from Manchester Uni linking cold damp weather to increased joint pain). Mental wellbeing is at the heart of being a healthy weight and exercising. We need to treat the person as a whole not just ' a knee' ' a hip' . So often that ' knee' is on a person who is overweight because they are traumatised by death, abuse, etc. GPS need longer appointment times so they can get to the core of the issue, early. We need more wellbeing advisors to go to the supermarket to guide people in healthy eating. So many times I see unhealthy weight people in the supermarket and look in their trolley and the reason is in the trolley! So many people attach emotions to food. We need to get to the heart of the issues! Invest more money in gp appointments more money in mental wellbeing and you will see a reduction in cost on orthopaedics. Educate people more and empower people more on what they can do to help themselves . Aqua running, strengthening exercises, stretches, plates, hydrotherapy, heat and cold therapies etc
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