1. Orthopaedic and trauma services – improving care for patients

2. Why services need to change
Extremely high cancellation rate in 2017/18 – 900 patients cancelled a combined 1,200 times. Over half of these patients were cancelled on the day.
Poor 18 week wait performance (63.3% March 2018 against a standard of 92%).
No segregated orthopaedic beds at any of the four sites, risking infections for surgery patients.
No ring-fenced elective beds.
Low of share of the market for elective orthopaedics (42%) – meaning NHS providers out of the region and private providers are performing over half of the elective orthopaedic procedures for our patients.

3. Service review
ULHT part of the national Get It Right First Time (GIRFT) programme that started in June 2017, and our own internal clinical service review (CSR) in September 2017.
ULHT board agreed principles agreed to make sure the service meets the highest national standards are:
Quality of care is improved for trauma and elective patients.
The productivity of the workforce and best use of resources is improved.
Unwarranted clinical variation is eliminated.
Patient outcomes are consistently captured, reported and tracked across the service.
Trauma and orthopaedics is managed as a single specialty to deliver the best outcomes for all Lincolnshire patients.

4. Current model 18/19 Contract Activity
I.e. how much work we are contracted to do by site and by type each year

5. Proposed model
Grantham to become a orthopaedic centre of excellence, majority of inpatient work.
Invest in theatres at Grantham and new surgical staff.
Day case surgery remains at Louth, Boston and Grantham, with paediatric day cases at Lincoln.
Trauma remains at Grantham, Pilgrim and Lincoln.
Outpatient clinics on all four sites.

6. Next steps Engaging public and staff on their ideas.
Proposal on a six month trial to be presented to ULHT Board.
Likely start date from August.

7. Your input
We’d now like your feedback on what maters to you in the delivery of trauma and orthopaedic services.
In groups you will be asked to rank the below statements:
Being seen quickly
Local access to pre-and post-operative care
Surgery at your local hospital
Seeing a specialist
Not having your procedure cancelled
Being cared for on a specialist surgical ward
Short length of stay in hospital
Being cared for on a well-staffed ward
Safe care
Cost-effective care/ good use of resources
No delay in discharge
Other