Orthopaedic surgery – consulting patients about large-scale changes

Client challenge

New technology, improving clinical practice and the needs of our aging population mean that the way healthcare is organised and delivered changes – probably more than most people think. 

A good example is orthopaedic surgery (bones and joints).  There is growing evidence that larger centres situated in fewer hospitals and performing more of the same kinds of operations get better results.

In North London, Verve supported a review orthopaedic surgery for a population of 1.6M residents and ten hospital sites providing surgery for them.

The communications challenge is always to explain and bring people along with change.  For NHS services, there is also a requirement to consult patients and the public, plus a duty under the Equality Act to consider groups who may be disproportionately affected, for example those with conditions which make surgery more likely.

Our solution

Over three years, we worked with the North Central London team every step of the way, listening to patients to pick up the issues most important to them and engaging communities across five boroughs.

We helped clinicians working in the different services to think through their process from referral for assessment to rehabilitation as they designed different models for how the system could be streamlined around best practice.

Then we supported the consultation and an integrated impact assessment, which examined implications for accessibility and travel, which are particularly important in orthopaedic care: how easy is it for disabled people, older people, poorer people to get to the centre?

The outcome

There was a large and inclusive response to the consultation and the Review went on to develop two major centres, reducing the ten hospital sites which had previously provided non-complex surgery.

Patients still remain under the care of the same consultant and preparation for surgery and rehabilitation remains local to where they live.

But the new system promises real benefits – planned cases are separated from acute surgery, so infection control is easier and operations less likely to be cancelled because of shortage of theatres.

Above all, evidence suggests that both surgery outcomes and the patient experience will be better.

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