Agenda item

ELECTIVE ORTHOPAEDIC CENTRES

Minutes:

Dr Bhan informed the Board that a presentation had been given recently concerning Elective Orthopaedic Centres to the Joint Health Oversight Committee.

 

Currently, elective orthopaedic centres in the south east were located at eight centres, run by four Trusts. The difficulty now facing the NHS and the CCG was how to manage inpatient elective orthopaedic care in the future, when faced with the dual pressures imposed on the service by increased demand, and financial constraints. As part of the Healthier South East London Plan, it was proposed to potentially centralise inpatient elective orthopaedic surgery at two of the eight existing centres. It was hoped that this would provide a better overall standard of care, and eradicate the current inequalities that existed in south east London.

 

Dr Bhan mentioned that the strategy had evolved from the work done by Professor Tim WR Briggs (Consultant Orthopaedic Surgeon-Royal National Orthopaedic Hospital) who had written a report entitled, “Getting it Right First Time”. It was expected that the two new centres would benefit from economies of scale, and it was likely that one centre would be set up in inner London, and one in outer London. Dr Bhan informed the Board a confirmed model already existed, and that the proposals would be brought before the Joint Committee of CCGs as part of the consultation process. To date, the proposals were supported by clinicians and evaluation groups.

 

The Chairman asked who was likely to be the provider. Dr Bhan informed the Board who the current providers were, and stated that the new providers had not been decided. Cllr Carr asked why the private sector had not been considered to be a provider. He felt that this could provide welcome competition and efficiencies. Dr Bhan responded that there was an existing model and pathway in the NHS. Cllr Carr expressed the view that this may not necessarily be the best pathway.

 

Dr Bhan continued by stating that issues such as post-operative complications had to be considered. Dr Parson highlighted the need for experienced surgeons with the requisite skills and experience, and that in most cases post-surgery, the NHS would be integral in putting in place relevant care and support packages. Individuals had to be prepared to be fit again and different sectors in the NHS would be involved in various aspects of care and support post-surgery. It was also hoped that economies of scale would result in better patient care, less cancellations, and better infection control. 

 

The Chairman noted that what was being proposed was a profound change in the delivery of elective surgery, and was also a big change for local residents. Dr Bhan commented that current provision on the Orpington site was good, but was only provided on a small scale. She stated that if a private provider was to get involved, the provider would have to build a new centre.

 

Cllr Ruth Bennett felt that what was required was to sell/market the principle of the new elective orthopaedic centres correctly. The public needed assurances that the new centres would provide better outcomes. It was agreed that this was an issue that should remain as a standing item on the agenda for the foreseeable future.

 

RESOLVED that the matter of Elective Orthopaedic Centres remain as a standing item until further notice.