On-island treatment for bone ops

LOCAL demand for hip and knee replacement surgery is expected to rise by 30 per cent over the next 25 years – but the good news is that more patients could be treated locally.

NHS Western Isles is currently considering the future of their orthopaedic services and are leaning towards a model of care which will reduce the number of patients having to go to the mainland for surgery and will retain and expand the current inpatient service.

Nigel Hobson, Nurse Director/Chief Operating officer at NHS Western Isles explained that the current service is not sustainable and outlines options for the future in a report to be presented to the next meeting of the Western isles health board.

To scrap the inpatient service altogether he says could mean hundreds of extra people travelling to the mainland for surgery and also the possibility of job losses at Western Isles Hospital.

He said: “From a socio-economic perspective, not having an inpatrient orthopaedic service on the Island would result in around 540 patients per annum (the majority of whom are elderly) travelling to the mainland for their surgery.”

He added: “Additionally the loss of inpatient orthopaedics would impact the departments which support this service. These include Theatres, Surgical Ward, Physiotherapy and Radiology, resulting in a loss of around 13 wte staff. Ultimately the loss of this speciality may make the hospital a less attractive place for clinical staff who want to come and work.”

The recommended model for the future is to have two full time orthopaedic consultants supported by a network of their colleagues in Raigmore. Until recently the Hospital had a resident consultant led inpatient orthopaedic and trauma service with a single handed consultant work or on call 24/7.

The new model should allow a greater number of patients to be treated locally and also increases the sustainability of the service. With less onerous on call requirements, the board are hopeful this will help recruitment, however this is still a risk.

The board have appointed two NHS Locum Consultant Orthopaedic Surgeons for a period of six months which allows them to maintain the service to patients while they evaluate the options for the future.