NHS Lanarkshire is involving stakeholders in the next step towards improving Trauma and Orthopaedic Services.   An option appraisal event will be held on 20 March 2018 as part of plans to create centres of excellence for both trauma and planned (elective) orthopaedic surgery.

Trauma and orthopaedics covers injuries and conditions relating to bones, joints, ligaments, tendons, muscles and nerves. Trauma includes everything from ankle sprains to broken legs.
A small percentage of patients may need an operation. This could be a planned operation such as a hip replacement, or trauma surgery for a serious injury following a car accident.

The plans for Trauma and Orthopaedic Services were consulted on as part of Achieving Excellence – Lanarkshire’s healthcare strategy, which was approved by the Cabinet Secretary for Health and Sport Shona Robinson in May 2017.

Dr Jane Burns, medical director for acute services, “We have already seen benefits for patients with a safer and more sustainable service since we moved to two sites in 2016.

“The next step is to move to a centre of excellence for trauma and one for planned orthopaedic elective surgery which will bring further improvements to patients both in terms of clinical outcomes and through the effective use of highly-skilled staff.”
Currently, both trauma and orthopaedic surgery is performed at University Hospital Wishaw and University Hospital Hairmyres.
As set out in Achieving Excellence, University Hospital Wishaw will be the Lanarkshire centre of excellence for trauma surgery.

This fits with proposals to create a major trauma network across Scotland which would see the creation of a major trauma centre at Queen Elizabeth University Hospital in Glasgow with Wishaw designated as the major trauma unit for Lanarkshire. Wishaw is best placed for this development due to its centre of excellence for paediatric care and geographic location with a catchment covering south/central Scotland.

The option appraisal in March 2018 will consider whether the best location for planned (elective) orthopaedic surgery is University Hospital Hairmyres or University Hospital Monklands.

Members of the public and clinical staff will be involved in the option appraisal. A report on the option appraisal will be considered at a Board meeting of NHS Lanarkshire later this year, where a final decision will be made.

All three Lanarkshire acute hospitals will continue to have consultant-led emergency departments with access to emergency surgery and medicine, supported by critical care, diagnostics and outpatients.

Most patients with an injury will continue to be seen at the emergency department of their local hospital. Only the most complex trauma cases which require surgery will be taken to University Hospital Wishaw.

For all orthopaedic patients, most of the care they receive is as an outpatient which will continue to be delivered at each of the Emergency Departments of Lanarkshire’s three university hospitals.

The current two-site service was introduced on in November 2016 when inpatient services moved from Monklands and were concentrated at Wishaw and Hairmyres.

Lanarkshire patients are spending less time in hospital and have fewer cancelled operations following this redesign of trauma and orthopaedic services. The redesign also facilitated a whole range of improvements to surgical services across Lanarkshire, including other surgical specialties at Monklands.
The move towards a single site for trauma and a single site for planned orthopaedic surgery followed feedback from Healthcare Improvement Scotland (HIS), the Scottish Government Peer Review process Getting It Right First Time (GIRFT), the General Medical Council (GMC) and NHS Education for Scotland (NES).
This led to NHS Lanarkshire carrying out a detailed review of its trauma and orthopaedic services from which these proposals have been developed.