Demonstrating the value of elective orthopaedic hubs at the NOA awards

With over 750,000[i] people currently waiting for elective orthopaedic operations in England, there has never been a greater need for highly productive units working in partnership. Edge Health was therefore honoured to sponsor and present the Partnerships and Integration Initiative award at the recent National Orthopaedic Alliance Awards event.

The winner of the award, South West Ambulatory Orthopaedic Centre (SWAOC) is the elective orthopaedic hub set up at the renovated Nightingale hospital in Exeter to deliver high-volume and low-complexity (HVLC) activity.

The SWAOC hub was formed from the national initiative to develop 91 hubs across the country and help drive down the backlog in elective orthopaedics. SWAOC won the award for its exceptional results, which included delivering over half (56%) of their activity as same day procedures – a rare, but critical achievement for managing limited inpatient bed capacity.

This outcome was driven by a clinical redesign of the facilities to best align with the hub’s goals and a multidisciplinary team that reviewed international best practice. To do this, the SWAOC team visited exemplar units, engaged with regional clinicians, and developed standardisation pathways of care to deliver better outcomes. As a result, fewer beds are taken up by patients recovering from surgery, reducing the burden on NHS resources more generally.

Jonathan Howell, Consultant Orthopaedic Surgeon, Royal Devon University Healthcare said:

“This award and recognition by our peers of the fantastic results achieved by our multi-disciplinary team, has delighted all of us at SWAOC, and the many people in the wider Devon community who have contributed to this project. It is particularly fulfilling for us to have been recognised for our innovative approach to elective orthopaedics so soon after opening this year, and it is testament to the tremendous efforts of all those people who have given their precious time to work on this venture”

Jonathan Howell, Consultant Orthopaedic Surgeon, Royal Devon University Healthcare

The elective hub and HVLC programme

Since the start of the COVID-19 pandemic, there has been increasing focus on the elective care backlog that has continued to grow. A solution that emerged from GIRFT in 2021 was the prospect of establishing elective activity hubs, like SWAOC, to rapidly deliver HVLC activity.

Work undertaken by Edge Health to support this programme looked at the opportunity for these hubs, and the capacity required to meet the potential demand. As a result, the policy received over £1.5 billion of funding for the next 3 years and in the last 9 months, over 90 hubs have been set up and are starting to deliver results.

Some of the hubs, like SWAOC, have demonstrated rapid results and now provide a template for others to learn from and follow – both nationally, in the NHS, but also internationally.

What can other orthopaedic departments learn from SWAOC

It is clear that system working, collaboration, and the development of new pathways have been core to the success of SWAOC.

Mary Stocker, Consultant Anaesthetist, Torbay and South Devon NHS FT said:

“We are delighted to receive this NOA Excellence in Orthopaedics Award in recognition of the exceptional patient outcomes and innovative pathways delivered by the SWAOC multidisciplinary team. The volume of outstanding feedback we receive daily from our patients is a tribute to our team and the outstanding care they provide.

Mary Stocker, Consultant Anaesthetist, Torbay and South Devon NHS FT

This and SWAOC’s ability to deliver over half of its activity as “same day”, and with only 1% staying longer than 24 hours, has enabled the unit to achieve patient flow. This patient flow has enabled the unit to deliver highly productive results with minimal cost and, arguably more importantly, less demand on people.

Edge has already worked with GIRFT to create a dashboard that enables Trusts to track their HVLC activity. As a result, the 63 orthopaedic hubs already set up in England can identify key areas of improvement in real time that will bring their surgical outcomes in line with the high-performing SWOAC hub.

Learn more

If you are interested to learn more about Edge Health’s work on HVLC pathways, and the NOA award, please do contact us directly at info@edgehealth.co.uk.

[i] https://waitinglist.health.lcp.com/ accessed 04/11/2022