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Improving Planned Orthopaedic Surgery for Adults in North Central

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Improving Planned Orthopaedic Surgery for Adults in North Central Improving planned orthopaedic surgery for adults in north central London 13 January to 6 April 2020 We are proposing changes to planned surgery for bones, joints and muscles (planned orthopaedic surgery) for adults. This includes hip and knee replacements; and other surgery of hips, knees, shoulders, elbows, feet, ankles and hands. Any changes could affect residents of Barnet, Camden, Enfield, Haringey and Islington and neighbouring boroughs. We need your comments and advice. Closing date for feedback 6 April 2020 A consultation document published by North London Partners in health and care on behalf of Barnet, Camden, Enfield, Haringey and Islington clinical commissioning groups. Introduction Helen Pettersen Prof Fares Haddad North London Partners in Clinical Lead for the review, Clinical Director of the Health and Care Convenor and Institute of Sport and Exercise Health and a Consultant accountable officer of NCL’s Orthopaedic and Trauma Surgeon at University College five CCGs London Hospitals North London Partners in health and care was established to tackle As a surgeon, who provides this kind of care every day, I know the Hospitals across north central London have some of the big health and care challenges we face in the coming difference it makes to patients. Damage to bones, joints and muscles years. We are a partnership of health and care organisations who are can be debilitating for people of all ages - whether it is a result of proposed a new way to organise orthopaedic working together to find solutions to address these challenges. Our ageing or trauma - but with the right care at the right time, the review of orthopaedic services is a good example of this. results can be life-changing. surgery for adults. We believe that planning We probably all know someone who has had a hip or knee replacement. Whilst the results of surgery are generally good, by working together as a Such operations can be life-changing for those living in pain or who find it community of clinicians we can share knowledge and expertise to ensure that together and sharing expertise and facilities will difficult to get around. Demand for orthopaedic surgery is growing all the every patient in north central London has world-class orthopaedic surgery. In time, but right now those who need care and treatment are not always seen our proposals, we have also committed to giving patients access to the latest result in vastly improved care for local people. in a timely way. developments in orthopaedic care and clinicians, the opportunity to refine their skills, through the best quality education and peer support. All of this We want this review of orthopaedic services to be an example of how will result in a cycle of improvement for everyone. we plan to work in future so that health and care professionals, working alongside patients and residents, use their collective knowledge and expertise We have learned from our peers around the country and have included their to improve health and care for residents who are using these services. I hope good practice into our plans. We have also spoken to hundreds of patients that you will add your knowledge and experience to our work by taking part about their experiences of our services to ensure that the future is shaped to in this consultation. meet their needs. I believe that our proposed plan for the future is a good one, which offers the best solutions to the challenges the NHS faces today. I hope you will agree. 3 What is planned orthopaedic surgery? Orthopaedic surgery treats damage to bones, Our proposals only affect Introduction ................................................................................................3 joints, ligaments, tendons, muscles and nerves planned orthopaedic surgery What is planned orthopaedic surgery? .........................................................4 (the musculoskeletal system). Patients may be for adults About this consultation ...............................................................................6 referred to an orthopaedic surgeon for a long-term The following orthopaedic services are not Why are we suggesting changes to orthopaedic surgery for adults? .............8 condition that has developed over many years, such affected by our proposals: as osteoarthritis or other non-emergency damage. • Emergency care Our proposals .................................................................................... 10 Surgery, such as hip and knee replacements, is • Children’s orthopaedic care Our ambition ............................................................................................ 11 the most common orthopaedic surgery offered in • Spinal surgery Where would patients have their surgery under our proposals? ................. 12 the NHS. However, other surgery of hips, knees, Where patients would have their care in the future .................................... 14 shoulders, elbows, feet, ankles and hands also falls • Specialist and complicated orthopaedic What does this mean for patients? ............................................................ 16 under this heading. surgery How the proposals could affect travel and different communities ............... 17 • Orthopaedic surgery for patients with Planned surgery is when patients have an Benefits and challenges of our proposals ................................................... 18 appointment booked in advance. It is planned complex medical conditions such as treatment, following a referral to hospital by a haemophilia The background to our proposals............................................... 20 GP and an assessment by specialists. It is sometimes • Local physiotherapy services for bones, How planned orthopaedic services work today .......................................... 21 called ‘elective’ or ‘non-emergency’ care. joints and muscles Evidence used in developing our proposals ................................................22 How our proposals were developed........................................................... 24 Developing our proposals collaboratively ................................................... 26 How much would it cost? ......................................................................... .26 What has happened so far, and next steps ................................................ 27 How our proposed changes support hospitals in north central London ...... 28 How to feedback on our proposals ............................................30 How will a final decision be made? ............................................................ 31 More detailed information about everything that is discussed in this document can be found on our Ways to take part in the consultation ........................................................ 32 website at: www.northlondonpartners.org.uk/orth_ Appendices ...............................................................................................34 consultation Consultation questionnaire (insertion) ........................................................ 35 4 5 To inform our decision-making, we’d like feedback By inviting people to take part in the consultation NHS services are better when patients and We are holding a public consultation from anyone with an interest in these services, we want to understand whether: healthcare professionals plan them together and in “To inform our decision- About this consultation between 13 January and 6 April 2020 including: autumn 2018 we shared our reasons for needing We are reviewing planned orthopaedic • We have developed the best possible solution to change the services with patients and others to get feedback on our proposals. making, we’d like feedback surgery for adults in Barnet, Camden, • Anyone who is currently having or has had to the current challenges in providing planned with an interest, and asked for their feedback. As There are several ways in which you can give your Enfield, Haringey and Islington and we’d experience of planned orthopaedic surgery orthopaedic surgery for those who need it in a result of these conversations, we have developed views during the consultation. Full details of each from anyone with an interest like your views on our proposals. north central London • Anyone who might need these services in future the proposals in this document. We’d now like of these feedback routes are on pages 32 - 33. In • We are doing all we can to ensure that services your advice again to ensure that our proposals are in these services” Two partnerships for orthopaedic surgery have • Families and carers of people who use, have addition to this detailed consultation document, are of the best quality right for the future. been formed by local NHS Trusts - UCLH and used, or might use these services we have produced a summary document, large- type, easy-read and audio versions. You can get Whittington Health and the North Middlesex • In developing our proposals, are we doing the This consultation is being run by North London • Residents of Barnet, Camden, Enfield, Haringey, these on the website, but if you would like a University Hospital (North Mid) working with the right things to ensure everyone who needs care Partners in health and care on behalf of Barnet, Islington and neighbouring areas who might use printed copy sent to you, a braille or audio version, Royal Free London. These partnerships have been can access it in a timely way Camden, Enfield, Haringey and Islington clinical working together to develop the plans about hospital services in north central London or a
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