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Multiprofessional Working – a new orthopaedic model

Multiprofessional Working – a new orthopaedic model. Dr Sarah Schofield Southampton Health Economy. Dr Sarah Schofield. GP PCG Chairman Sabbatical at Southampton University Hospitals Trust (SUHT) Chairman, Whole Systems Orthopaedic Board Assistant Medical Director, SUHT

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Multiprofessional Working – a new orthopaedic model

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  1. Multiprofessional Working – a new orthopaedic model Dr Sarah Schofield Southampton Health Economy

  2. Dr Sarah Schofield • GP • PCG Chairman • Sabbatical at Southampton University Hospitals Trust (SUHT) • Chairman, Whole Systems Orthopaedic Board • Assistant Medical Director, SUHT • Assistant Medical Director, ETVS PCT

  3. Today • Background • What has been achieved • Successes and Challenges • How • Where to from here

  4. Orthopaedics August 2000 • Waiting times targets • CHI • Serious clinical incident • Low morale • Complaints • Lack of confidence in the service

  5. Patient pathway • Workshop • Patient pathway • Prevention • Outpatients • Inpatients • Discharge processes • Community care

  6. Orthopaedic Outpatients August 2000 • 800 referrals per month • 400 appointments available • 40% conversion rate • 18 month wait for appointments • Reducing targets for waiting times (NHS Plan) • Complaints and dissatisfaction

  7. Solutions • Traditional solution • Clerical/clinical validation • Multiprofessional Triage Scheme

  8. Multiprofessional Triage • Pilot started January 2001 • Romsey Hospital • Lower limb team • Second team started summer 2001

  9. Multiprofessional Triage • Team of professionals working together • 30 minute appointments • Patients see one professional with input from others when necessary • Not treatment service but fast track into other services • 6 weeks waiting times

  10. Governanceand Education • Monthly sessions in acute trust • Competency framework • Appraisal and review • Training together • MSc • Patient feedback

  11. Triage Teams

  12. Structure • 3,000 patients 2002/03 • Central management • 3 lower limb teams • 2 upper limb teams • 2 back teams • 52% patients referred back to GP • 20% patients referred onto outpatients

  13. Ripple Effects • Community services • Informed patients • Conversion rate • Pressure on inpatient lists and targets • Training of junior grades and students • Workforce issues

  14. Successes • Access – time & geography • Expertise • Long appointments • Access to other services • Patient satisfaction • Education – patients, Teams, GPs • Cost • Waiting times targets

  15. Challenges • Staff contracts • Working across boundaries • Evolution • Suspicion • Workforce • Estates • Rollout

  16. How? • 4 individuals • Legwork • Networking • Recognition that people are much more inclined to support what they help create, and resist what is forced upon them • Win-win • Computer modelling

  17. How? • Flexible approach • Pilot • Education a priority • Champions – management and clinicians, primary and secondary care • Understanding of whole pathway • Link to Whole Systems

  18. Future • Part of whole systems plan • Referral broker • Managed Care • MSc • Other specialties

  19. Summary New service which was set up to provide care in the right place at the right time with the right professionals, with the patient rather than the system at its centre

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