Delivering Day Surgery Primary Joint Replacement Outside of a Specialised Arthroplasty Hub
Chairs: Edward Dunstan & Sarah Mitchell
Day surgery arthroplasty is very high on the list of GIRFT for NHS Trusts to achieve. There are multiple extremely successful Day Surgery pathways such as that of SWAOC in Exeter, that achieve huge percentages of large joint arthroplasty within the Day Surgery setting. However, not all Trauma and Orthopaedics Units are attached to or have close associations with an arthroplasty hub or isolated Day Surgery Unit.
In this session we hope to discuss developing a pathway for Primary Joint Arthroplasty within a DGH setting. In addition, advice on selecting appropriate patients, encouraging them that this surgery when undertaken in this method is very positive.
A discussion on the Barriers to Day Surgery Arthroplasty, which is not all about the anaesthetic, and how to develop job roles to improve ambulatory pathways.
The team delivering this session have huge experience of delivering both Trauma and Orthopaedic Surgery via Day Surgery and other specialties. There will be opportunities to ask questions throughout and also to an expert panel towards the end of the session.
Agenda:
14:30 - 14:47 Day Surgery Primary Joint replacement: Developing a pathway from scratch within a DGH setting Philip Sauvé
14:48 - 15:05 Ambulatory Arthroplasty Surgery - making this the default pathway for all Mary Stocker
15:05 - 15:22 Day Surgery Ambitions and Influence. Progress towards shorter lengths of stay in Glasgow and across Scotland Lindsay Hudman
15:23 - 15:40 Overcoming barriers to effective Day surgery Karen Harries
15:40 - 16:00 Discussion, Q&A
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Edward Dunstan
Consultant Orthopaedic Surgeon, NHS Fife
Having qualified as a Doctor in 1993 I have over 25 years of Orthopaedic experience. I trained in at the internationally renowned Royal National Orthopaedic Hospital, Stanmore where I was the Senior Surgical Officer and awarded the Seddon Society Medal for research. There I trained with some of the leading hip and knee replacement surgeons in the UK. My fellowship year was spent in London training in minimally invasive techniques and rapid rehabilitation. In 2008, in Fife, we set up one of Scotland's first Enhanced Recovery Programmes. Since then we have visited several national and international centers, learning new techniques of enhanced recovery including Day Case Arthroplasty Programs. This learning culminated, in August 2018, when we performed the first Day Case Hip Replacement in Scotland. The Day Case Arthroplasty programme has gone from strength to strength and now 25% of all my Total Hip Replacements are successful Day Case discharges. The median LoS for all of my patients is one day and the average LoS <1.5 days.
From 2016 to 2020 I was Chair of the Scottish Committee of Orthopaedics and Trauma and sat on the Council of the British Orthopaedic Association.
Since 2017 I have been the Clinical Lead for Major Trauma in South East Scotland.
Since 2019 I have sat on the council of the British Association of Day Surgery.
Since 2021 I have been specialty adviser to the CMO of Scotland.
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Sarah Mitchell
Consultant Orthopaedic Surgeon, Trauma Lead, NHS Fife Orthopaedics
Sarah has been a Consultant Orthopaedic Surgeon with NHS Fife since 2015. She has a specialist interest in trauma and elective knee surgery including arthroscopy, soft tissue knee surgery, knee preservation surgery and arthroplasty. She is the Trauma Lead for NHS Fife Orthopaedics.
Sarah has completed a trauma fellowship in Auckland City Hospital, New Zealand and a knee fellowship in Bristol’s Southmead Hospital.
Sarah was the first surgeon to successfully perform day-case total knee replacement arthroplasty in Scotland, and contributes to the development of this service for patients of the NHS Fife area
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Philip Sauvé
Consultant Trauma and Orthopaedic Surgeon (specialist interest in hand and wrist surgery), Portsmouth Hospitals University Trust, Honorary Senior Lecturer, University of Portsmouth
Phil qualified from St Mary’s Hospital Medical School, Imperial College in 1998, completed basic surgical training at Frimley Park Hospital and higher surgical training in the Wessex deanery. He undertook fellowships at the Chelsea and Westminster Hospital and the Pulvertaft Hand Centre. Phil was appointed as a Consultant Trauma and Orthopaedic Surgeon with a subspecialty interest in hand and wrist surgery at Portsmouth Hospitals University NHS Trust in 2010. He has been the T&O Clinical Director in the Trust for almost 3 years.
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Mary Stocker
Consultant Anaesthetist, Torbay and South Devon, Clinical Lead, South West Ambulatory Orthopaedic Centre
Mary has been a consultant anaesthetist in Devon with a strong interest in day surgery for over 20 years. She led the Torbay Day Surgery Unit for 14 years was a member of BADS council for 10 years and their President for 3 years. She currently sits on the executive committee of the International Association of Ambulatory Surgery. She has published widely in the day surgery literature and regularly lectures on all aspects of day surgery.
She is joint clinical lead for the South West Ambulatory Orthopaedic Centre which has pioneered a revolutionary approach to lower limb arthroplasty surgery, ensuring all all patients are treated on an ambulatory pathway with outstanding results. These pathways have been rolled out across all acute providers in Devon and are now being heralded as the standard pathway across the NHS. Mary also works for NHSE South West as regional day surgery lead