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Planned Care Programme – Trauma and Orthopaedics

Aim and objective: To enhance the delivery of planned care, by facilitating initiatives designed to improve the management of demand and capacity, promote greater elective activity and address waiting times.

Implementation of National Trauma and Orthopaedic Plan

  • Support the implementation of the National Orthopaedic Plan to ensure maximum utilisation of available capacity.Dependent on additional funding, provide additional improvements to support patient access and reduction of waiting lists.
  • Monitor Board plans to ensure activity is delivered against agreed targets.

Strategic Priorities: Improving quality and efficiency; National reporting and strategic oversight.

Development and Dissemination of National Pathways and Resources Via the Scottish

Orthopaedic Services Delivery Group (SOSDG):

  • Develop and implement 2 national clinical pathways to reduce variation and improve patient access.
  • Support Boards to implement high impact opportunities (including ACRT, PIR, ERAS) and reduce unwarranted variation.The focus of ACRT will be on certain key conditions, particularly hip and knee osteoarthritis, wrist ganglia, tennis elbow, and halus valgus.For PIR, the key focus will be arthroplasty and foot and ankle/shoulder/hand subspecialties.
  • Monitor ERAS and same-day surgery activity through the ARISE dataset (on a quarterly basis).
  • Share best practice on developing clinical teams and work with workforce planning to support service delivery for frailty trauma patients.Develop an organisational survey on current trauma provision across Scotland.Benchmark services and identify service needs to assist with strategic trauma and hip fracture strategic planning.
  • Incorporate analysis of Care Opinion feedback into local and national meetings to understand needs of patients, carers and service users, starting with the Scottish Hip Fracture Audit.This will help to inform and develop trauma and orthopaedic services.
  • Create and maintain information about key trauma and orthopaedic conditions and after-care on NHS Inform to support patients, carers, service users and the general public.

Strategic Priorities: Promoting and implementing sustainable solutions, Improving quality and efficiency, Data and evidence and Stakeholder engagement and collaboration.

Board Engagement and Clinical Leadership

  • Lead ongoing T&O Peer Review Cycle to ensure that recommendations have been implemented and any ongoing challenges are addressed to improve patient access and clinical care.
  • Share learning and good practice and developments from Peer reviews across Scotland.
  • Implement Getting it Right First Time (GIRFT) principles to reduce variation, improve pathways, increase efficiency and effectiveness and achieve cost savings via procurement savings.

Strategic Priorities: Stakeholder engagement and collaboration; Improving quality and efficiency.

Demonstrating impact through Measurement and analysis

  • Organise and participate in national events, including the annual Scottish Hip Fracture Audit (SHFA) to help drive improvement across NHS Scotland.
  • Support the implementation of the national Scan for Safety programme through the Scottish Arthroplasty Project (SAP) and Public Health Scotland (PHS).
  • Support the Scottish National Audit Programme (SNAP) to monitor outcomes and outliers through National Audits, including the Scottish Hip Fracture Audit (SHFA) and Scottish Arthroplasty Project (SAP).Address any negative outliers through the SNAP process and escalation policy to improve outcomes.
  • Support ongoing SAP and SHFA research programmes to improve standards of care and clinical outcomes.
  • Develop Fracture Liaison Service (FLS) Audit to streamline pathways and treatment to prevent future fractures
  • Provide relevant content and narrative in support of PHS publishing the Annual SHFA and SAP reports.
  • Support waiting time’s performance and the allocation of additional funding opportunities to maximise capacity, improve.

Strategic Priorities: National reporting and strategic oversight; Improving quality and efficiency.

Strategic planning

  • Support Boards to undertake strategic planning to understand future capacity requirements, including through recognised published trajectories (Hip Fractures) and future CfSD funded analytical work on scheduled and unscheduled care.

Strategic Priorities: Improving quality and efficiency; Data and evidence.