Airedale NHS Foundation Trust have this week launched the first NHS ‘one-stop’ upper limb clinic.
The clinic includes a consultant radiologist, significantly reducing waiting and treatment times for patients with shoulder pain.
It will mean patients with shoulder or elbow problems including bursitis, impingement or rotator cuff injuries and tennis or golfers elbow, will be able to see a consultant surgeon and consultant radiologist , get a diagnosis and treatment plan and start treatment such as injections and physiotherapy, all at the same appointment. It will reduce patient appointments at the hospital from four to one and will reduce waiting times to around four weeks, making a significant difference for those patients in pain and discomfort.
Consultant orthopaedic surgeons James Tyler and David Bowe will lead the weekly clinic along with consultant radiologist Dr Amit Bharath and specialist physiotherapist Stacey Lalande.
David Bowe, Consultant orthopaedic surgeon at Airedale NHS Foundation Trust says:
“The most significant benefit is that we’re really reducing the amount of times patients have to come back to the hospital to a single appointment. Our patients can now find a diagnosis on the day, get a treatment plan and start that treatment on day one if it is injections or physiotherapy. For those patients that need surgery we can give them the information and discuss it with them on the day, so they are not having to go away and come back each time.
The team are planning that once the clinic is established, patients will be seen and treated within ninety minutes.
Some patients with conditions like frozen shoulder who need an intervention such as hydrodilatation or for younger patients with shoulder instability where they need an MR arthrogram, they can be scheduled for another appointment as these can’t be done on the day. However those patients can still have the benefit of physiotherapy from their first appointment or if needed can have a guided injection as the radiologist will be there in clinic.
“We’re taking a much more team focussed and patient centred approach, rather than just a consultant dealing with a patient as it would have been in the past. It’s now very much a case of a group of specialists all working as a team to get the patient seen and treated as soon as possible.”
We’ve taken the opportunity to transform our service, our clinic setting and how we see patients, at the same time ensuring we keep our staff and patients safe.”
James Tyler, Consultant Orthopaedic Surgeon at Airedale NHS Foundation trust says:
“For a clinic that has consultant surgeons, a consultant radiologist doing the ultrasound scan, and having a specialist physiotherapist and treating physiotherapists, we believe it to be a first. We have also invested in an online system so patients can report their own symptoms to us before clinic and throughout their treatment and afterwards, without having to come back to the clinic so further reducing the number of appointments they need. Combining it all together we think it is the most ‘one-stop’ it can possibly be.”
Dr Amit Bharath, Consultant Radiologist at Airedale NHS Foundation trust says:
“The significant benefit of having a radiologist in clinic is that we can give immediate diagnostic answers to the patients. By working very closely with the surgeons rather than having patients come back 3 or 4 weeks later, we can answer the question at the time of their presentation and also do an intervention. It’s virtually unheard of to have a patient being assessed by a consultant surgeon and then scanned and imaged by a consultant radiologist, all within one clinic. There are massive benefits for patient satisfaction and patient safety, especially in the Covid era.“
Stacey Lalande, Specialist Physiotherapist at Airedale NHS Foundation Trust says: “The big thing is about stopping the return visits for patients and being able to get everything done at one time, to shorten the pathway to make it more efficient and improve outcomes by working together as a team.”
Michelle Sellars, Outpatients Sister at Airedale NHS Foundation Trust says:
“ As part of the NHS Long Term Plan, the focus was to transform outpatient services, and we were already looking at more patient centred clinic provision, Covid 19 has just expedited that process. I feel that the One Stop Clinic is an effective use of valuable resources, and improves the diagnostic pathway for our patients. Instead of them seeing a doctor in outpatients, being booked for multiple investigations requiring visits to different departments, on different days and often weeks apart, then having to return to get the results, the one stop clinic reduces and improves that patient journey.”