The local NHS is presenting proposals for a new, joined-up approach to delivering hospital-based adult orthopaedic services across Liverpool.

If approved, a public consultation on a single orthopaedic service for the city is expected to take place in Liverpool, Knowsley and Sefton during the summer.

This would be the first of a series of proposals to bring teams from different hospitals in Liverpool together as a single service.

Orthopaedic services are used by people with injuries or diseases affecting their bones, joints, ligaments, tendons, muscles or nerves. They include both planned (or ‘elective’) procedures such as hip and knee replacements, and unplanned, emergency procedures caused by major traumas such as a road traffic accident or industrial accident.

Currently in Liverpool, these services are provided by two separate teams based at Aintree University Hospital and the Royal Liverpool & Broadgreen University Hospitals.

NHS Liverpool Clinical Commissioning Group (CCG), the organisation which is responsible for planning NHS care in Liverpool, has been working closely with both Trusts and neighbouring Clinical Commissioning Groups, to explore ways to improve these services as part of its Healthy Liverpool programme.

The proposals for improving orthopaedic services have been developed working closely with orthopaedics specialists from each hospital, who believe that in the future they should operate as part of a single, city-wide Liverpool Orthopaedic and Trauma Service. This would involve separating planned and unplanned procedures, so that they happen on different hospital sites in the future.

At the moment, patients needing planned procedures can go to either the Royal Liverpool Hospital or Aintree Hospital, but under the new proposals the vast majority of planned orthopaedic care in Liverpool would take place at Broadgreen Hospital. This would enable Aintree Hospital to better focus on caring for very seriously injured, emergency patients from across the region, as the major trauma centre for Cheshire and Merseyside.

All orthopaedic outpatient services would continue to be delivered across all three hospital sites, ensuring that the majority of orthopaedic care is able to be delivered as close to home as possible for patients.

These proposed changes would help enable local services to meet new national standards for orthopaedic care, and ensure that all patients in the area receive a consistent, high quality service.

They would also mean that all orthopaedic patients would benefit from reduced waiting times, reduced length of stays in hospital, and fewer cancellations of planned operations.

In order to facilitate these proposals for improving adult orthopaedic services, it would be necessary to relocate some Ear Nose and Throat (ENT) services from Broadgreen Hospital to the regional Merseyside Head and Neck Cancer Centre at Aintree Hospital, and some Urology and general surgery services currently based at Broadgreen would need to move to the new Royal Liverpool University Hospital site.

Dr Fiona Lemmens, Clinical Director for the Healthy Liverpool hospitals programme, said:

“Making sure that people have access to the very best hospital services - wherever they are treated in the city - is central to the Healthy Liverpool programme.

“We’ve been working with local orthopaedics doctors to look at how hospital services could be improved, which has led to these proposals for a single, city-wide orthopaedics service. We believe this way of working offers real benefits for patient care, making it easier for Liverpool’s hospitals to share expertise and training, attract the most talented staff, and meet the highest clinical standards.

“However, it’s important to stress that no decisions have been made at this stage. Any changes to current orthopaedic services would be set out in a public consultation, asking people for their views, which which we hope will take place during the summer.”

Daniel Brown, Consultant Orthopaedic Surgeon at the Royal Liverpool Hospital, said:

“There have recently been several major new national directives about the way that we are expected to manage orthopaedics and traumas in the future. These are all designed to improve patient safety, experience and outcomes. However, the current system in Merseyside does not allow us to deliver these changes effectively.

“By combining the orthopaedic and trauma services at Aintree, Royal Liverpool and Broadgreen hospitals into a single service, working together, we have the opportunity to not only meet these new standards, but also to become a national centre of excellence for orthopaedic and trauma care. There is 100% support from the orthopaedic consultants across the city for this proposal, and we are very excited about this project.”

Paul Carter, Consultant Orthopaedic Surgeon at Aintree University Hospital NHS Foundation Trust, said:

“By changing the way we deliver orthopaedic services and combining our resources between hospitals, we believe we can achieve a greater continuity of care and better outcomes for patients. This proposal for a single, city-wide service would also enable us to provide best practice to every patient in a way that can’t be achieved by continuing as separate services.”

These proposals for a single, more joined-up adult orthopaedics service across the city could also help pave the way for closer working between other clinical teams at Aintree University Hospital and the Royal Liverpool and Broadgreen University Hospitals. The two Trusts are currently in discussions about the possibility of becoming a single organisation in the future.

On 14th March, a feasibility study setting out the proposals for making changes to Liverpool’s orthopaedic services will be presented to Liverpool City Council’s Social Care and Health Select Committee.

The proposals will also be presented to Overview and Scrutiny Committees (OSCs) in Sefton (21st March) and Knowsley (30th March), because any changes to orthopaedic services in Liverpool would also affect patients from these neighbouring boroughs who use them too.

If approved, the CCG is planning to hold a 12-week public consultation during the summer, in which it will ask people across Liverpool, Knowsley and Sefton for their views, in order to help shape and refine them.

Adult orthopaedic services are the first of a number of areas of hospital care in the city currently being considered for development into a single service with city-wide delivery, as part of Healthy Liverpool plans.

Other areas currently being considered for a single, city-wide service include cardiology, cancer services, and stroke services.