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North Cumbria University Hospitals NHS Trust - 70 years of the NHS


Home > News > New care pathways providing faster and more effective treatment

New care pathways providing faster and more effective treatment

Posted on Tuesday 25th June 2013
Jeremy Rushmer

Dr Jeremy Rushmer

North Cumbria University Hospitals NHS Trust is continuing to implement the Care Closer to Home strategy which was consulted on in 2009.

The planned transfer of emergency high-risk trauma and orthopaedic patients from West Cumberland Hospital in Whitehaven to the Cumberland Infirmary in Carlisle successfully started on Monday 10 June 2013. This is in order to ensure the best possible clinical outcomes for patients who have high risk trauma and orthopaedic injuries such as fractured neck of femur (hip fractures). Patients who have surgery in Carlisle then return to Whitehaven for rehabilitation.

Since the transfer started two weeks ago, 11 high risk patients have been transferred from Whitehaven to Carlisle, with seven being patients with hip fractures. Out of the seven patients, six were successfully transferred back to West Cumberland Hospital for their post-operative rehabilitation within the target time of 48 hours.

When high-risk trauma patients arrive in A&E at West Cumberland Hospital, they are being quickly transferred to Carlisle for their surgery and are taken back to West Cumberland Hospital by the Ambulance Service for further care and rehabilitation if it is required.

The key aims of this change are safer care, effective care and improved patient experience. In the Cumberland Infirmary, there is a 24/7 trauma rota with a dedicated consultant-led trauma operating list all day Monday to Friday and half-day lists at weekends. This allows the Trust to ensure that out-of-hours operating is minimised as per national guidance.

There are still two trauma lists at West Cumberland Hospital every week for patients who can go home and return for planned urgent procedures and more elective lists have been moved to Whitehaven to provide care closer to home, more choice and reduce waiting times. Elective procedures are now not being cancelled due to emergencies and every consultant surgeon has a minimum of one full day operating per week which improves efficiency and patient flow.

There is more cross-site working within the Trust with all orthopaedic surgeons spending some of their time at the opposite hospital site. The ortho-geriatric nurse at the Cumberland Infirmary is liaising closely with West Cumberland Hospital to actively ensure medically stable patients are going back to Whitehaven as soon as possible.

The next planned change involves transferring all general surgical high risk patients and forms a key part of the Trust’s journey of improving the care we deliver. The Trust Board will start discussions with general surgeons today on their proposals. Closer working amongst clinical teams has helped the Trust to ensure patients get quicker access to services and it has provided enhanced choice to patients.

Dr Jeremy Rushmer, Interim Medical Director, explains: “More patients are going to be moving between both hospital sites to get the best possible care we can provide. We estimate around 10 patients a week will be transferred from Whitehaven to Carlisle for more complex surgery and we have started with trauma and orthopaedic surgery. This has freed up capacity at West Cumberland Hospital, allowing for extra elective patients to be treated there. There is also a greater flow of medical staff between both sites to carry out operations and consultations with patients.

“The transfer of high-risk trauma patients has been taking place for two weeks now and has been very successful so far. We have transferred the expected amount of patients and there have been no concerns from the Ambulance Service. We are ensuring there are beds for patients to come to in Carlisle and then go back to in Whitehaven post-operatively.

“We want to ensure that patient safety is not compromised at any point and have agreed that this can be best done by centralising our expertise in one area.”

NHS Cumbria Clinical Commissioning Group (CCG) Chief Executive, Nigel Maguire said: “We are working very closely with the Trust over these changes to ensure we deliver the highest possible standards of clinical care, and the patients receive the best possible outcome.

“The quality and safety of clinical services that we commission will always be at the heart of the decisions we make.”