In the summer of 2017, local commissioners consulted the public in Liverpool, Sefton and Knowsley about a proposed reconfiguration of Orthopaedic and Ear, Nose and Throat (ENT) services across Aintree University Hospital, Broadgreen Hospital and the Royal Liverpool University Hospital. These hospitals are part of the newly merged Liverpool University Hospitals NHS Foundation Trust.
The proposal positioned Aintree University Hospital as a site for emergency trauma and orthopaedic services, and Broadgreen Hospital as a site for elective trauma and orthopaedic services. People could still visit the accident and emergency (A&E) department at the Royal Liverpool University Hospital themselves if they had an orthopaedic injury that needed urgent attention, but if once they were assessed it was decided that they needed an operation, they would be transferred to Aintree University Hospital. In order to facilitate the required changes, it was proposed that all in-patient ENT activity currently delivered at Broadgreen Hospital would be delivered at Aintree University Hospital. Clinicians believe this new way of working will make it easier to share expertise and training, attract the most talented staff and meet the highest clinical standards.
It was clear from the consultation feedback that there was support for the changes, and the majority of people who responded believed the proposal would improve the quality of care patients receive. Some concerns were also raised over public transport and this feedback helped the trust to understand what arrangements would need to be put in place to support access. As a result, a number of steps were agreed. The trust will provide information about transport options in patient letters; promote familiarisation visits for patients who have not been to the hospital their surgery will be performed at; and where access issues are identified for specific patients, the option for afternoon surgery and therefore a later admission time will be made available, provided it is clinically safe.
The proposal was subsequently approved by both former trust boards (May 2018), the Joint Committee of the North Mersey Commissioners (November 2018) and the Joint Health Scrutiny Committee for Cheshire & Merseyside (March 2019).
In order to deliver the changes, the trust has been working closely with teams across all three hospitals to ensure the transition to the new models of care in the safest way possible for patients and staff. This has involved a series of internal quality assurance reviews to confirm all service areas affected by the changes have in place the necessary staffing, processes and operational documentation ready for a safe go-live date and that mitigations are in place to manage identified risks.
Following months of preparation, the changes to orthopaedics took place in November 2019. This is exciting news and will ensure all patients receive the best possible care, by specialist staff, across all hospital sites.
At the same time as delivering the changes outlined above, the trust has identified an opportunity to align and streamline outpatient booking processes across trauma and orthopaedic services. This new way of scheduling appointments will be based on a six-week cycle, which will allow clinical rotas to inform how appointments are booked. This will make the most of the appointments available, reduce cancellations and offer flexible appointment options to patients. To support these changes, staff rotas will have to change and unfortunately this might have a short term impact on some patients who already have booked appointments. The Trust will be writing to those affected to advise them of the changes.
The findings from the consultation, as well as further background information which was published during the consultation, can be found below.