SIX months into the setting up of a dedicated foot and ankle treatment unit at a Gwent hospital, surgeon Kartik Hariharan believes he and colleagues are well on the way to creating a centre of excellence in all-round treatment and care.
Ysbyty Ystrad Fawr, on the outskirts of Ystrad Mynach, became the base for most foot and ankle diagnostics and treatments during the summer.
And Mr Hariharan, a consultant orthopaedic surgeon specialising in foot and ankle work, is more convinced than ever that this was the right move.
The aim is to develop a one-stopshop philosophy, with outpatient and treatment appointments at the one unit, and with as much as possible of the assessment, diagnostics and pretreatment preparation done in one visit.
“We’ve managed to amalgamate foot and ankle surgery for the whole of Gwent here, except for very unwell patients, who still need to be treated at the Royal Gwent or Nevill Hall hospitals, because they have the auxiliary services to treat them if something goes wrong,” he said.
“Travel is still an issue for some patients, particularly those living on the other side of Gwent, but we are trying to iron that out.
“But once people get here and experience what we can offer them, they are usually very pleased.”
The unit is in the £172 million hospital’s main outpatient department, and as well as surgical procedures performed by Mr Hariharan and his colleagues, there is new equipment to help both diagnosis and treatment.
This includes a machine for dynamic pedo-barography, which allows specialists to assess the weight-bearing characteristics of individual patients.
“This is of paramount importance to the people we see and the machine is useful pre-operatively, in helping determine what abnormality there is, and post-operatively, in helping us measure the success of the treatment,” said Mr Hariharan.
“It is also very good for the orthotists, who make insoles and special footwear, as they can use the information the machine provides. And we are hoping it can be used to benefit people with diabetes, because foot ulcers are a problem.”
The unit has also successfully made a bid for funding for an extra corporeal shockwave treatment machine.
“It helps with troublesome problems like heel pain. We have a large volume of patients with Achilles’ tendon problems and heel pain, and there is recent evidence to confirm shockwave treatment is of use,” said Mr Hariharan.
Teamwork is vital to minimise visits
TEAMWORK is vital to the centre’s development as one of excellence in foot and ankle treatment, said Mr Hariharan.
“There is an orthotists’ clinic running in parallel to our consultations, so patients get seen during the same appointment, and on occasion they can be assessed on the same day for their fitness for surgery, and have CT scans and so forth.
“The aim is to cut the patient pathway to one visit, where they are seen and treatment options are discussed.”
Another development being tried out is a ‘virtual’ clinic, with patients telephoned at home to discuss scan results, after working hours.
“We will get feedback from patients about whether that is as satisfying to them as a live clinic. Patients’ feedback is very important.
“The travel issue is still difficult but patients have been fantastic, and made every effort to be here on time.”