PATIENTS requiring orthopaedic treatments in Gwent could in future be dealt with at one of a series of centres of excellence being considered for the area’s hospitals.

Orthopaedic specialists and Aneurin Bevan Health Board bosses are considering the potential benefits of concentrating sub-specialties such as fractured neck of femur (hip), shoulder and elbow, and spinal services on single sites. The aim would be to create centres of excellence to provide the best possible outcomes for patients and develop the skills and experience of the specialist teams involved in each centre. Currently, the majority of such sub-specialities are provided at Gwent’s two main hospital sites, the Royal Gwent in Newport, and Nevill Hall at Abergavenny.

The Clinical Future programme for modernising hospital services in Gwent proposed centralising all emergency trauma cases at the proposed Specialist and Critical Care Centre (SCCC), to be built at the former Llanfrechfa Grange Hospital site near Cwmbran, and that proposal stands. It also envisaged other elective orthopaedic cases being dealt with at different Local General Hospital (LGH) sites, such as the Royal Gwent and Nevill Hall, which will become LGHs when the SCCC opens – and at Ysbyty Ystrad Fawr. However, if the centres of excellence plan is adopted, other orthopaedic sub-specialties would most likely be sited individually at any one of these three.

A centre of excellence for fractured neck of femur (hip) patients could involve an integrated service with a special focus on elderly patients and rehabilitation after treatment, which a health board report claims would provide “better patient experience, (and a) seamless, managed care pathway from admission to operation to rehabilitation to discharge.”

Concentrating the workforce onto fewer sites would also, it argues, create more efficient and sustainable services.

The centre of excellence idea is already being developed in Gwent, for foot and ankle patients.

Set up at Ysbyty Ystrad Fawr, in Ystrad Mynach, 18 months ago, this one-stop shop philosophy provides outpatient and treatment appointments at the one unit, with as much as possible of the assessment, diagnostics and pre-treatment preparation done in one visit.

The hospital deals with foot and ankle diagnostics and treatments for all but the most unwell patients who may also need the back-up services that the Royal Gwent or Nevill Hall Hospitals currently provide, and that the SCCC will provide in the future.