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Bhavika Patel, Saadia Khan, Abhishek Das, David Bowe and James Tyler
Airedale NHS Foundation Trust, UK
ScientificTracks Abstracts: Pulsus J Surg Res
Objectives: To evaluate the benefit of introducing a “one-stop” shoulder clinic involving orthopaedic, radiology and physiotherapy services, in terms of time and money saved. Methods: A genuine one-stop service was introduced combining the services of two orthopaedic consultants, two orthopaedic middle grade doctors/advanced physiotherapy practitioner, one musculoskeletal radiology consultant, and two general physiotherapists. The service allows for clinical and radiological evaluation, ultrasound-guided procedures (including suprascapular nerve blocks), and specialist physiotherapy. It was provisioned in one large clinical area with multiple patient cubicles. Patients were initially consulted by the orthopaedic team, and most received an ultrasound scan with or without an ultrasoundguided injection, performed by the radiology team. Patients were then consulted again by the orthopaedic team or advanced physiotherapy practitioner, and a rehabilitation programme was commenced as indicated. Patient attendee numbers and hospital attendances saved were collected prospectively. Costs were calculated using figures generated from the hospital's finance department. Results: Between October 2020 and October 2021, a total of 338 patients were seen. Compared to initial presentation, the EQ- 5D Visual Analogue Scale (VAS) for pain improved on average by 12.1 points, and the EQ-5D VAS for general health improved by 4.8 points at one year. There was also an average improvement of the EQ-5D-5L health index by 0.08 after one year. Five hundred and nine future appointments were saved. An overall cost saving of £198.12 per patient was estimated, which includes cost of ultrasound scan of the shoulder, physiotherapy attendance and outpatient follow up. There was an average improvement of 8.9 points of the Oxford Shoulder Score after one year. Conclusion: The one stop shoulder clinic has streamlined the elective shoulder service, reduced hospital attendances, and saved considerable costs during the COVID-19 pandemic. Recent publications: Patel B, Aqil A, Riaz O, Jeffers R, Dickson D. The 2nd metacarpal cortical index as a simple screening tool for osteopenia. J Bone Metab. 2020;27(4):261-266. doi:10.11005/JBM.2020.27.4.261
Bhavika is a Specialty Doctor working in Trauma and Orthopaedics in Airedale General Hospital, West Yorkshire, United Kingdom. She has a particular interest in upper limb surgery and is previously published in the Journal of Bone Metabolism. She has given podium presentations at conferences for the British Society of Surgery of the Hand (BSSH), International Federation of Societies for Surgery of the Hand (IFSSH) and British Orthopaedic Research Society (BORS). She has also delivered poster presentations at the Association of General Surgeons Great Britain (ASGBI), Association of Surgeons in Training (ASiT) and the Fitton Prize Meeting.
