Hip and knee surgery patients are being sent home from Southmead Hospital early in a drive to get through a backlog of elective operations caused by the pandemic.
Patients who have had a hip or knee replacement and are deemed suitable for ‘hospital at home’ support are being discharged after two days, rather than the usual five days.
Councillors expressed concern about post-operative patients getting three fewer days of hospital care, but a hospital chief assured them the initiative was safe at a public meeting last month.
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Elective waiting lists grew during the coronavirus pandemic as NHS hospitals did not have the staff or facilities to carry out all booked procedures as well as provide treatment for Covid-19 and other patients.
By the end of April, 6,425 patients had been waiting for elective surgery for more than a year, and 41 had been waiting for more than two years, across Bristol, North Somerset and South Gloucestershire, a report to the meeting said.
The NHS Clinical Commissioning Group (CCG) for the region was subsequently chosen along with 11 other areas to participate in a government ‘accelerator’ pilot to speed up the delivery of elective operations.
It introduced the early discharge scheme at Southmead Hospital as part of a raft of pilot initiatives paid for with £8.5million of capital funding.
Kingswood councillor April Begley, who is a member of South Gloucestershire’s health scrutiny committee, said: “To take three days away from five is actually quite a lot.”
But Evelyn Barker, deputy chief executive at North Bristol NHS Trust, which runs Southmead Hospital, assured her the orthopaedic supported discharge scheme was well managed.
‘People aren’t just pushed out the door’
Ms Barker said hip and knee replacement patients are assessed for their suitability for early discharge, some are transferred to step-down beds in the community instead of being sent home, and those who are sent home are managed by a dedicated ‘hospital at home’ team of doctors, nurses and physiotherapists.
“People aren’t just pushed out the door home without any support,” she said.
Ms Barker, who is responsible for the accelerator pilot at the CCG, said she was hopeful it would reduce elective surgery waiting times over the coming months.
The initiatives are designed as far as possible not to put extra pressure on NHS staff who have been through the “worst year” in NHS history, she said.
They included ordering more hospital equipment and ‘modular theatres’, as well as extending some outpatient clinics by an hour a day.
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Efforts at Southmead suffered a blow last month when the hospital came under intense pressure from a rising number of Covid cases, emergency patients, and people suffering from the winter diarrhoea and vomiting bug norovirus, just as more and more staff were having to self-isolate amid the so-called ‘pingdemic’.
“We’ve absolutely had everything thrown at us that we could possibly think of,” Ms Barker told the health scrutiny committee on July 28.
She said Southmead had only one of three wards left for elective surgery patients, having lost at least one to emergency patients.
Three wards in the hospital were being used for norovirus patients.
Two wards were for Covid patients but this has since dropped to one, a spokesperson for the hospital trust said.
The spokesperson said: “Orthopaedic Supported Discharge is a scheme that is currently only being offered by North Bristol NHS Trust, but with a view to rolling it out elsewhere in the future.
“It is offered to appropriate patients who are screened in advance to check their suitability and ensure they meet key criteria, such as having someone at home with them. It only relates to knee and hip replacement surgery.”
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