/Ophthalmology_Orthopaedic_Consultati

Proposals for developing Ophthalmology and Orthopaedic Services in mid Yorkshire NHS Kirklees The Mid Yorkshire Hospitals NHS Trust NHS Wakefield District

July / August 2012

Ophthalmology and Orthopaedic Services Proposed changes

Introduction This document is designed to let you know about proposed changes to ophthalmology (eye) services and orthopaedic services (bones, joints and fractures) provided by The Mid Yorkshire Hospitals NHS Trust, and how you can let us know your views.

The proposals do not affect the range of services provided by the Trust but would mean changes to where some of them are provided.

We believe these changes will help us provide the best possible eye care and orthopaedic care in a modern environment with the most up-to-date equipment.

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Proposals for developing Ophthalmology and Orthopaedic Services in mid Yorkshire

About these services Ophthalmology services The service is provided by a team of dedicated doctors, nurses, opticians, orthoptists and many other support staff who provide a wide range of eye care services and clinics to both adults and children. These include medical and surgical services, general eye clinics, and planned and unplanned ophthalmology services – a detailed list is shown in the questions in section E on page iv of the questionnaire.

Visits to our ophthalmology clinics are by appointment only with no walk-in service.

Anyone with any concerns about their vision or eyes should contact their General Practitioner (GP), local optician, walk-in centre or, in an emergency, the Emergency Department (ED) at hospital.

Orthopaedic services Orthopaedic surgeons deal with the repair and treatment of any bone in the body, usually with the exception of the ribs and the skull. Often an orthopaedic surgeon is needed in a ‘trauma’ case – that is, an accident or injury. At other times an orthopaedic operation may be used to treat a condition of the bone that has been caused by something other than trauma – such as a serious infection, or a birth deformity. A large part of the orthopaedic workload involves the fitting of artificial joints like hip joints and knee joints.

Orthopaedic surgeons also deal with parts of the body other than bones, like tendons and ligaments. In complicated trauma cases they may work closely with colleagues from other specialties like plastic surgery or hand surgery to ensure the best possible outcome for the patient.

The Trust provides a wide range of orthopaedic services and clinics to both adults and children, including surgical services, general clinics, and planned and unplanned services.

Proposals for developing Ophthalmology and Orthopaedic Services in mid Yorkshire

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What changes are we proposing?

Proposed changes to eye care services There are two parts to the changes being proposed: • moving glaucoma, medical retina and cataract services from Pinderfields Hospital in Wakefield to Pontefract Hospital. Currently the service carries out 18,000 to 20,000 outpatient appointments and surgical procedures each year on 2445 patients. This works out as 49 people per week. Patients from Wakefield District – particularly those living in the west of the district will also have the option to receive their surgery and procedures at Dewsbury and District Hospital.

• moving the Macular Degeneration Service from Clayton Hospital in Wakefield, which is due to close, to Pinderfields Hospital in Wakefield. There are currently around 760 patients receiving this service at Clayton Hospital who would in future receive their treatment at Pinderfields.

Proposed changes to inpatient orthopaedic services To develop Pontefract Hospital as a major elective orthopaedic centre. This would mean that the majority of planned orthopaedic surgery for patients across the district would take place here, rather than in both hospitals. At present only day case orthopaedic surgery is done at Pontefract and all inpatient surgery is done at Pinderfields. This will include first time hip and knee replacement operations and upper limb (arm and shoulder) surgery.

Patients from Wakefield District would also have the option to receive their surgery and procedures at Dewsbury and District Hospital.

There will be no changes to outpatient appointment arrangement with appointments provided in Wakefield, Pontefract and Dewsbury.

Some specialist orthopaedic work would continue to be done at Pinderfields Hospital in Wakefield, including unplanned orthopaedic work and inpatient orthopaedic surgery for children – making use of the state of the art children’s ward at Pinderfields. Pinderfields Hospital would also provide care for patients with more complex orthopaedic needs – including second-time knee and hip replacements (revisions) and people more likely to require high dependency care or intensive care after their operation.

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Proposals for developing Ophthalmology and Orthopaedic Services in mid Yorkshire

Why are these changes being proposed?

To improve care for patients There is clear evidence that centres of excellence deliver better outcomes for patients and help with the recruitment and retention of highly qualified staff.

Developing centres of excellence for orthopaedics and glaucoma, medical retina and cataract procedures would bring together specialist equipment and expertise leading to improved quality of care.

To make better use of hospital capacity Moving planned orthopaedic services out of Pinderfields would allow us to reuse this space to meet a demand for additional general ‘medical’ beds. An additional 24 beds would be available at Pinderfields for sick patients with a wide variety of conditions who require hospital admission. This would reduce the need in the future for people from Wakefield District to be admitted to Dewsbury and District Hospital for urgent hospital care.

Improved diagnostics/patient convenience Creating the ophthamology centre at Pontefract would mean that we could offer a wider range of diagnostics that would be available on the day, reducing the need for return visits or referrals to other hospitals.

Maintaining the Macular Degeneration Service in Wakefield This service is currently provided for patients from both North Kirklees and Wakefield District at Clayton Hospital in Wakefield. Clayton Hospital is due to close as part of changes previously agreed. Moving glaucoma, medical retina and cataract treatments from Pinderfields to Pontefract would mean that there would then be space at Pinderfields Hospital for the Macular Degeneration Service, so that it would still be accessible for patients from North Kirklees.

Reducing spend on independent sector hospitals Currently, the local NHS pays around ÂŁ1.5m for patients to receive planned orthopaedic operations and treatment at independent hospitals, which may be outside of Wakefield District. For example, 431 out of 860 knee and hip replacement operations for people from Wakefield District are carried out at independent hospitals.

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The changes proposed to orthopaedic services would allow the vast majority of orthapaedic work to take place in a local NHS hospital. This would help to increase the Trust’s income, and make services more sustainable. It will also reduce the inconvenience of patients having to travel out of the area for their care.

When would the changes take place?

We would like to make the changes to eye care services by autumn 2012. The changes to inpatient orthopaedics would take place from spring 2013.

Your views We would like to know what you think about these proposals and any concerns you may have. Your views are important to us and mean that we can make changes that will benefit patients. We would be very grateful if you would use the response form at the back of this booklet to tell us what you think.

Questions and answers Are you doing this to save money?

This is about improving patient care and providing services as efficiently as possible.

These changes will allow better services to be provided for patients. They will also ensure that Macular Degeneration services continue to be centrally located and help to reduce the need to cancel planned orthopaedic operations due to emergency work.

While saving money is not the main reason for the proposals, the Trust’s financial position means that we need to think about how we can provide services more efficiently so this is an important consideration of any plans.

The changes to orthopaedic services would help to boost the income available to the Trust by up to £1.5m. The proposed changes to eye care services would move us closer towards vacating Clayton Hospital and the South side of the old Pontefract Hospital, saving more than £750,000 a year.

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Proposals for developing Ophthalmology and Orthopaedic Services in mid Yorkshire

Why are you committed to developing centres of excellence?

We want the best possible results for our patients and evidence shows that creating centres of excellence achieves that.

Will these proposals affect me if I currently go to Dewsbury and District Hospital?

No, there will be no impact on patients currently using Dewsbury and District Hospital. These proposals only relate to changes in Wakefield District. Dewsbury and District Hospital will continue to provide a full range of orthopaedic services and glaucoma, medical retina and cataract services alongside other ophthalmology services.

People who live in Wakefield District will have the choice to go to either Dewsbury or Pontefract for planned inpatient orthopaedic services and for glaucoma, medical retina and cataract services.

How will you use my comments?

The information we receive will help us to understand what works well and what can be improved, and to plan the best way to organise and deliver services.

We will consider all responses and take your comments into account before making any changes. The views of patients and the public are one of the three main factors that are considered when making decisions about how services are provided, with the other two being patient safety and value for money.

Please use the following questionnaire to tell us your views and return it to the FREEPOST address on the form. We would like to have all your views by 16 August 2012.

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If you require this document in another language or another format such as large print or audio tape please contact PALS on: 0845 602 4832.

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Proposals for developing Ophthalmology and Orthopaedic Services in mid Yorkshire

Ophthalmology and Orthopaedic Services

Please print out the following eight pages when you have read the whole document.

Complete the form and send it back to us.

Your views

No stamp is required.

A 1.

Developing Centres of Excellence

Do you agree with the principle of The Mid Yorkshire Hospitals NHS Trust developing centres of excellence to improve patient outcomes?

Yes

No

Not sure

Please give your reasons for this

B 2.

3.

Access and transport

How do you generally travel to hospital for appointments, operations or procedures? (please state the main form of transport used) Public Transport (bus or train)

Walk

Cycle

Car

Taxi

Free hospital shuttle bus

Patient transport

Any other form of transport (please describe)

Are you likely to have any difficulties travelling to Pontefract or Dewsbury to receive eye care services or orthopaedic operations? Could anything be done to help you access these services?

Proposals for developing Ophthalmology and Orthopaedic Services in mid Yorkshire

i

C

Proposed change to eye care services

Please also complete section E if you have used ophthalmology services in the last 2 years.

4.

Do you have any concerns about the proposal to move glaucoma, medical retina and cataract services from Wakefield to Pontefract?

Yes

Not sure

Please give your reasons for this.

5.

Could anything be done to make this change easier for you?

6.

If glaucoma, medical retina and cataract services were no longer provided in Wakefield would you prefer to use Dewsbury or Pontefract?

Dewsbury

7.

Pontefract

Neither preference

Do you have any concerns about the proposal to keep the Macular Degeneration service in Wakefield (for all patients in North Kirklees and Wakefield District) by moving them from Clayton Hospital to Pinderfields Hospital?

Yes

ii

No

No

Not sure

Please give your reasons for this and if you think anything could be done to make this change easier for you.

Proposals for developing Ophthalmology and Orthopaedic Services in mid Yorkshire

D

Proposed changes to inpatient orthopaedic services

Please also complete section F if you have used inpatient orthopaedic services in the last 2 years.

8.

Do you have any concerns about the proposal to move inpatient planned orthopaedic services from Wakefield to Pontefract Hospital?

Yes

No

Please give your reasons for this.

9.

Could anything be done to make this change easier for you?

Not sure

10. If

orthopaedic services were no longer provided in Wakefield would you prefer to use Dewsbury or Pontefract?

Dewsbury

Pontefract

Neither preference

11. Do

you agree with the principle of increasing the number of procedures carried out in local hospitals rather than independent hospitals?

Yes

No

Not sure

Please give your reasons for this.

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E

Eye care services - current and recent service users

Please complete this section if you have used ophthalmology services in the last 2 years?

12. Which

13. What

hospital did you have your appointment, procedure or treatment?

Clayton (Wakefield)

Dewsbury

Pinderfields (Wakefield)

Pontefract

kind of service or clinic did you use?

General ophthalmology clinics Oculoplastics and lacrimal services including repair of droopy eyelids, tear duct obstructions, removal of tumors in and around the eyes, eyelid reconstruction, laser skin resurfacing, nurse-led cyst clinics and tear duct operations Cornea and anterior segment services, including retrieval of eyes for donation Glaucoma services including selective laser trabeculoplasty (SLT) Macular degeneration Medical retinal and uveitis (inflammation of the middle layer of the eye) Diabetic virtual screening clinics Children’s ophthalmology, including retinopathy screening and strabismus (squints and cross eye) Adult strabismus (squints and cross eye) Cataract clinic Laser clinics Orthoptic services including visual fields or peripheral vision checks and preschool vision screening Glaucoma Low vision aid (LVA) clinic Registration of a visual impairment Ophthalmic imaging (taking detailed pictures of the eye using a variety of techniques) Other (please describe)

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Proposals for developing Ophthalmology and Orthopaedic Services in mid Yorkshire

14. What

was your experience of using these services? For example - did the appointment run to time, were the facilities adequate and did you receive good care?

15. Is

F

there anything that could be done to improve the experience you had in hospital?

Orthopaedic services - current and recent service users

Please complete this section if you have used inpatient orthopaedic services in the last 2 years?

16. What

17. What

18. Is

kind of operation or procedure did you have?

Knee replacement

Hip replacement

Children’s orthopaedics

Other (please describe)

Arm, elbow or shoulder operation or procedure

was your experience of using these services?

there anything that could be done to improve the experience you had in hospital?

Proposals for developing Ophthalmology and Orthopaedic Services in mid Yorkshire

v

G

Equality Data Collection

In order to ensure that we provide the best services for all of our communities, and to ensure that we do not knowingly discriminate against any section of our community, it is important for us to gather the following information.

This information cannot be used to identify you and will be kept confidential. You do not have to answer any of these questions, but we would be very grateful if you would.

19. What

is the first part of your postcode? e.g. HX1, HD2, WF10 etc.

Please enter here

20. What

Prefer not to say

gender are you?

Female

Male

Prefer not to say

21. Do

you consider yourself to be transgender?

Do you live in the gender opposite to that assigned at birth?

Yes

22. What

No

Prefer not to say

Under 16

16 - 25

26 - 35

36 - 45

46 – 55

56 - 65

66 – 75

76 - 85

86 +

Lesbian (same sex)

Gay man (same sex)

is your age?

Prefer not to say 23. What

is your sexual orientation?

Bisexual (both sexes)

Heterosexual / Straight (opposite sex) Other (please state)

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Proposals for developing Ophthalmology and Orthopaedic Services in mid Yorkshire

Prefer not to say

24. What

is your ethnic background?

Asian, or Asian British

Black, or Black British

Mixed

White

Bangladeshi

African

White & Asian

British

Chinese

Caribbean

White & Black African

European

White & Black Caribbean

Gypsy/ Traveller

Indian Kashmiri

Irish

Pakistani Prefer not to say

25. Do

Other (please state)

you consider yourself to belong to any religion?

Buddhism

Christianity

Hinduism

Islam

Judaism

Sikhism

No religion

Prefer not to say

Other (please state)

26. Do

you consider yourself to have a disability?

Under the Equality Act 2010 a disability is defined as ‘a physical, sensory or mental impairment which has, or had a substantial and long-term adverse effect on a person’s ability to carry out normal day to day activities’.

Yes

No

Prefer not to say

Proposals for developing Ophthalmology and Orthopaedic Services in mid Yorkshire

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27. If

yes, what type of disability do you have?

Learning disability/ difficulty

Long-standing illness or health condition

Mental health condition

Physical or mobility

Hearing

Visual

Prefer not to say

Other (please state)

28. Do

you provide care for someone?

Such as family, friends, neighbours or others who are ill, disabled or who need support because they are older.

Yes

No

Prefer not to say

Please return this form to: Communications and Engagement NHS Calderdale, Kirklees and Wakefield District FREEPOST NEA12747 Wakefield WF1 1LT

Thank you very much for your time.

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Proposals for developing Ophthalmology and Orthopaedic Services in mid Yorkshire