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Trauma and Orthopaedics

Trauma

Fracture clinics are currently operating at Bronglais, Withybush and Glangwili Hospital's.

There is currently no fracture clinic's at Prince Philip Hospital due to social distancing measures on this site, however this is being continually reviewed and will restart as it is possible and safe to do so. Patients are being managed through the consultant led service at Glangwili Hospital.

The majority of our patients being managed through these clinics are being done so virtually. 

MIU has continues to be provided at Prince Philip Hospital.

Elective  

Outpatient appointments are taking place at all venues as they were pre-COVID.

All referrals graded as urgent will be seen first before we address our routine waiting list. Every patient will be booked through the contact centre as per normal practice.

The digital platform, Attend Anywhere, is being used within upper limb clinics held at Glangwilli Hospital. This enables us to conduct virtual appointments using video technology, providing the opportunity to maximise engagement with our patients.

 

Treatments

Trauma management

Trauma surgery (priority 1) has continued to take place at Withybush, Bronglais and Glangwili Hospital's.

Glangwili General Hospital has been active as a Trauma Unit as part of the South Wales Trauma Network since September 2020. 

Elective

All patients awaiting surgery continue to be clinically prioritised according to the Royal College of Surgeon’s guidance. 

As you are aware, COVID-19 has impacted on our ability to treat elective orthopaedic patients and waiting lists have grown substantially as a result.

NHS bodies across Wales, including ourselves in Hywel Dda, are facing multiple challenges including the impact of staff leave, self-isolation, difficulties in discharging medically-fit patients, high emergency demand and an increase in COVID patients being admitted to hospitals. 

We are currently able to undertake limited inpatient and day case surgery at Bronglais hospital, Aberystwyth and day case surgery only at Withybush Hospital, Haverfordwest. Orthopaedic surgery at Prince Philip Hospital, Llanelli restarted on 14th March 2022 and we are constantly reviewing the ability to increase activity as the current sessions are lower than pre-COVID levels.

We are therefore mindful that additional resources are required to assist in address the backlog of patients waiting for surgery whose condition is likely to have deteriorated since being listed for surgery.  It is important that we address our waiting lists by treating patients in line with their clinical urgency and, in line with Royal College Guidance, Consultants have risk stratified patients on their waiting lists. The focus will be on addressing these risk stratified cohorts in order to ensure we are treating those with the complex needs first.

Due to restricted and intermittent surgical activity, the ability to reliably calculate a patients wait time for surgery is extremely difficult and, as patients are continually added to these waiting lists, predicted wait times change continually.  We therefore thank our patients for their patience and advise that should they experience any deterioration to their condition that they request a follow-up appointment with their consultant.

 

Future plans

Outpatients 

Retain full outpatient clinic allocation on all sites.

Explore what other opportunities are available to offer additional virtual appointments and support an increase in outpatient capacity.

Treatments 

Continual position reviews with the aim of increasing inpatient elective surgery across sites. This will only be feasible on the basis of low COVID levels, staffing and bed availability.

 

How to make contact

Please refer to your patient letter for contact details or contact the PALS team on telephone number: 0300 0200159 or email: hdhb.patientsupportservices@wales.nhs.uk

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