1. Highland Orthopaedic and Trauma (ACCESS) Optimising use of Trauma and Elective capacity Piers Renshaw Raigmore

2. Raigmore: 11 consultants, 8 on call 5 trainees from Dundee and Aberdeen 2 SD and 1 GPST Subspecialities Shoulder Foot and Ankle Spine Hands Paeds Revision Large geographical area with fluctuating population Large peripheral commitment @300 hip fractures per annum @800 arthroplasties per annum Consume our elective smoke in future ?

3. Clinicians: Triaging letters 1 consultant 1 session Urgents to on call surgeon ‘Only those needing surgical opinion’ Booking procedures Ortho administrator PFB Returns by need Virtual #/Arthroplasty clinics Flex IP/OP In over job plan activity (informed by DCAQ) Fill IP/OP avoid DNAs

4. Beds: Two wards Trauma 30 beds Elective 28 beds LOS ERAS Hip fracture nurse Minor trauma home while waits Geography Pre planning in periphery Care elsewhere Remote non operative care Repatriation

5. Theatres: One all day trauma list (recently converted from split El/Tr) One half day trauma list Sat and Sun Two all day Elective lists at present (Longstanding plus Vanguard) Planned theatre refurbishment includes two Elective theatres plus trauma theatre Session usage Monthly partners meeting Start times/surgical briefs Number of cases Full day lists Anaesthetic/surgeon issues Scheduler !?

6. Other locations: Periphery (clinics why not operating) Belford, Fort William Caithness General hospital Golspie Broadford, Skye Off site but in Inverness Advantages Beds protected Teams protected Ring fenced Disadvantages Sick patients Less flexible if increased trauma load

7. THANKYOU