1. South East London NHS Orthopaedic Services
Ideas for making orthopaedic services better

2. Orthopaedic Orthopaedic means parts of your body like your Bones
Joints
Ligaments
Tendons
Muscles
Nerves.
It is about how your body moves.

3. Good orthopaedic services
We want to make orthopaedic services better for everyone in south east London.
We have some ideas about how to do this.
We want to know what you think.
If we decide to make big changes we will ask everyone what they think. This is called a public consultation.

4. Helping us decide what to do
We talked to
Patients and the public
Doctors, nurses, other healthcare staff and health commissioners
Orthopaedic surgeons and other people from south east London hospitals
Social care staff from local authorities
Healthwatch and other groups in the community

5. Planned operations
There are 7 hospitals in south east London that do orthopaedic operations where patients need to stay in hospital overnight.
Some surgeons have more experience than others of different types of orthopaedic surgery.
Routine operations – operations like hip and knee replacements. The hospitals do lots of these. All the surgeons in the different hospitals do these operations in a similar way.
Complex operations – these are more difficult operations, like ankle replacements. Surgeons might do complex operations in different ways and are likely to do these less often.

6. Why we need changes
People are living longer so a lot more people will need orthopaedic surgery.
Some patients are waiting a long time for their appointment.
If there is an emergency (like a car crash), orthopaedic surgery might be cancelled to carry out emergency surgery.

7. Why we need changes
We need to use the money we have for orthopaedic services in the best way we can.
We want to make sure patients that have orthopaedic surgery heal well and get better as quickly as they can.
We want all patients to get the same standard of care and surgery.

8. Having 2 orthopaedic centres
We want to compare how things are now with our idea of having 2 centres for planned orthopaedic operations. We think having 2 centres to do all planned orthopaedic operations will work best. These centres would be a part of hospitals that are already there. We think this will make orthopaedic services better for everyone.

9. What this means Having 2 planned centres means
More operations so people don’t have to wait so long.
Fewer operations being cancelled because the centres will only do planned operations.
Better infection control so people get well as quickly as they can.
Patients will be well looked after before and after their operation by expert staff
Operations will cost less and make better use of the money.

10. What might change
It is only the operation that would happen at 1 of the centres.
Patients will be able to go to the hospital nearest to them for anything they need before and after surgery.
For example:
Appointments before surgery.
Surgery that is completed in one day and does not need a patient to stay in over night.
Follow up appointments after surgery.
Emergency orthopaedic surgery will still be done in A and E.

11. There are 4 hospitals who want to provide these services
There are 4 hospitals who want to provide these services. If we go forward we will need to choose 2 of them, after a consultation.
Guy’s Hospital
University Hospital Lewisham
Queen Mary’s, Sidcup
Orpington Hospital

12. Choices for 2 orthopaedic centres
Choice 1
Guy’s Hospital and
University Hospital Lewisham
Choice 2
Orpington Hospital
Choice 3
Queen Mary’s, Sidcup
Choice 4
University Hospital Lewisham and Orpington Hospital
Choice 5
University Hospital Lewisham and Queen Mary’s, Sidcup
Choice 6
Orpington Hospital and
Queen Mary’s, Sidcup

13. How we will choose
A group will look at all the information. They will decide which choices out of the 6 work well. They will also decide which choices will not work well.
The group will be made up of
GPs
NHS commissioners – these are the people who decide what NHS services are needed and how much they will cost
People from patient groups
People who are experts.

14. Committee in Common
The group will look at all the choices. They will tell a committee of senior GPs and managers from the 6 NHS areas in south east London and a group of patients. This committee is called the Committee in Common. The Committee in Common then decide which choices to ask the public about in the public consultation.

15. Asking the public
After the Committee in Common make the final choices there will be a public consultation.
This is when everyone who lives in south east London has the chance to say
If they think having 2 orthopaedic centres are a good idea.
Which 2 hospitals should become the orthopaedic centres.

16. What happens after the public consultation
If we decide to have 2 orthopaedic centres it might take several years to do this.
There will be more information about what happens next after the public consultation.

17. Telling us what you think
Nothing has been decided yet.
We want to know what you think of the ideas so far.
We also want to know how you would like to take part in the public consultation.
You can tell us what you think in these ways
Online: ourhealthiersel.nhs.uk
In writing: Our Healthier South East London, PO BOX 64529, London SE1P 5LX or On

18. Some questions for you
Do you think the changes we want to make will make a difference to the people you care for? This might be in a good or a bad way – please tell us more.
If the changes are bad, is there anything that we can do to make things better?
If there changes are good, is there anything we can do to make things even better?
Is there anything else we haven’t thought about that would make orthopaedic surgery better?

19. Public consultation
How would you like to take part in the public consultation?
Do you or anyone you care for need extra information to take part?
What information and formats would you find most useful and how should we make this information available?
How would you like to feedback to us?
Are there any other questions we should be asking?
Do you understand how the changes we want to make fit into our work called ‘Our Healthier South East London’?
Do you want to tell us anything else?