Joint Working Pays Off – Telephone Consultations Reduce Need for Hospital Visits

Patients with hip and knee replacements are taking part in a trial at Forth Valley Royal Hospital which could avoid them having to travel to Larbert for face-to-face clinic appointments.

It involves local staff checking patients’ progress by telephone and, if there are no particular problems, asking them to attend a routine X-ray within the next three weeks at a time convenient to them. This could be at Forth Valley Royal Hospital or Stirling Community Hospital.

The new pilot service is already freeing up consultant time to see new and urgent cases and avoiding patients having to travel to hospital for clinic appointments.

Several hundred hip and knee replacements are carried out annually in NHS Forth Valley. Checks are made at one year, then at five yearly intervals until 15 years. After that patients normally receive undergo an annual assessment. The vast majority of joint replacements are now scheduled to last between 10 and 15 years, due to the type of materials used and advances in anaesthetics and placement techniques.

NHS Forth Valley Arthroplasty Nurse Mary McDermott said:  “We watch for signs of loosening and wear and tear. Once that happens we can work with patients to decide whether to revise or re-do the replacement joint. Checks always used to be carried out at face-to-face clinics but patients contacted so far by telephone like the idea. It means they don’t need to take time out to travel to hospital. They also appreciate the three week window for an X- ray appointment because it gives them a choice of when they can attend.”

Any patients who report problems or pain when contacted by phone are booked in for a face-to-face appointments as soon as possible and advised to have their X-ray before attending.

Staff are currently designing feedback forms to officially evaluate the benefits of the pilot service and, if successful, the approach could be rolled out to other clinics. The pilot is also contributing to a new Creating Capacity to Care Challenge which gives health and social care across Forth Valley the opportunity to make changes which will free up appointment time, create extra capacity and reduce pressure on frontline services.