The document discusses the implementation of a Virtual Fracture Clinic (VFC) model at Brighton and Sussex University Hospitals NHS Trust (BSUH) as an alternative to the traditional new patient fracture clinic model. Some key issues with the traditional model included 45% of patients needing time off work for appointments and only 44% being discharged at their first appointment. The VFC aims to 1) bring treatment to patients' homes to improve experience, 2) ensure management decisions are made by orthopaedic consultants, 3) provide standardized evidence-based treatment, and 4) reduce outpatient appointments. The VFC evaluation found improvements in several areas compared to the traditional model.

1. Understanding Virtual Fracture Clinic's
James Gibbs Orthopaedic Consultant BSUH NHS Trust
Lucy Cassidy Advanced Practice Physiotherapist BSUH NHS Trust
Sophie Richardson Technical Sales Manager Microsoft

2. Think of a time before the
internet and Wifi… so pre 1991

3. Online shopping – Smart, interactive, constantly evolving to serve the
customer better
Buying car insurance – comparison sites, able to compare and contrast
multiple streams of information
The train line -
Examples of digital solutions
making life easier…
Private service providers
What do they all have in
Common?

4. Lets play spot the difference
in the NHS….
Despite vast leaps and bounds in the
development of technology the NHS is
still very slow to harness the efficiencies
of just the simplest technologies.
You get a letter for your
appointment that if you need to
change to make a phone call…

5. 1. Health and wellbeing gap – Prevention
2. The care and quality gap – ‘Unless we
Reshape care delivery
Harness technology
Drive down variations in quality and safety of care
then patients’ changing needs will go unmet, people will be harmed
who should have been cured, and unacceptable variations in
outcomes will persist.’
3. The funding and efficiency gap
NHS 5 year forward

6. Location: Brighton, England
Date: April 2nd 2013

7. 80+ steps or 3 lifts
Why
Change?
Waits of up to 90 minutes for hospital car
parking space

8. The question we considered
was….
Is the current, widely used model
for the new-patient fracture clinic
the most patient-focused, cost
effective, and evidence-based
model that can be used at BSUH
& Nationally?

9. Evaluation of traditional
practice
45% of patients required time off work to attend the clinic.
44% of patients were discharged on their first appointment.
We scored highly on:
– Patients feeling that they were listened to (89%)
– Results were explained (84%)
– Patients given an opportunity to ask questions (87%)
But only 44% were given any advice on exercises or what to do next.
Overall patient satisfaction was 76%.
Key: National, Organisational and Individual factors

10. Drivers for challenging
existing practice
National level:
• NHS deficit
• Right Information, Right Place, Right Time
• Reduced sickness
Organizational level:
• Waiting times for T&O follow-up
• Waiting time for OP physiotherapy
Wrong profession, wrong place, wrong time
Individual level:
• Inconsistent level of care
spectrum from fellow to
consultants
• Variation of treatment
management
• Over-imaging of patients?
• Unnecessary time off work to
attend clinics with no change
of management plan

11. 1. Improve patient experience by bringing first-line treatment to them in the comfort
of their own home.
2. Ensuring that all management decisions are made by an Orthopaedic Consultant
and that any follow-up care is under the correct specialist in the correct time
frame.
3. That all patients receive standardised, protocol-driven, evidence-based
treatment to ensure a high standard of care for all patients, which is shared with
their GP.
4. Reduce the number of outpatient appointments with a knock-on effect to
supporting services such as physio, imaging & admin.
Objectives set for the VFC
“Right Professional, Right Place, Right Time”

12. Location: Brighton, England
Date: 27th August 2013