PathwaysPathways

Sarah RodriguesSarah Rodrigues

MSK CATS Team Lead MSK CATS Team Lead (Watford/Dacorum)(Watford/Dacorum)

Virtual Foot/ankle pathwayVirtual Foot/ankle pathway

Discharged

Pre-op and surgery(pt meets the consultant)

Seen by Podiatrist or discharged

Podiatrist to contact GP andpatient w ith outcome

Virtual clinicD iscussion w ith consultant

Assessed and treated by Podiatrist Orthopaedics Referred to Foot health

MSK CATS Screen referral

Referral from GP

Virtual Podiatry clinicVirtual Podiatry clinic

Expected outcomes include: •Small reduction in ‘new’ appointments at the Acute Trust•Refined pathway for patients requiring referral for surgery attending Community podiatry clinic •Improved communication between Community and Acute Trust clinicians•Reduction in need for patient to attend multiple outpatient appointments Outcomes measured by: •Numbers of patients booked directly to surgery (Local data collection)•Reduction in numbers of new appointments at the Trust (may be difficult to to ascertain as numbers are relatively small)•Patient satisfaction questionnaires •Staff satisfaction questionnaires

Benefits to patientsBenefits to patients

Improved access to patient careImproved access to patient care Refined pathwayRefined pathway Reduction of out patient appointmentsReduction of out patient appointments Rapid assessment and resulting treatmentRapid assessment and resulting treatment One stop shop serviceOne stop shop service Seen by the most appropriate clinicianSeen by the most appropriate clinician Safe service: MDT approach with consultant Safe service: MDT approach with consultant

expertise.expertise.

Other BenefitsOther Benefits

Benefits to Clinicians/Staff Opportunity for ESP (Podiatry) to develop their skills in MSK Surgical referralsImproved integration between servicesIncreasing effective use of Community Consultations Benefits to PCT Reduction in referrals to Acute Trusts outpatients Increased efficiency within Community Care settingsReduction in unnecessary investigations

Conditions include:Conditions include:

          Hallux Valgus         Morton’s neuroma         Haglund’s deformity         Achilles Tendonopathy         Tarsal Coalition         Os Trigonum syndrome         Tibialis Posterior Tendon Dysfunction         Osteoarthritis/exostoses         Ganglion         Footballers Ankle         Chronic/repeated ankle sprains         Peroneal Tendon Subluxation Syndrome 

Costs and savings

Consultant *

1 PA per month £300 per PA (4 hours)

Includes 5% on-costs 3780.00  

 ESP Podiatrist (Virtual Clinic) 

4 hours per month @ £35.91 per hour (clinical) 1 hour per month @£35.91 per hour (administration)  

Including 10% on-costs

1896.05 

  Including 10% on-costs

474.01  

   

Additional Admin 1.5 hour per month (Point 17) @11.74 per hour

Including 10% on-costs

232.41

Prescribing Nil 00

Project resources Within current teams 00

Estates Nil 00

Total Costs   6382.47 

 

Savings    

Outpatient savings 120 New Appointments @ £174.27 (includes MFF) 

20912.40   

Total Savings Savings minus total costs 14529.93

Part Year Effect Savings (6m)

  7264.97

Future plans/ideas.Future plans/ideas.

Pain pathwayPain pathway CTS out come measureCTS out come measure CTS researchCTS research ?Virtual Shoulder clinic?Virtual Shoulder clinic ?Ultrasound guided injection clinics?Ultrasound guided injection clinics Name change! CROPSName change! CROPS