1. Orthopaedic Referrals Via Multi-Professional Triage Teams and ‘Polyclinics’ Mr Benedict Rogers MA MSc MRCGP FRCS(orth) The Fred Heatley Meeting 27 Feb 2008, Brighton

2. “ The days of the district general hospital seeking to provide all services to a high enough standard are over.” Sir Ara Darzi, Health Minister, The Guardian, 11 July 2007

5. Aim Evaluate consecutive referrals to a DGH lower limb orthopaedic clinic Direct from GP Via MPTT/Polyclinic

6. Methods

8. Comparative statistical analysis of the temporal differences between the two groups was performed using an ANOVA (SPSS 11.5) Patient Demographics Date GP Referred to MPTT clinic Date @ MPTT clinic Date @ Hospital Orthopaedic Clinic Reviewed @ MPTT by whom? GP/physio Patients perception of MPTT professional consultant/junior doctor/ GP/physio/nurse MPTT Clinic Diagnosis None made/Correct/Incorrect?

9. Results

10. 277 Patients Referred for lower limb orthopaedic opinion 132 patients Via MPTT clinic 145 patients Direct from GP 76 patients Seen by GPwSI 56 patients Seen by physiotherapist 277 new patient referrals Hospital orthopaedic clinic

11. MPTT patients wait 62.4 days longer (p<0.05) than patients referred directly from their GP P<0.05 P<0.05 Referral Time to Hospital Orthopaedic Clinic

12. Patient perception of role of healthcare professional at MPTT / ‘Polyclinic’ 84% incorrectly identified the healthcare professional conducting their consultation at the MPTT clinic.

13. Assessment of diagnoses made for the cohort of patients initially assessed at the MPTT/‘Polyclinic’ clinic Over 50 % had no diagnosis or the incorrect diagnosis

14. Discussion

22. Polyclinics to replace traditional doctors’ surgeries Simon Alford, The Sunday Times, 16 Feb 2008 Ignore GPs. Polyclinics are the future Cradle-to-grave healthcare is as realistic as Dr Finlay's Casebook. We need specialists David Aaronovitch, The Times, 19 Feb 2008 ‘ Waste’ warning on polyclinics ITN news 16 Feb 2008 GPs’ leader hits out at plans for Soviet-style ‘polyclinics’ Anushka Asthana, The Guardian, 17 Feb 2008 ‘ Super surgery’ plans condemned ‘ Polyclinics’ may threaten the patient base of hospitals BBC News 16 Feb 2008 B.Rogers MA MSc MRCGP MRCS FRCS(orth) N.Bradley FRCS (Orth)