Event Resources – Musculoskeletal Programme Area: Project Updates

This event took place at Durham County Cricket Club in Chester-Le-Street on Tuesday 15th September 2015. Please find below the speakers and presentations from the day:


Spreading the use of high dose antibiotic cement to prevent infection following surgery for hip fracture

Mike Reed, Northumbria Healthcare NHS Foundation Trust

Surgical site infection after hip fracture repair is a disabling and costly problem affecting about 4% of patients. AHSN NENC have helped fund this project to encourage clinicians and Trusts to use a high dose dual antibiotic cement (a minor modification to the existing hip surgery procedure). A trial of this procedure has shown that it reduces infection rates in hip replacement patients by more than 50%. With 1535 hip repair surgeries per year in the region, this represents a potential cost saving to local Trusts of more than £530,000.

Back Pain Pathway

Helen Ridley /Charles Greenough, South Tees Hospitals NHS Foundation Trust

Lower back pain is the largest single cause of disability in the UK. Currently, a significant majority of patients end up in secondary care having expensive tests and treatments that are potentially unnecessary. The Back Pain Pathway project introduces a simplified and standardised treatment pathway for back pain. Staff are trained to “demedicalise” simple back pain and “red flag” serious pathology. Simple cases can then be treated appropriately in a primary care setting and severe cases quickly escalated to secondary care. This will result in a better patient service and fewer delays. It will also eliminate ineffective investigations and reduce referrals for fusion surgery.

Patient Safety Collaborative falls prevention project

Rachel Carter, The Newcastle upon Tyne Hospitals NHS Foundation Trust

Falls are the most commonly reported patient safety incident in NHS Trusts in England. 5% of falls at home result in fractures. Overall, falls cost the NHS more than £2.3 billion per year. The Royal College of Physicians (RCP) FallSafe Care Bundle is a set of guidelines for preventing falls in hospitals. This project aims to embed the RCP FallSafe Care bundle within 3 regional trusts: Newcastle, South Tees and County Durham and Darlington. The protocol should reduce falls on each participating ward by 20%. For NuTH a 20% reduction in hip fractures alone would equate to a saving of £40,000 in surgical costs.

“Falls are preventable not inevitable”

Hip fracture and fragility fracture prevention

Emily Hadaway and Jill Mitchell, Hadrian Primary Care Alliance Limited

The Hadrian Primary Care Alliance (HPCA) is a co-operative corporate venture of 13 GP practices. All HPCA Practices are research active and as a collaborative group can conduct research that will have a bigger impact on patients. This project aimed to identify patients at high risk of fragility fractures and intervene as early as possible with preventative measures. 5889 patient assessments took place and 1467 therapy Interventions occurred (e.g. Medication initiation, medication change/optimisation, patient education, information and compliance advice). This was estimated to save around £260,184 on hip fracture costs and identified 299 new patients for QOF registers. The process is also highly transferrable to other conditions such as COPD and Asthma.

AHSN NENC Fractures Programme

Jill Mitchell, AHSN NENC Falls and Fractures Programme Lead

Jill Mitchell, the Programme Lead for the Falls and Fractures Programme at the Academic Health Science Network (North East and North Cumbria) gave an overview of progress to date. As evidenced by the previous presentations, the current project work in the programme aims to disseminate best practice in the prevention and management of fractures and falls. The programme aims to identify gaps and opportunities to improve population health outcomes in the region and create an environment for learning and in which findings can be disseminated throughout the other AHSN regions.