Transcript Slide 1
Podiatric Surgery Mike Townson Background • • • • • • • • Previous commissioning interest Venue? Care UK – Walk in Centre Lower Limb Pathway Persistence Good data Good recruitment Integration Service • • • • November 2010 155 procedures 1 theatre session Lower limb assessment and follow up clinics What has happened • • • • Profile Consultant led Up skilling Integration Activity • 13 Surgical Procedures – Scarf & Akin – PIPJ Arthroplasty – Chielectomy – Amputation – Lapidus – Exostectomy • 8 Injection Therapy Orthopaedics Back log Injection midfood right Fusion ipj left 2nd toe Fusion left hallux ? Removal of screws right hallux Bilateral scarf/akin Removal of toenail left hallux TMTJ right fusion foot Wedge excision nail bed left little toe Orif non-union left metatarsal Open debridement right talus Scarf/akin left hallux Excision MT head right 2nd toe Lapidus right hallux Excision right foot ganglion Scarf/akin left hallux Arthroscopic ankle fusion left HRG Code HRG Desc Primary OPCS Procedure Desc Age LOS INTERMEDIATE FOOT PROCEDURES FOR NON -TRAUMA CATEGORY 1 WITH CC 62 6 FUSION OF FIRST METATARSOPHALANGEAL JOINT NEC HB33B INTERMEDIATE FOOT PROCEDURES FOR NON -TRAUMA CATEGORY 1 WITH CC 67 3 FUSION OF FIRST METATARSOPHALANGEAL JOINT NEC HB32Z INTERMEDIATE FOOT PROCEDURES FOR NON -TRAUMA CATEGORY 2 69 2 PRIMARY ARTHRODESIS AND INTERNAL FIXATION OF JOINT NEC HB32Z INTERMEDIATE FOOT PROCEDURES FOR NON -TRAUMA CATEGORY 2 75 0 CUNEIFORM OSTEOTOMY PROX.PHALANX RESECT.HEAD FIRST METATARSA HA31C MAJOR FOOT PROCEDURES FOR TRAUMA WITHOUT CC 33 2 PRIMARY OPEN REDUCT/FRACTURE/LONG BONE/EXTRAMED/FIX USING PL HB32Z INTERMEDIATE FOOT PROCEDURES FOR NON -TRAUMA CATEGORY 2 61 1 PRIMARY ARTHRODESIS AND EXTERNAL FIXATION OF JOINT NEC HB33B GP Governance • • • • • • • Medical Director Vascular Professor Medicines Committee Strong process Quality documentation Transparent audit Evidence of team training Where next? • • • • • All foot surgery has no value!? Whole time post Develop team Change pathway Links to other services/pathways