The Mass Knee Clinic: a new NHS outpatient care model showing clinically led transformation in practice. Issue 1 (27th October 2020)

• Record Type: Journal Article
• Authors: Li, Lily; Nahas, Sam; Jandoo, Rajan; Williams, Sarah; Lionel Ganippa, Haddon Paul; Bhattacharya, Rajarshi; Nathwani, Dinesh
• Is Part Of: BMJ innovations. Volume 7:Issue 1(2021)
• Page Start: 117
• Page End: 122
• Publication Date: 2020-10-27
• Subjects: economics -- musculoskeletal -- orthopaedics; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjinnov-2019-000419
• Languages: English
• ISSNs: 2055-8074

Abstract

Abstract : Background: The Mass Knee Clinic is an innovative, patient-focused and efficient clinic introduced into our hospital in April 2017. The UK Government has mandated referral-to-treatment (RTT) time for patients to be within 18 weeks to improve patient care. The new clinic involves seeing high numbers of patients by amalgamating all new non-traumatic knee disorders (up to 200) from primary care into one clinic day every 6 weeks. The premise and success of the clinic is multifactorial and involves focused multidisciplinary consultant-led care in every case, training opportunities for junior doctors, a 'one-stop shop' for patients allowing them to be seen by a consultant, physiotherapist and receive a date for surgery all in 1 day, and subspeciality consultant presence, preventing multiple reattendances. Methods: We present the results of prospectively collected data on wait times to clinic, time-to-treatment and outsourcing of new referrals, 1 year after the initiation of the new clinic model (n=56). This data was compared with data 1 year prior to the Mass Clinic being introduced (n=56). Results: Time from primary care referral to first Orthopaedic review was reduced from median 13.5 weeks to 11 weeks (statistically significant (p=0.00512)). RTT was reduced from median 30.5 weeks to 15.5 weeks (p<0.01), allowing a significant reduction in waiting times for the patient. Outsourcing was eliminated, and the number of appointments per patient also halved. Conclusions: The new Mass Clinic with focused consultant-led care and multidisciplinary approach has led to significant reductions in patient wait times and cost savings for the hospital.