COMMUNITY-BASED ORTHOPAEDIC FOLLOW-UP: IS IT WHAT DOCTORS AND PATIENTS WANT?

Abstract

Our objective was to investigate how patients, general practitioners (GPs) and orthopaedic trainees, feel about the proposed governmental changes to reduce orthopaedic outpatient clinics by having GPs and specialist nurses follow-up post operative orthopaedics patients in the community. This was a cross-sectional questionnaire study of Teaching hospital and general practitioners in the Norfolk primary care trust.

Of 73 orthopaedic post-operative patients who attended outpatients over a one week period in July 2007, all responded. Of 250 General Practitioners, 239 responded. Of 38 orthopaedic trainees at the level of SHO (post MRCS) and SpR’s (Eastern deanery rotation and Pott rotation) 30 responded. Main outcome measures: opinions of GPs, Surgical trainees and Patients regarding proposed changes to outpatient orthopaedic clinics.

Of the patients 56 of 73 (77%) felt the surgeon was best suited to manage them post-operatively. Of these 47 felt that it was very important that the surgical team saw them post-operatively. Also 53 felt that their GP did not have sufficient knowledge and experience to adequately deal with their current orthopaedic problem. General Practitioners: Only 12 of 239 (5%) felt very confident assessing post-operative patients. Inadequate resources available to diagnose and treat post-operative complications was noted by 74% as the reason for not performing follow-up in primary care, and only 18% felt they should follow up post-operative patients. Trainees: All felt that following up their own post-operative patients was important to their training.

Most patients, GPs, and orthopaedic trainees had serious doubts about proposed governmental changes to reduce orthopaedic outpatient clinics by having GPs and specialist nurses follow-up post operative orthopaedics patients in the community.