Dr Claire Blandford, Consultant Anaesthetist, Torbay & South Devon NHS Foundation Trust 

Day case surgery continues to push boundaries and offer huge potential benefit for NHS trusts and patients. However, achieving total joint arthroplasty as a day case procedure is somewhat of a new frontier for many trusts - consequently there has been significant appetite for specific conferences addressing these principles. Following on from a series of well received conference dates in 2018/19, HCUK (Healthcare Conferences UK) partnered with BADS (British Association of Day Surgery) to offer two dates in Autumn 2020, this time utilising virtual platforms due to the limitations of the COVID pandemic.  

The days were specifically themed to allow maximal extractable relevance for delegates and aimed to provide a comprehensive review drawn from national experts and shared experience across several centres in the UK. Small group breakouts were included throughout both programmes, along with virtual networking opportunities and an online exhibition. We would also like to thank our sponsors for their contribution to these two events.  

Day case Major Knee Replacement (05.10.20) 

This conference included anterior cruciate ligament (ACL), uni-compartmental knee (UKR) and total knee replacement (TKR) themes. The conference was chaired by BADS council members and delivered via a Zoom facilitated platform. Dr Kim Russon (Consultant Anaesthetist - Rotherham and president of BADS) chaired the morning sessions.  The first speaker was Dr Mary Stocker (Consultant Anaesthetist - Torbay and immediate past president of BADS) who delivered a comprehensive session on optimising day case pathways and key elements of suitability & planning.  This was then followed by two centres giving insights into how they had successfully transitioned their services to facilitate day case joint arthroplasty: Rotherham NHS Foundation Trust and Torbay & South Devon NHS Foundation Trust.   

The Rotherham team, comprising Mr Alex Anderson (Consultant Orthopaedic Surgeon), Dr Kim Russon (Consultant Anaesthetist) & Ms Kayleigh Wright (Specialist Physiotherapist) presented their work on developing a default to day surgery process for ACLs and how this evolved to facilitate day case UKR surgery. They noted transitioning their discharge location from inpatient ward to dedicated day surgery unit improved their same day discharge rates. This session was then followed by the Torbay team of Dr Claire Blandford (Consultant Anaesthetist), Mr David Isaac & Mr Mike Kent (Consultant Orthopaedic Surgeons) who presented nine years of local experience in achieving day case ACLs and UKR surgery; progressing more recently to include successful day case total hip & knee arthroplasty (>90% same day discharge rates achieved.) The team presented the transformational process undertaken to achieve this and the precise details of their surgical and anaesthetic pathways.  

The afternoon session was chaired by Dr Mary Stocker. The first speaker was Dr David Johnston (Consultant Anaesthetist- Belfast) who covered analgesic aspects of knee arthroplasty surgery presenting various local anaesthetic techniques and multimodal strategies. This was followed by Dr Robbie Erskine (Consultant Anaesthetist – Derby) who described a ‘golden combination’ of ultra short-acting spinals with long lasting blocks to facilitate day case surgery. His talk provided a wealth of useful information and the principles he conveyed would also have application to other surgical procedures. We then heard from Dr Stocker again who’s afternoon session really highlighted the critical value of data- not only in uniting teams in shared ownership of outcomes but also as a driver for units to refine process and performance.  The final session of the afternoon was delivered by a surgeon/ anaesthetist team from Calderdale; Mr Graham Walsh (Consultant Orthopaedic Surgeon) & Dr Nisha Bhuskute (Consultant Anaesthetist). They presented their data, sharing impressive day case rates in TKR surgery and also showed how they utilise digital technology, including wearable tech directly linking discharged patients with hospital physio services to enhance patient experience.   

Perhaps you will join us for the next two meetings on 25th March (Knee) & 29th April (Hip) 2021?