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 Total Hip Replacement (04.11.21) 

One month later and we had further ascended the lower limb to reach the hip joint as the focus for the day’s presentations. The morning was chaired by Mr Ed Dunstan (Consultant Orthopaedic Surgeon – Fife & BADS council member) and the afternoon was chaired by Dr Mary Stocker; who also delivered the first talk of the morning reprising her well received & highly informative session on optimising day case pathways. The next speaker was Mr Hiren Divecha (Consultant Orthopaedic Surgeon – Wigan) who presented the pathway by which they as a team had undertaken their first day case total hip replacement (THR). This session also included a personal account from one of Mr Divecha’s first patients who wholeheartedly endorsed his experience and provided a true insight into the physical & psychological benefits of day surgery to patients. The final session of the morning shared the experience of a surgeon/ anaesthetist team from Torbay; Mr Mike Kent (Consultant Orthopaedic Surgeon) & Dr Claire Blandford (Consultant Anaesthetist). They presented their work on enhanced recovery pathways, how they designed and introduced a day case hip replacement pathway to their trust and the refinements to process undertaken since.  

The programme had a further 4 sessions in the afternoon. Mrs Hilary Young (Advanced Nurse Practitioner) presented the Northumberland experience. Long recognised as a high-volume centre with low lengths of stay she introduced a new patient education app they had developed and discussed ways that effective teamwork & messaging enables early confident discharge. Hilary specifically highlighted the critical importance of early mobilisation in breaking the cycle of poor mobility/↑pain/↑medication/↑side effects/↓mobility.  Dr Stocker also spoke in the afternoon delivering valuable advice on measurement and utilisation of data to achieve results.  We then heard from Mr Ed Dunstan who described ‘The Scottish Journey’ discussing how their pathways have evolved over time, championing positivity in the NHS and sharing the splendid patient feedback their pathway has generated.  His talk was complimented by Mr Steve Young’s session (Consultant Orthopaedic Surgeon – Warwick) who shared insights of development in their unit spanning 15 years+, raised consideration of how we define ‘failure’ and ‘success’ and proposed six key focal areas for delivering successful outcomes in this field.  

In summary these two days brought together experts and enthusiasts from across the United Kingdom to share ideas and learning. We heard from many centres who are all achieving excellent outcomes and whilst certainly there are some common core principles in achieving successful day case joint arthroplasty there is also much diversity of practice & ‘local bespoking’ too -  which does draw to mind the lyrics of an 80’s pop song (if you’ll forgive the bracketed inclusion) “it ain’t (just) what you do,  it’s the way that you do it”.   

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