Information for referrers
In 2019, North London Partners in health and care worked with providers of elective orthopaedic care in north central London, to design a new model of care. The overall aim, which draws on international evidence, was to reduce waiting times and minimise cancellations by the creation of elective orthopaedic centres which separated planned and emergency care.
Proposals for this new model were subject to a public consultation, which ran from January – April 2020. A final decision, which approved the proposals, was made in September 2020. The new model of care will come into effect from April 2021.
North Central London Elective Orthopaedic Network offers excellence in orthopaedic care, research and education.
It is provided by North Middlesex University Hospital NHS Trust, Royal Free London NHS Foundation Trust, Royal National Orthopaedic Hospital NHS Trust, University College London Hospitals NHS Foundation Trust and Whittington Health NHS Trust.
The Network has been created to improve the care offered to patients. It is based on partnership working between hospital trusts.
Working together in this way means patients can receive timely, high-quality care. Clinicians from across hospitals will work together as a single team, have joint training and education, and hospitals can share their facilities, opening up access to more dedicated beds and operating theatres.
There are two partnerships for planned orthopaedic care that patients can choose from:
- University College London Hospitals working with Whittington Health
- Royal Free London (Barnet Hospital, Chase Farm Hospital, Royal Free Hospital) working with North Middlesex University Hospital
- Outpatient appointments could take place at University College Hospital or The Whittington Hospital.
- Day surgery could take place at University College HospitalGrafton Way Building or The Whittington Hospital
- Inpatient surgery will take place at University College Hospital Grafton Way Building
- Outpatient appointments could take place at Barnet Hospital, Chase Farm Hospital, Edgware Community Hospital, Finchley Memorial Hospital, North Middlesex University Hospital or the Royal Free Hospital.
- Day surgery could take place at Chase Farm Hospital or North Middlesex University Hospital
- Inpatient surgery will take place at Chase Farm Hospital
Royal National Orthopaedic Hospital is part of the NCL Elective Orthopaedic Service and will take referrals for complex orthopaedic care.
Patients will choose between the two partnerships and will receive the same high-quality care wherever they go. They will continue to have the choice of out-of-area and private providers.
Royal National Orthopaedic Hospital (RNOH) will take referrals for complex orthopaedic care,including revision surgery. RNOH also receives referrals for spinal operating and children. If referrers are unsure if a referral is appropriate, advice and guidance on eRS can be used for any questions.
All patients receive:
- Improved education classes (joint school) to help them understand their operation and what to do to support their recovery
- Appointments with a named surgeon and their surgical team, who would stay with them throughout their care, regardless of where it takes place
- Rehabilitation support after their surgery
- Access to high dependency or intensive care units if they need additional care after their surgery
- Support from care coordinators if they have conditions such as dementia or a learning disability to help them understand their care and where it might take place
More complex pathways of care
- More complex surgery continues at the Royal National Orthopaedic Hospital. This is a specialist tertiary centre and key member of the network, working with all of the partners to deliver to specialist care across north central London. Referrers can use advice and guidance on ERS to determine if particular cases meet referral criteria for this hospital.
- Patients with other complex medical conditions, such as haemophilia, will have their surgery at the hospital which specialises in their condition
When making a referral to the service
- Where appropriate, please explain the model clearly and the implications of a patient's choice for the location of their outpatient appointment and potential surgery
- Direct them to the information for patients on this website, including the patient choice film
- If a patient expresses a preference, please note this on the referral
Considerations when making a referral
- Would a patient benefit from the support of a care coordinator - support for those with dementia, learning disabilities, anxiety or other health conditions that might affect their experience of care.
- Does the patient need information about travel, transport etc to aid their decision?
- Is there a clinical reason that they should go to a specific hospital?