Scotland Surgical Services Transition: August Update

August 25, 2017

Further to the last communication in July, NHS National Services Division is sending out another update to keep everyone in the loop around the transition to a single surgical service in Scotland.

“Whilst ensuring that patients receive their surgery and care on time has been the priority, work also continued to introduce the new service model by the end of June 2017. To date, it has not been possible to fully implement the plan and the reason for this are identified below. A Transition Oversight Group (TOG) involving NSD, NHSGG&C, NHS Lothian, Cleft Care Scotland and the Cleft Lip & Palate Association (CLAPA) has overseen the transition to the new service.”

“NSD has therefore reviewed progress against the implementation plan and made the following findings:

Theatre capacity for cleft surgery is in place for the new service.
Provisional job plans are in place for discussion with all three surgeons.
An annual timetable has been prepared for the surgeons to attend clinic and ensure local outreach cleft clinics are provided as agreed.
The infrastructure required for a national multidisciplinary team meeting to discuss patients’ needs at the appropriate time in their surgical journey is in place.
A Care Pathway for Clinical Psychology Service is also in place and a referral form has been agreed.
The new cleft surgery service will participate in the UK wide cleft care audit organised by Cleft Registry and Audit Network (CRANE) going forward. This will ensure independent scrutiny of the team’s surgical outcomes.
Patient satisfaction questionnaires to capture patients’ experience have been developed, so the service can identify where it can improve.

However, NSD’s review also found that there had been significant barriers to implementing the plan in full. For example, due to only having 2 out of 3 surgeons available, the proposed trial of the new service from December 2016 to end of June 2017 could not take place. Many of the Cabinet Secretary’s conditions that accompany the move towards the new service could not be taken forward as a result.”

“While some of the plans have been delayed, the infrastructure for the single cleft surgical service on one site is in place, but it will only be fully established when three surgeons are operating at full capacity and the surgeons’ job planning and service provision plans can be fully agreed between them. Once this is achieved NSD will provide a further evaluation of the new service in 6 months’ time to allow time for the service to be established and embedded. Thereafter, evaluation of the service will move to an annual performance review in line with all other national services. It is anticipated that once fully up and running the new service can deliver a stronger and better service for all cleft patients in Scotland, irrespective of where they live.”

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