Carpal Tunnel Report

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Telephone: 01900 233170
Care closer to home

Specialist services in minor surgery, dermatology and ophthalmology provided in a community setting

Cumbria Medical Services

Community Based Carpal Tunnel Service

Service Quality Performance Report

April 2016 – March 2017

The service is provided by Dr Martin White, GPwER in minor surgery, who is mentored and supported by John Harrison, Consultant Orthopaedic Surgeon. The service is provided from Maryport Community Hospital, London Road Community Clinic, Carlisle, Captain French Surgery and Keswick Hospital.

The service is bookable via Choose and Book after a referral from the patients GP surgery.
Referrals to the service must meet the following evidence based criteria;

• Symptoms are severe and functional ability reduced
• Conservative measures such as the use of night splints, physio and injection have failed
• Positive nerve conduction studies
• Uncertain diagnosis

The average waiting time from referral to assessment is 4 weeks
Patients are sent a comprehensive patient information leaflet on the procedure and directed to our website for further information.
All patients were assessed and treated within 18 weeks of referral.

Activity

543 patients were seen by the service between April and March 2017.

55% went on to have carpal tunnel decompression under local anaesthetic performed by Dr Martin White.

59 patients were referred for nerve conduction studies.

299 minor hand procedures have been carried out from April – March 2017.

 ctchart.jpg

Following an assessment by Dr White, a further 244 of referred patients did not go on to have a CT release performed. These patients were treated as follows:

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Complications

13 post-operative infections were reported via the feedback form, which required antibiotics. As we do not see the patients in clinic unless they request a FUP it is unclear whether these patients have had a true infection or whether it has been confused with post-operative swelling and inflammation and given antibiotics unnecessarily.

However, to keep the post op infection rate low the following changes have been made;

1) When sutures are cut after tying the knot, ensure they are completely flush thus preventing a small amount of suture sitting proud of the wound which might act as a portal for infection
2) Use a mepore dressing to cover the wound and advise patient to keep it covered.
3) Ensure all connecting doors in the theatre are closed and ventilation on.

An audit will be carried out on 100 consecutive patients who will be followed up in clinic to check the wound for infection.

Patient Satisfaction

All patients are given the opportunity to feedback on the service with 98% saying they would recommend the service to their family and friends.

100% of patients are forwarded a patient survey 16 weeks post-op questioning them on a range of subjects including the booking arrangements, scar satisfaction, effectiveness of local anaesthetic, clinic facilities, doctor and nurse manner, and overall satisfaction.

150 responses to date with 86% rating the service excellent, 10% good and 4% satisfactory.

Patients are also given the opportunity to feedback on ‘iwantgreatcare’ and via our website www.cumbriamedicalservices.co.uk

Patient comments include

April – September 2016

  • Would recommend the surgery rather than continue with the pain as the surgery works - very happy with treatment and procedure.
  • First class operation. Physio from Sunderland said it was one of the neatest operation sites she has seen. Thanks.
  • I am very impressed with the completed operation. My sister had the same help with carpal tunnel; her experience was very different to mine. Well done and thank you.
  • Being able to park without going around in circles. Appointments on time, not much waiting around to be seen. I would come back to have my other hand done as soon as it gets worse.
  • Very good and local to me which is important and fast, not much waiting for appointments and actual op was quick also. Thanks.
  • The operation was fine, lovely staff made me feel at ease. I followed aftercare instructions and am now completely healed and cured and pain free. Highly recommended.
  • I couldn't believe that the symptoms I had (extreme pain, numbness, pins & needles) have almost entirely gone thanks to this carpal tunnel surgery. I really thought that at the age of 71 I was going to have to suffer the rest of my life. I am very grateful that I had this surgery.
  • It is excellent to have these services in local outposts around the area, more convenient and more personal.
  • I was very satisfied after having the treatment. I am able to sleep comfortably and suffer no pins and needles or aches at all.
  • I'm happy everything went okay. I'm just left with a little numbess at the tip of my middle finger.
  • I was very pleased with the confident cheerfulness of both Dr White and his assistant and also that the operation could be done in Kendal. I know that the hand will take time to recover fully which I am expecting following the initial consultation.
  • The service and op were excellent. I had a good experience; I would not put anybody off having the treatment. Thank you.
  • The whole procedure was carried out professionally and all in all not a bad experience. Thank you to Dr White and his team.
  • It's just nice to be able to sleep at night pain free. Thank you.
  • The service was great, I only hope when I have my left hand done I can go to the same place with Dr Martin White doing the procedure.

October 2016 – March 2017 

  • I would honestly recommend this treatment to anyone needing it! My brother is now on the waiting list! The clinic at Maryport Hospital where I had the procedure was brilliant - I was actually out of the clinic in about 20/25 mins. Couldn't believe how quick it was.
  • I can't find fault with any of the treatment I received. I don't think you could improve it in any way. I thought it was very good.
  • I had excellent care and attention shown throughout.
  • Wonderful, the doctors and staff were absolutely brilliant.
  • All staff were lovely, I was made to feel at ease. It was quick and the staff were very professional.
  • The operation has been a complete success and I am very pleased I had it done.
  • Service was very good, better than I thought it would be. Would recommend this operation to everyone.
  • Dr White, very informative and considerate. Nursing staff, excellent.
  • The treatment was first class, there was no waiting around as I was seen at my appointment time. All staff were friendly and asked numerous times if I was okay.
  • Service was excellent. Put at ease about everything.
  • As soon as I arrived at the clinic I was dealt with superbly, everything was explained to me clearly.  The staff as a whole were excellent, the operation was fine.  A very friendly and professional team.
  • Very happy with the clinic, surgeon explained everything he was going to do and one of the nurses she talked to me all the way through.  She was really lovely, so was all the clinic staff - thank you.
  • Fast efficient, very good.
  • This service was excellent. The outcome is much better than expected and the scar evidence is almost invisible. Finally the finger articulation is almost completely back to normal with the underlying internal scar tissue continuing to recede. This is all just great. Many many thanks.
  • The doctor and nurses and admin staff were all fantastic.  It was good to be able to have the operation closer to home than having to travel over an hour to Carlisle.  Any questions I had were answered promptly.  I telephoned with a concern after I had my right hand done and was called back within 5 minutes with answers and reassurance that all was well.  My carpal tunnel was very debilitating and although the recovery is quite a long time it has resolved the issues in both hands and was definitely worth having it done.  I have nothing but praise for all concerned in my care and treatment.
  • Dr White and his team couldn't have been nicer. Would have had this procedure done sooner had I been aware of the carpal tunnel service. Really no need for hospital stay - waste of time, money and resources. Scar is healing nicely and hand function back to normal. Only slight discomfort when using garden shears - but this is only to be expected. Thanks to Dr White and his team.
  • Absolutely wonderful treatment from brilliant NHS staff.  I would be happy to pay more tax to support the superb NHS - the 8th wonder of my world!