Hernia Report

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

Cumbria Medical Services

Community based Hernia Repair Service

Service Quality Performance Report

April 2017 – March 2018


Introduction

A community based Hernia Repair Service is delivered by Dr Martin White, GPwSI in minor surgery, who is mentored and supported by Mr Sam Dresner, Consultant General and Gastrointestinal Surgeon at James Cook Hospital, Middlesbrough.

The service is provided from London Road Community Clinic, Carlisle and Maryport Community Hospital.

Initial assessment appointments are also offered from Captain French Surgery, Kendal

The service is indirectly bookable via Choose and Book.

Activity

  • 363 Patients were seen by the service from April to March 2018 inclusive.
  • 204 Patients had hernia repair carried out under local anaesthetic.
  • 159 Patients were assessed and either discharged or referred onto the Acute for GA surgery.
  • 84   Patients had a range of co morbidities including ischaemic heart disease, atrial fibrillation, chronic obstructive pulmonary disease, diabetes and obesity

The average waiting time from referral to assessment is 4 weeks

All patients were assessed and treated within 18 weeks of referral. All patients are sent a comprehensive patient information leaflet on the operation and directed to our website for further information.

A breakdown of the appointments provided is shown in the table below:

hernia activity 2018

Following an initial assessment by Dr White:
43    Patients were referred on to secondary care for surgery under general anaesthetic
1      Patient sent for ultrasound
115 Patients were discharged back to their GP

Reasons for discharge ranged from asymptomatic, benign divarication of recti and epididymitis.

Post-operative complications

Following their procedure all patients are followed-up the next day by telephone, and all offered a review in clinic 6 weeks later.

  • 5 Patients recorded as having a post-operative infection requiring antibiotics
  • 1 Patient had a haematoma and was seen in A&E
  • 8 patients reported still having some discomfort 8 weeks post operatively and all offered reviews.

Patient Satisfaction

100% of patients are forwarded a survey 6 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.

  • 148 Questionnaires have been returned to date with 99 % saying they would be extremely likely to recommend the service to their family and friends.
  • 1 Patient found the experience unsatisfactory but did not wish to attend for a review.
  • 94% patients rated the service as excellent
  • 5% patients rated the service as good
  • 1% patients rated the service as satisfactory
  • 100% of patients said the nursing and medical staff did all they could to make them feel as relaxed and comfortable as possible during their stay
  • 98% of patients said the doctor listened and treated them in a manner they appreciated, and explained the problem and treatment to their satisfaction.
  • 98% of patients indicated that the care instructions given after their operation to take home was explained to their satisfaction.
  • 96% of patients said the painkillers provided after surgery were satisfactory.
  • 98%of patients said the found it useful that the doctor telephoned them the following day
  • 94% of patients reported they had no complications following their surgery
  • 100% of patients were satisfied with the clinic facilities

Patient comments

April – September 2017

  • Thank you Dr White and the other surgeon too. I was about to write to you to say the operation went well. I am able to do most things I could do before the hernia. Swelling's gone. I'm glad I got it done by you and the other surgeon. Thank you very much to you and the staff for being very kind to me. God bless you all.
  • Dr White and his team made the procedure comfortable and it was carried out in a professional manner. The doctors and attending nurses were friendly and cheery making the whole exercise relaxed.
  • This team in Cumbria is unbelievably efficient. After seeing my GP I had an appointment at a clinic in my town the following week and a date for surgery about one month after that. As I was able to take the local anaesthetic option, disruption to normal life was minimal. I have had a lot of excellent care from the NHS over the years, but every step of this treatment pathway was exceptional and I would recommend the team to anyone
  • From the minute the operation started everything was full of conversation from start to finish which kept things pleasant. It took your mind off what was actually happening. Thank you very much.
  • Excellent staff, from initial consultation in Carlisle to the nurses and staff at Maryport. Had slight pain 4 weeks after surgery, rang clinic and Dr White made time in his day to see me and put my mind at rest. Thank you all.
  • I did have some pain when returning to cycling after 6 weeks. Dr White rang me and gave me reassurance that this was part of the healing process and gave me advice on how to proceed. All in all I do not see how this service could be improved. I particularly liked the straightforward professionalism and friendliness of the whole team.
  • It was certainly a different experience; the care during and after was very good and professional. It is a service I would certainly use again. Thanks to all of you.
  • The whole procedure, from first visit to my GP to the operation itself, was accomplished in about 7 weeks - an outstanding achievement for a procedure which gets a lot of bad press in relation to waiting times. I was put at ease by the facilities and staff at Maryport. Everything was personal and convenient. I felt those involved were focussed on me and my condition - even when they had a pretty full list for the day.
  • The treatment I received was first class by all the staff. I was kept at ease throughout the operation; it all went ahead very quickly and I was looked after with a cup of tea and a biscuit by the nurse afterwards. Thanks to all the staff involved, please convey this to Dr White and his team.
  • Pleasant experience throughout. Staff were excellent. 8:30am-9:40am- wow. Treated me like an old friend. Why can't more NHS procedures be like this? 10 out of 10. Thank you for improving my life.

October 2017 – March 2018

  • The doctors and nurses were first class. Thank you.
  • Very good service. Explained in detail at all stages. Local anaesthetic needed to be re-applied during the procedure several times but not an uncomfortable experience. Dr White and his colleague were excellent.
  • Excellent, courteous service, operation by clearly very experienced surgeons. Couldn't have asked for better service. Thanks again.
  • The whole procedure was excellent. Staff were friendly and helpful and went out of their way to put me at ease during the surgery.
  • Very professional, extremely caring - a very high standard set.
  • I received great service from start to finish. The short timescales from my initial consultation with my GP to having the operation was really impressive. Dr White and his team at Maryport went about the procedure in a professional and friendly manner which helped to put me at ease.
  • Very impressed with the service provided. I experienced no pain following my operation and no serious discomfort.
  • I really appreciated the informality of the experience - friendliness and sense of humour of staff. Excellent team work.
  • The treatment I received from the initial assessment appointment with Dr Martin White, through the operation and the aftercare was excellent and I was very impressed. I would like to take this opportunity to thank doctors, nurses and staff involved in my treatment at the London Road Clinic, Carlisle.
  • All in all a very neat repair done. Only a tiny amount of bruising along the scar. All staff were brilliant and helpful. Thanks for a great job.
  • I was very pleased with the service I received from the initial consultation at Hilltop Heights and the quick appointment for the procedure due to a cancellation. I have Parkinson's Disease and was very pleased with the respect and consideration from everyone involved.
  • The staff made me feel safe and comfortable. They took my mind off the operation by talking to me which was so helpful.
  • Under the circumstances I can honestly say that this was a fantastic experience. Every one of your team has been absolutely brilliant. Thanks again.
  • I was really happy with everything. I had complete confidence in the medical team. They were all confident, friendly and reassuring. The whole area that we were in was so clean including the toilets so I was happy with that. I am so pleased to have this opportunity to say thank you to all of you, including the office staff. Also, how quick I was able to get the appointment. Well done everybody, I am very grateful, thank you. Also grateful for the invaluable advice for the days and weeks after surgery which has been very important and useful.
  • I was very impressed by the friendliness and professionalism of the service. I was also very pleased and relieved that the time gap between the initial consultation with Dr White and the procedure itself was only just over a month. I would not hesitate in recommending the hernia repair service to anyone who needed it. The overall experience was similar to a visit to the dentist!
  • Lovely, friendly staff reassured me and made me comfortable with the procedure. I felt informed all the way through and the staff were happy to answer my questions.

For more information on this report or the hernia service please contact Pauline Stuart at paulinestuart@nhs.net