Community Based Carpal Tunnel Service
Service Quality Performance Report

April 2020 – March 2021

Introduction

Our community based Carpal Tunnel Service is delivered by Dr Martin White, GPER 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 and Keswick Hospital.

Patients are referred to the service by the MSK team.

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

Patients are sent a comprehensive patient information leaflet on the procedure and directed to the CMS website for further information.

Over the last 12 months during the COVID pandemic there have been a number of different clinical safeguards and protocols introduced to enhance the safety of both patients and staff. Referrals during this period have fluctuated month to month, but CMS has continued to provide a high quality service to patients ensuring a continued responsive, flexible service is on offer to meet patient demand and need.

Waiting times

The average waiting time from referral to assessment is 4 weeks. All patients in this reporting period were assessed and treated within 18 weeks of referral.

Activity

548 patients were seen by the service between April 2020 and March 2021. Of these, 71% went on to have carpal tunnel decompression performed by Dr Martin White.  42 patients had a bilateral procedure.

Following an assessment by Dr White, a further 29% of referred patients did not go on to have a CT release performed. 

88 patients were treated by injection.

7 were given a follow up appointment.

42 patients were discharged as asymptomatic.

14 patients were referred for nerve conduction studies.

10 patients were referred onto secondary care for further assessment.

Post-Operative Complications  

7 post-operative infections were reported via the feedback form, which required antibiotics.

Patient Satisfaction

100% ofpatients were forwarded a patient survey 12 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.

99% of patients felt they were treated with courtesy throughout their appointment(s).

97% of patients were given a clear explanation of their condition, any medication requirements and their treatment.

99% of patients felt they were involved as much as they wanted to be in decisions about their care and treatment.

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

94 questionnaires have been returned to date with 77% of patients saying they are extremely likely to recommend to friends and family, and 20% likely to recommend.

Patient comments included

  • Fabulous service brilliant team who I’d recommend highly for their empathy, information and efficiency and also loved the fact that this could be done in a cottage hospital – well done.
  • Great service and treated really well by staff and the doctor. The only thing I would have liked was a follow up appointment just to make sure everything is as it should be.
  • First class credit to NHS.
  • All very good. I was nervous at first re Covid etc. but was put at ease.
  • I was impressed with how smoothly everything went. I was greeted at the door and spent a total of 25 mins in the room. It was so efficient and convenient. The doctor and nurses provided a distraction of light conversation which was nice and included me. I am very happy with the service I received.
  • I would suggest getting both hands done at the same time should be discouraged. I did it at my request without really understanding how debilitating the restrictions in use of both hands would be at the early stages of recovery (first few days).
  • Both hands were done very fast, no more pain. Service very good.
  • I was extremely pleased from the moment I walked in the door until leaving. The care from all involved was excellent. Thank you.
  • Excellent, a great team. Had my other hand done January 2018. This operation was more uncomfortable than the first (Dr White said it was tighter than the other hand. He is excellent).
  • Excellent service and result.
  • Both hands were done very fast, no more pain. Service very good.
  • I am very impressed with all aspects of the service. I was conscious throughout both procedures and enjoyed talking to the professionals that took very good care of me.
  • Very happy with the quick and efficient service and appointments system.
  • The nurses and doctor put me completely at my ease and I felt comfortable throughout.
  • Absolutely excellent service from start to finish. Highly professional and caring team with excellent communication skills.     
  • Very grateful for early appointments by Dr Barber and Dr White. Many thanks.
  • Number 1 people. Very caring. Put you at ease. Number 1 treatment. Number 1 service. Simply the best.
  • Brilliant! Online booking a total failure. As soon as your staff got involved it was brilliant. I could not have wished for better treatment, my compliments to you all – thank you.
  • Service was very efficient and professional.
  • Good service, no waiting time.
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