Community Based Carpal Tunnel Service
Service Quality Performance Report

April 2022 – March 2023

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, Arnside House, Carlisle (moved to Carlisle Healthcare South in January 2023) 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.

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

530 patients were seen between April 2022 and March 2023. This is a slight decrease of 7% of patients compared to the number of patients seen in clinic during 2021-2022.

Of those patients seen during 2021-2022, 334 went on to have Carpal Tunnel decompression performed by Dr Martin White. 36 of these patients had a bilateral procedure, 42 were procedures for Trigger Finger.

Of those that did not undergo any of the above:

90 patients were treated by injection.

19 patients were referred for nerve conduction studies

6 patients were referred onto secondary care for further assessment

52 patients discharged as asymptomatic

Post-Operative Complications  

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

Patient Satisfaction

100% of patients were forwarded a link to Survey Monkey asking them to complete a patient satisfaction 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.

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

96 surveys have been completed to date. The following results were highlighted using whether the patient would recommend CMS to family and friends:

Patient comments included

  • ‘Fully satisfied with everything’
  • ‘I had been suffering with severe carpal tunnel syndrome in my right hand for over 12 months and because I was experiencing numbness to my right hand when carrying out just about any activity and more so when driving… the whole thing started to worry me. It was my dominant hand and working in healthcare myself, the priority for me was to get back to a good state of health and functionality. After finding it impossible to see my GP I self-referred to physio at WCH and after several months of treatment was referred on to the MSK team who diagnosed me straight away and sent me for nerve conduction studies. Soon after that I was I was offered a surgery date at Maryport Cottage Hospital. The whole journey after being referred to MSK was seamless… and I was put at ease as soon as I walked through the door at MCH. The consultant and team around him were upmost professional and talked me through the whole procedure, putting me at ease and reassuring me that the outcome would be good. It took 8 weeks to get back to work and to full capacity but that was mostly in part to the physicality of my job role and the healing process.
  • I cannot fault the service as a whole… I feel privileged to work within the NHS and as part of the wider multidisciplinary team and I’m proud of my colleagues at MCH for striving to provide the best care possible for their patients. They are an amazing team and that shines through in abundance and I couldn’t be anymore great full to them for their support. I will need surgery on my left hand eventually because I do have moderate symptoms of carpal tunnel in that one but the consultant injected the hand on the same day I had surgery on the right which has helped massively with symptom control and with a bit of luck this will last up to 12 months 😃 I know moving forward that when the time comes for the next surgery, I’ll be in good hands. Thanks, Kerry Morris’
  • ‘Felt at ease both times’
  • ‘Treatment good. Injection in the other hand good but has started to lock again’
  • ‘Immediately following the carpel tunnel surgery, both wrists, wounds were bandaged, but the iodine around my fingers was not cleaned off to any degree. This transfered onto the clothing I was wearing and as I could not wash my hands, my husband had to help clean off with wet wipes once I was home … I believe it would have been better to have cleaned up immediately following the surgery .. but the procedure at this point was all starting to feel a bit rushed and to get me out of the room . Also the information sheet I was provided with made no mention of bruising to my palms and thumb area.. which I experienced and would be useful to have the info sheet updated to mention this as it would have been useful to know as this was not mentioned verbally’
  • ‘Very good service from start to finish. Do not suffer with Carpal Tunnel syndrome. Get treatment asap. Thanks again’
  • ‘I feel there is a way to go before I am able to use my hands as before’
  • ‘The treatment didn’t work. The treatment was carried out very efficiently’
  • ‘It was amazing, I felt better straight after operation. Operation done amazing, nurses were amazing too. So happy that decided to go ahead with it. Great thank you all!’
  • ‘I think you should be pre warned that the pain and the lack of dexterity that goes with this operation last for a considerable time after everything looks completely healed’
  • ‘Very quick operation. No pain at that time, I little pain and uncomfortable after but I expected that. Everyone in the clinic were very nice give me the right information I needed’
  • ‘The best service I have received from the NHS, outside that of my local gp practice at Wigton. Thank you’
  • ‘Have been to physio through my work and going to see my own doctor for the second time today. Not happy with my progress’
  • ‘Still stiff and slight triggering…slowly getting better… More my healing …as service excellent’
  • ‘The Dr and nurses were very professional and caring. I had an infection in the healing scar and I was given antibiotics by my GP. Dr White and nurses checked my hand out following week to reassure me’
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