Community Based Hernia Repair Service
Service Quality Performance Report

April 2020 – March 2021

Introduction

Our 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 Keswick Hospital.

The service is bookable via Choose and Book after a referral from the patient’s GP surgery.

Referrals to the service must meet the following evidence based criteria:

  • History of incarceration or real difficulty in reducing hernia
  • Increased risk of strangulation (high risk in female patients)
  • Inguinoscrotal hernia
  • Progressive increase in size of hernia month-on-month
  • Significant pain or discomfort sufficient to cause significant functional impairment

The risks and benefits of surgery are all fully discussed with the patient during the assessment appointment.

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. All patients are sent a comprehensive patient information leaflet on the operation and directed the CMS website for further information.

Activity

The community Hernia Repair Service has seen a total of 358 patients in this reporting period.

Following an initial assessment by Dr White;

185 patients had hernia repair carried out.

  • 68 patients had a range of co morbidities including IHD, AF, COPD, Diabetes and Obesity
  • 49 patients were referred on to secondary care for surgery under general anaesthetic
  • 7 patients were referred on to other specialities such as pain management, ultrasound, x-ray
  • 117 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. 

  • 6 patients recorded as having a post-operative infection requiring antibiotics

Patient Satisfaction

100% of patients were 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.

100% of patients were treated with courtesy throughout their appointment by all staff.

100% of patients were given a clear explanation of their condition, any medication requirements and their treatment.

100% of patients were involved as much as they wanted to be in decisions about their care and treatment.

78 questionnaires have been returned to date for this reporting period. According to the results from the Friends and Family test the following patients would recommend CMS:

Patient Comments Included

  • I was nervous before the procedure but I was made to feel extremely comfortable and my mind was very much put at ease by Dr White and his staff. Thank you all very much for your help and professionalism.
  • Great service which meets the needs of the patient. Many thanks to all involved.
  • I was very apprehensive about the op, but can say I should not have been. Everyone made my visit a good experience. I have also done what the doctor and surgeon told me to do after my op which has helped my recovery. I would just like to say thank you to all concerned.
  • The medical team was superb, great laugh and really put me at ease as I was nervous but the procedure went faultlessly and was over in no time.
  • Competent, courteous, professional. I can highly recommend the service provided by the CMS team.
  • Very convenient, especially during Covid and being able to avoid a busy hospital. Convenient parking. All staff were really great, confident, capable and understanding.
  • Very nice staff and doctor could not have asked for more, thank you very much.
  • Dr Martin White and his team were fantastic. Thank you!
  • This was my first experience of an operation and I must say I was treated excellently. The staff from the surgeon down were brilliant. Very friendly and kept me informed throughout. Just like to say a big thank you to all the team.
  • Very professional throughout. Very good bedside manner and very caring nursing staff. Although I did feel a little queasy during surgery I was made to feel more at ease with the care of the nursing staff. P.S. a big thank you to all concerned.
  • Very punctual and professional service with a relaxing atmosphere which made my operation easy to have done.
  • The treatment I received from the initial appointment at Carlisle and surgery at Maryport was excellent. Dr White and his staff made you feel at ease and answered any questions, queries in a way that you understood and not left wondering afterwards.
  • Treatment I received would be difficult to better. The experience was quite stress-free due to the detailed efforts of the whole team. Thank you.
  • All the staff were excellent, friendly and helpful. I cannot find fault in any way.
  • The whole process was faultless, could not have asked for a better service. Everyone, from the surgeons to the nurses, show great professionalism. Outstanding.
  • The service as a whole was excellent – a very good team. Maybe more detail on the process of healing/possible pain(s) etc. Compared with prior to the operation it is much better.
  • Professional and very prompt service. I am very grateful.
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