Community Based Hand Surgery Service
Service Quality Performance Report

April 2018 – March 2019


The Cumbria Hand Surgery Service was developed in partnership with the Queen Elizabeth Hospital, Gateshead in 2016.

The service is provided at Hilltop Heights Community Clinic in Carlisle and is bookable via NHS eReferral and direct referral from the MSK service.

The service is led by consultant colleagues, Mr John Harrison and Mr Jagannath Chakravarthy, who are both dedicated hand and upper limb surgeons at the Queen Elizabeth Hospital.

The conditions seen include:

  • Dupuytren’s contracture
  • Thumb base arthritis
  • Cubital Tunnel syndrome (ulnar nerve entrapment at the elbow)
  • De Quervain’s tenosynovitis
  • Hand swellings including ganglions
  • Carpal Tunnel Revision

All the surgery is performed under local anaesthetic.   If this is not possible due to other health problems or the complexity of the surgery, patients can opt to have their surgery under general anaesthetic at the Queen Elizabeth in Gateshead or in Cumbria.

All surgery is subject to strict criteria for treatment following the current evidence based guidelines.

Our Hand Surgeons

John Harrison specialises in surgery of the upper limb, having done a fellowship at Wrightington Hospital and practices the latest evidence based treatments.  John regularly treats professional sportsmen from football, Rugby, British Superbikes, and Team GB Rowing.  He has published and presented his work nationally and internationally. His research has directly led to the development of replacement joints for the elbow and wrist and he has published a new technique for the treatment of exercise induced compartment syndrome of the forearm.

Jagannath Chakravarthy originally trained in Birmingham before moving North in 2012 to join John and the team at Gateshead. He also specialises in shoulder, elbow and hand surgery, introducing awake shoulder arthroscopy in Gateshead. He is keen to be able to offer the same level of service to Cumbrian patients in Cumbria.

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.

Referrals and Activity

146 patients were referred into the service, 52 by the MSK service, 90 direct from GPs and 4 from CMS.

Following assessment 96 patients (66%) had a total of 124 procedures with 23 patients having more than one procedure11 patients (8%) were referred across to the QE in Gateshead for their operation.

13 patients were treated with a steroid injection on the same day as the assessment.

56 patients (59%) were reviewed following the operation with 9 patients seen twice.

Total procedures carried out by the Cumbria Hand Surgery Service for this period are as follows:

The Cumbria Hand Service had a total of 4 DNA during this reporting period.

Patient Satisfaction

45 questionnaires have been returned to date for this reporting period.

98% of patient would recommend the Cumbria Hand Service to friends and family and 93% of patients rated the service as good or excellent.

Patient comments included:

  • Lovely friendly helpful staff talked me through the procedure, then chatted about this and that which took my mind from the operation
  • I can only say that I wish I had had my carpal tunnel ops here instead of the infirmary.  The clinic was easy to get to and park.  The staff were organised and very friendly.  The whole process was a far more pleasant experience.
  • I found the treatment and service excellent.  Appointment times were well kept and all the staff friendly and helpful.
  • Throughout my diagnosis all the doctors, nurses were very helpful, supportive and caring.  I was well looked after by all concerned in the NHS.  Thank you all.  The surgery was completed to a very high standard – thanks again.
  • In my case there was a choice of treatment/no treatment.  I was very pleased with my treatment, that this was explained fully with possible consequences in each case.  So that the decision, which was entirely mine, was not difficult to make.
  • The doctor and the nurse were very friendly, talked all the way through the surgery which made me at ease all the way through the operation.  Excellent service, did not feel uncomfortable at all
  • The surgeon and his nurses were exceptionally good and caring.  My questions were answered clearly and sympathetically.  They were an excellent advert for the NHS.

Patient comments included:

  • Service fantastic, the surgeon did what he could, given I have arthritis in my hands.  A real gentleman who let me fully participate in the process
  • Very efficient and friendly staff, good at communicating with me, I even got a cup of coffee and a biscuit after my op 10/10
  • The service was good, but outcome not a success, finger stiff and painful
  • I have attended the clinic at Hilltop Heights throughout the year for the trigger fingers, surgery in September 2018.  Throughout my consultations/surgery the service treatment I have received has been beyond expectations.  I am very impressed.  Mr. Chakravarthy and his team of assistants/nurses were very professional/friendly and put you at ease.  Thank you all and keep up the good work.
  • I was happy with my treatment at the clinic, but I am not happy with the outcome of the operation.  I have complex regional pain syndrome and am still taking pain killers at this date: 30/12/18 – Patient was referred to Pain clinic at hospital by his own GP following hand clinic
  • Mr. Chakravarthy was excellent in every way.  He made the procedure less concerning and all the staff were very kind and exceptional.  Please thank them for me
  • All the staff were very good and friendly.  I will be back in 2019 for my right hand to be done.  Thank you all.
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