An orthopaedic centre of excellence for Fife

To launch ‘Delve’, our new, in-depth news section, we decided to delve behind the recent headlines to learn more about our the Fife Elective Orthopaedic Centre; the motivation behind the multi-million pound project; the team working behind the scenes to bring the project to fruition and what the centre will mean for residents across Fife.   

Our timing is impeccable as this week sees the cutting of the first sod on the project – or the breaking of the ground which marks the start of a building project. To read more about the history of Orthopaedics in Fife see our Laying the foundations Delve article.

Our new centre of excellence aims to provide the highest standards of care. Simply put, this means providing a resource that will promote best practice and innovation, allow for cutting edge research to be carried out on site, and provide a platform where our staff and trainees can be educated to the highest possible standards. 

These principles are already well established within the Trauma and orthopaedic department of NHS Fife. This new facility will allow further development and embedding of good practice within the multidisciplinary team. It will provide a facility that has been designed specifically for the delivery of orthopaedic services and designed around the core components for a centre of excellence.

The FEOC will provide orthopaedic services over three floors. It will support a spectrum of ‘elective’ surgical procedures – these are planned operations that do not happen as a result of an emergency.

The facility has capacity to offer the whole spectrum of orthopaedic surgeries including hip and knee replacements, soft tissue knee surgery, foot and ankle surgery and upper limb procedures.

Whilst limited day surgery activity may remain at the Queen Margaret Hospital in Dunfermline, it is planned that same day surgery will be relocated to the new build to take advantage of the integrated theatres which will enhance arthroscopic (keyhole) surgeries.

NHS Fife does not provide back surgery and this will continue to be offered by the tertiary Neurosurgery departments in Dundee and Edinburgh.

NHS Fife already offers an innovative orthopaedic environment, with some of the most efficient theatres in Scotland. The department has also achieved some of the shortest waiting times for surgery. This was all undertaken within an ageing facility. A purpose-built facility will make all these things easier.

Patients will benefit from further development of a multidisciplinary approach by having most orthopaedic services being delivered from this dedicated facility. We see it truly as a ‘one stop shop for all orthopaedic services’.

The building has been designed to offer a working environment that offers flexibility and capacity to deliver orthopaedic planned service to NHS Fife patients over the next 20 years. We recognise that orthopaedic service delivery continues to evolve. 

Most notable currently is the increase in the proportion of surgeries that can be performed as day case procedures. The build therefore has been designed to provide ward space that can flex to support increasing numbers of day case procedures.

The theatres are being developed as integrated theatres. These are likely to be the first dedicated integrated theatres in Scotland. ‘Integrated’ refers to the way digital images are visible around the theatres. It ensures the surgical teams can position images from cameras, monitors, x-rays or arthroscopic equipment on the most suitable screens to get the best possible results. The facility will ensure that NHS Fife can remain at the forefront of surgical advances to the benefit of patients of Fife.

The theatres have been designed and future proofed to ensure they can support advances in surgical techniques such as the development of robotic assisted orthopaedic surgery for hip and knee replacements, and advances in intra-operative imaging.

These technologies are in development and are likely to become a key part of future practice. 

Patients will benefit from having the majority of orthopaedic services delivered from this dedicated facility. This centralising will allow greater efficiency and planning of service delivery. Patients will also benefit from a facility that has been designed to make the most of digital advancements in patient care. A lot of this relates to how patient information is made available.

Part of the NHS Fife Digital Strategy is to develop paperlite clinical environments and the facility has been designed to support this digital innovation. The goal is to involve the patient more in the decision making about their care by supporting two-way information sharing and allowing some consultations to happen remotely, minimising unnecessary hospital attendances.

The building has two meeting rooms included for teaching and training. These will be linked to theatres, so students will be able to watch surgery in real time, via theatre cameras. This will support teaching of medical students and training medical staff of all grades.

As the centre will centralise a lot of the orthopaedic activity on a single site, it will limit the time trainees and students need to spend travelling between sites.

In addition, our construction partners Graham’s can provide work experience opportunities to local schools during the build process.  

As part of our arts strategy for the project, we are planning on incorporating areas where school children can display artwork. This will ensure that displays change for the benefit of patients whilst supporting engagement with local schools. It is another aspiration to involve local schools and provide opportunity to come and see what happens in a hospital and there are facilities to support this