The Need

In February 2015 Raigmore Hospital in Inverness needed to add additional capacity to its orthopaedic surgery provision.

Raigmore Hospital, a District General Hospital based within NHS Highland, had longer than optimum waiting times for elective orthopaedic procedures. The hospital looked for a solution to help them drive down waiting lists and, having worked with Vanguard Healthcare Solutions previously, worked with them to develop the best solution.

The option they chose would set them in good stead to meet changing and continually evolving need at the hospital two years later when a planned £30m overhaul of nine of its existing operating theatres was rolled out.

To help minimise disruption, while work was on-going to refurbish the existing theatres and to create an additional brand new operating room, two theatres would be closed on a rolling programme.

With patients from the (Highland) region’s 234,000 population potentially travelling from a huge geographical area extending from John O’Groats in the north to Glen Coe in the South , it was important there was a solution in place which allowed surgery across a number of specialities to continue as normal, despite the hospital having two fewer theatres to work within.

The Vanguard Plan

Working alongside the management, clinical and estates team at Raigmore in 2015, the Vanguard team developed a plan to provide an ultra-clean laminar flow theatre, joined to the hospital by a corridor, for its orthopaedic capacity work. This was carefully sited close to the existing main theatre suite and admissions area, allowing for the best possible patient flow.

It was planned this would be used for orthopaedic work including hip and knee replacement as well as fine surgery such as hand procedures.

Two years later, the planned refurbishment work began and the hospital’s needs changed.   With little time to plan, the Vanguard team and laminar flow theatre were able to show great agility and flexibility to meet this changing need, even in an emergency situation.

The Vanguard Solution

The initial laminar flow theatre deployment was extremely successful with more than 1,000 procedures taking place a year.

While the hospital’s refurbishment work was underway, they experienced a major structural issue which meant that all existing theatres were immediately closed, and would be for three weeks.

On little more than a day’s notice, the Vanguard unit became the hospital’s emergency theatre – used for trauma surgery during the day and as an emergency theatre overnight. As described by Kenny Oliver, Service Manager of Theatres and Anaesthetic at NHS Highland – “it was a real life saver, literally”.

The theatre then became the go-to for a range of different specialities to help with capacity as theatres were closed as part of the refurbishment and orthopaedics was moved back into the main theatres.

The Outcome

During the refurbishment, teams working in the mobile solutions undertook procedures in specialities including breast and gynaecology, ENT, oral and maxillofacial, plastic surgery, general surgery, colorectal, vascular, urology and trauma – as well as orthopaedics.

The breast team had long expressed a desire for an ultra-clean theatre environment as provided by the laminar flow and this was a particular success.

In all, the mobile solution was on site for just over five years and, on average, saw 1165 procedures carried out every year – a total of 5825. As a facility, it proved to be truly flexible and offered the high quality clinical space needed to carry out a range of different speciality procedures