One stop MDT foot and ankle clinic: our experience and results

P. Garg, A. Sott, P. Hamilton, S. Yousaf

Introduction: Management of foot and ankle pathology often require patients to attend multiple visits to healthcare institutions for various assessments, investigations and interventions. We envisioned a “One stop foot and ankle clinic” model to offer our patients all of this in the same visit, aiming to improve patient experience whilst reducing cost to the Trust.

Methods: We set up a monthly multidisciplinary outpatient clinic with three foot and ankle consultants, a BOA fellow, a Specialist registrar, a Physiotherapist, a nurse practitioner, a Radiologist for Ultrasound diagnostics and interventions, an Orthotist and an Orthopaedic Practitioner providing Electro-shock wave therapy along with image guided injections. We measured the service improvement by counting the additional services offered to attending patients on the same day thus reducing repeated patient attendances. We measured patient satisfaction by a special feedback form assessing their experience of the clinic. Cost savings were recorded through reduction of follow up visits, increased surgical conversion rates and decreasing DNA rates.

Result: We saw between 40 and 50 patients per event. The same day referral rate for investigations/ treatments averaged 58% (range 52%-66%). Both discharge rates and booking for surgery rates were increased as compared to the previous model by 12%. There was an overwhelming positive patient feedback .96% thought it was a better and efficient experience and 92% preferring this clinic model . Cost analysis showed an overall saving of costs incurred with this model by decreasing overall DNAs and increasing discharge and surgery conversion rates.

Conclusion: “One stop clinic model” has been an enormous service improvement with great increase in patient satisfaction and overall cost savings. It aligns with the national drive to reduce follow ups and .making the service more patient centred. We would want to promote this as a model for the future of F&A clinics.