The ED direct discharge rate was 23% (n=2115/6385)(Figure 1). There were therefore 4270 (67%) patients reviewed at the VFC (Figure 1). Out of the total study group, 1687 (26%) were discharged after virtual review by an orthopaedic consultant and a nurse led telephone consultation, and a further 395 (6%) were reviewed in the nurse-led clinic and 1889 (30%) in the specialty clinics. There were 233 who were referred directly to further imaging based on the VFC discussion. These patients were subsequently followed up in the specialty clinics. Only 34 (0.8%) patients were indentified at the VFC as requiring semi-urgent admission for surgery (Figure 1 & 2). The overall rate of ED and VFC discharge was 3802/6385 (60%). 2517 patients required face-to-face review compared with 4270 under the traditional system.