There are several problems with the traditional model of care:
- There is often not enough time to spend managing complex cases
- There are many patients who do not require review as they have simple, stable, self-limiting injuries that are already resolving
- Immoblisation in plaster and backslabs leads to inevitable appointments for removal, whereas the use of modern splintage allows functional rehabilitation and self-care once the initial pain and swelling subsides
- “Paternal” model of care where patient’s ability to recognise resolution was removed
- Training opportunities are reduced by the need to see overbooked clinics
- Patients are brought back for unneccessary review appointments in many cases, rather than taking responsibility and getting in touch if resolution does not proceed as expected
- Often there is a need to re-referral to a sub-specialist for an opinion, with a further arrangement for admission for definitive management. This process can lead to multiple attendances and delay in management.
- Early attendances at fracture clinic are a point where pain and immobility is usually at its most severe.