A specialist orthopaedic service at the Norfolk and Norwich University Hospital (NNUH) is celebrating its one year anniversary since the service started in August 2017.

The Paediatric Orthopaedic Emergency Service was introduced to provide specialist emergency orthopaedic care to patients aged 0-12 across Norfolk and Suffolk, 24 hours a day, seven days a week.

Specialist Paediatric Orthopaedics has been a service that the NNUH has offered for more than 30 years, and in recent years has grown from a single consultant to 4 consultants, making it the biggest children’s orthopaedic unit in the East of England. This expansion has allowed the introduction of this new round-the-clock service which means that these specialist consultants have been able to see younger patients suffering from infection in the bones and joints, complex fractures and orthopaedic conditions from across Norfolk and Suffolk at any time of day or night. Prior to the launch of this service, younger patients would have needed to travel as far as London or Birmingham to receive this level of specialist out-of-hours care.

The service is made up of four consultants, who have all trained in Children’s Orthopaedics at centres of excellence across the UK and beyond. They are supported by the NNUH Radiology team, Paediatric Anaesthetic team, Paediatricians, Specialist nurses, Physiotherapists and Secretaries. “It’s a massive multi-disciplinary effort to provide this round-the-clock service” explains NNUH Paediatric Orthopaedic Consultant, Anish Sanghrajka. He added: “Over the last 12 months, the service has made great progress and has seen fantastic benefits for our younger patients and their families. Having this service means that patients and their families don’t have to travel to London or Birmingham during often very stressful times for them, and they can benefit from this specialist expertise at any time of day or night a lot closer to home.”

Mr Sanghrajka said: “The service also shows fantastic collaborative working between NNUH and the other local trusts in the region.” The service receives referrals from James Paget Hospital, Ipswich Hospital, West Suffolk Hospital and the Queen Elizabeth Hospital in King’s Lynn.

The introduction of the service came in alignment with the team’s ‘Virtual’ Paediatric Orthopaedic Emergency Clinic (POEM clinic), where if deemed appropriate, younger patients and their families or carers receive a telephone consultation instead of a hospital appointment. This service has managed 1500 patients in its first year, and has reduced the number of unnecessary appointments for younger patients, which ultimately is of great benefit to them as they don’t need to be taken out of school to attend hospital appointments.

The service developments made by the team were recently recognised nationally and internationally with NNUH colleagues presenting their work to the British Trauma Society Conference and the European Federation of Orthopaedics and Traumatology.

Erika Denton, NNUH Medical Director said: “It’s fantastic to see what a difference this service has made to young people across Norfolk and Suffolk. I’d like to thank the whole multi-disciplinary team for their hard work to get this service up and running and congratulate them on reaching this one year milestone.”

Case study

Emma McCarthy with Lillie McCarthy

Lillie McCarthy, who is from Caister-on-Sea, was only nine months old when she was referred to the Paediatric Orthopaedic Emergency Service at the Norfolk and Norwich University Hospital (NNUH) at the end of last year.

One evening Lillie’s mum, Emma, had noticed that Lillie was experiencing pain in her right arm, which meant that she wasn’t able to use it and was causing Lillie a lot of distress.

Emma explained: “It was clear Lillie was in a large amount of discomfort so we took her straight to the A&E department at the James Paget Hospital. What we didn’t know was what was causing the pain and after multiple scans, tests and a GP visit too, we were referred to the specialist service at NNUH by James Paget Hospital to try and find out what was causing Lillie’s pain.”

Once seen at NNUH, Lillie was diagnosed with ‘Osteomyelitis’– an infection which can occur in bones like your arm, legs and back. Lillie had this infection in the radius, (the main bone forming your wrist), next to the growth plate, from where the bone grows.

Lillie had an urgent surgical procedure to remove and reconstruct the part of the bone that was infected, which was overseen by Mr Sanghrajka and the team. Lillie was given a cast and kept on Buxton Ward for a total of two weeks to make sure she recovered from the surgery and was making good progress.

Emma said: “It was a very stressful time for us but the care that Lillie received was amazing. From the nurses and surgeons to all the ‘behind-the-scenes’ staff, they all went above and beyond to help Lillie get better. We’re very grateful that this specialist service was so close by, as travelling further afield would have definitely created additional stress for our family.”

Lillie has had a couple of follow-up appointments since the procedure and the team at NNUH will now see Lillie every six months for the next few years to monitor her progress.

Emma added: “Lillie kept smiling the whole way through and is now enjoying life to the full. I’d like to send my deepest thanks to everyone involved in Lillie’s care.”