March 2014

Dear Colleague,

Attached are the unconfirmed minutes from the SCOT committee meeting held at Crieff in January 2014. For those who don’t want all the detail -below is a brief summary about what was discussed.

Membership changes

The new office bearers and membership have now been finalised:

Mark Blyth                 Chair
Sean Kelly                Vice Chair
Tim White                  Treasurer
Andy Ballantyne      Secretary

Gam Ayana, Drummond Mansbridge and Brian Rooney for GGC
Neill Craig CD for Grampian from J Bidwell
Piers Renshaw taking over Clinical lead for Highland from A Kent

Training programme report

The annual interviews for ST1 recruitment are due to take place end of February in Glasgow. Interviewers should be confirmed in the next week.

In addition there are a number of ST3 trainees to be selected primarily for the west from the UK National selection process being held in Leeds Apr 28 – May 2. Those interested in helping out should contact their local training programme director.

It is likely in the future that there will be a consideration to decouple training in Scotland with already some ST posts being converted to core training, but the detail around this has yet to be worked out.

Zimmer Travelling fellowship

Congratulations to Stuart Aitken and Emily Baird on winning this years fellowship to travel to units in North America on trauma and paediatrics.

Scottish MSK Research day

This has been run successfully for 2 years now in Dunblane at the end of November and offers an opportunity to get medical students and foundation year doctors to present their work. A research group developing multicentre research ideas is also being developed. Those interested should contact

Scottish Orthopaedic Surgery Development Group (SOSDG)                  

SOSDG have been challenged by government to determine priorities and work out what is required to develop and improve Orthopaedic services. Five work streams have been identified:

AHP MSK Redesign This has been implemented in A&A, Lanarkshire and Lothian with a significant reduction in ortho referrals already seen. It is important that we get involved in the training of the AHPs so that surgical pathology is not missed. More from

Fracture Pathway Redesign This continues to gather momentum with full implementation in Lothian, Fife, Tayside, Borders and much of Glasgow and Clyde. Interest has been expressed from the majority of other units in Scotland. Further information can be accessed at or or

Enhanced Recovery We are now on our 4th Enhanced recovery audit cycle.

There have been great improvements with >80% patients now on some form of enhanced recovery (hip and knee). Opportunities for improvement have been identified over fasting/fluids and 7 day physiotherapy.

The MSK enhanced recovery steering group aims to continue to support this initiative with peer review visits to provide advice on future improvements.

Hip Fracture Care Pathway The most recent report was released in October of last year and noted areas of excellence as well as areas where care was poor. The report recognises the importance of getting the geriatricians on board. There is a move to standardise interventions. Comments to

Demand & Capacity Planning A whole system review was undertaken in Tayside considering both the trauma and the elective service. The aim was to develop a predictive modelling tool to help plan a Demand capacity and quality approach. (DCAQ).

Essentially what the process has achieved is to:

  • Highlight capacity issues in theatre and outpatients.
  • Demonstrated misalignment of service across the region
  • Quantified backlog for sub specialities
  • Informed job planning
  • Informed strategic plans and succession
  • Provided unequivocal, evidence for NHS Tayside executive team on need to invest in ortho services.

Hopefully a similar process will be rolled out across the rest of Scotland.

National Procurement

The tenders for hip and knee replacements are up for renewal in the next 12 months. An opportunity exists to tender on a national ceiling price for implants which could produce considerable savings and yet retain clinical freedom in the choice of implants available.

SCOT has been asked to supply clinicians to help in this process and it has been agreed that names of individuals would be supplied through the Scottish Arthroplasty Project.

SCOT summer meeting

Planned for Friday 29th August at Dunblane Hydro – mark your diaries.

Topics are likely to include Trauma with the designation of the 4 Scottish Level 2 trauma centres, the SAP with sessions on research and a current concepts update for the general Orthopaedic surgeon by a number of sub-specialists.

I hope you have found this update useful. It’s your committee – get involved – either by contacting me or your local area representative.

All the best.


Mark Blyth
SCOT Chair
Glasgow Royal Infirmary

14th March 2014