The jewel in our crown

By Joe Dias
BOA President 2012

I am privileged for having spent my career as an Orthopaedic surgeon in the National Health Service. 

It is a unique health system striving to deliver care to an entire population and doing so, despite the twin challenges of ‘manpower and money’. 

The British Orthopaedic Association and its members have contributed extensively to this in clinical practice.  Quality has been improved (eg, NJR, GIRFT, ODEP, MTC and using ‘Best Practice Tariffs’ to improve care).  This would not have been possible without the National Health Service, which has been the facilitator for these improvements.

Our work in educating our workforce, as well as attracting and keeping our trainees, has also supported our nursing staff and our Extended Scope Practitioners.   We have looked after our surgeons, especially when they are challenged in their workplaces through the Invited Review Mechanism.  All this has helped us negotiate particularly difficult times and helped deliver the best possible care for our patients.

Our members have contributed at the senior most levels of the NHS to help us through the pandemic and steer us through the recovery phase.  Orthopaedic surgery has come to the forefront of national clinical research, and this would not have been possible without the National Health Service and the NIHR. 

In all these ways we have truly delivered on our motto of ‘Caring for Patients, Supporting Surgeons and Transforming Lives’.  This has left me proud of being part our NHS and BOA.

We are seeing new challenges with the break-up of the Clinical Team structure, the deep-seated disenchantment in our trainees, the uncommon patient’s ‘expectation’ of care as a right, the challenges in funding and particularly in our manpower.  The work burden has left our staff feeling isolated and unsupported.  There is a shift of work into a less incorporated private sector.  Patient access is currently deteriorating, challenging our ability to help them.

The solutions may lie in the better use of technology to improve access to our expertise and the use of 'Big Data' to predict who needs better or more frequent care.  Our future generation of surgeons and the British Orthopaedic Association will continue to innovate and support this jewel in our crown and to nurture our NHS in its time of trouble.

It has been a privilege to work, teach, lead and innovate in this NHS.