Trust HQ Gloucestershire Hospitals NHS Foundation Trust
Alexandra House, 2Nd Floor, Cheltenham General Hospital, Cheltenham, GL53 7ANContact details and opening times
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Review titled MDT trauma & Orthopaedics (Foot & Ankle)
Rated 1 star out of 5
by Fel Temp Reparatio - Posted on 25 April 2024
For those who are not aware - an Multi-Disciplinary meeting (hereafter referred to as an MDT), does not usually involve the patient so decisions about their care are made behind closed doors by a team of "experts" . It is anything but a positive experience for the patient, who instead is confronted by a team of experts who have a pretty closed mind in terms of the best course of action for the patient. The panel have very little interest in listening to the concerns of the patient and instead put the interests of the trust first, in terms of promoting a procedure that is most cost effective rather than one that offers the best outcome in terms of quality of life for the patient. Opinion is stated as fact - rather than providing any scientific basis for any recommendations. So in my case ankle fusion was stated as a positive experience, because the consultant could provide plenty of people that were happy with such a procedure (A mere opinion.) When I countered that with a statement that many people I know who have had ankle fusion, have regretted the decision I was immediately treated with distain . Similarly my concerns with regards to increased risk of arthritis in surrounding joints, if fusion were conducted were similarly dismissed despite the fact that most long term studies of patients who have undergone ankle fusion have indeed suffered arthritis in surrounding joints (Ebelard et al 2014, Gaedke et al 2018, Goldberg et al 2022.) Concerns about an inability to walk on uneven ground post fusion (which is very useful if you happen to work, as an Archaeologist) were also similarly dismissed as unimportant. Given that I am no longer able to work in the field , I trained to work in due to the major deterioration of the ankle - any treatment that at least gives some chance of being able to walk on uneven ground would of course be preferable. But again that's not even considered at MDT. There is no opportunity to submit independently derived assessments (Physiotherapist reports) etc prior to the meeting , instead there is only the opinion of the Team present who aren't aware of the prior history of the case, or why a patient would prefer a particular option ( that for instance might just be career saving.) Finally the team, make assumptions about the individual based on how the majority of patients deal with a particular condition- rather than considering the individual in question . So the priority for all patients with ankle arthritis is presumed to be pain management; whereas in my case the priority is very much improved movement of the ankle joint. In short an MDT involves too many assumptions on the part of the medical team, without any opportunity for the individual to present their case or individual narrative. Please do not assume this is a positive experience to discuss your care but rather see it as a method for the trust to justify their policy of prioritising cost effectiveness over patient quality of life.
Visited October 2023
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