Huddersfield grandmother becomes hospital’s 100th day case knee replacement patient

Presentation At Huddersfield Hospital

Huddersfield grandmother Caroline Hirst was VIP for the day at BMI Huddersfield Hospital on Wednesday (12 August) as she became the hospital’s 100th person to receive a knee replacement as a day case patient.

She was presented with a colourful bouquet and a bottle of wine by surgeon Graham Walsh and anaesthetist Nisha Bhuskute who, with the BMI Huddersfield team, have transformed knee surgery in Yorkshire and beyond.

A nationally-accepted length of hospital stay for a new knee is between one and four days. However, at BMI Huddersfield Hospital, it’s now the ‘norm’ for a patient to be admitted in the morning, have their operation while still awake and be back at home in time for tea the same day.

A shorter length of stay has long been associated with a speedier and safer recovery – the recent events with Covid-19 have also shone a light on the need for a shorter length of stay, as people try to reduce their contact time in hospital.

Mrs Hirst, who lives in Mirfield with husband Robert, was treated to a flurry of celebration at the hospital for her operation to replace her left knee.

“It was brilliant,” she said. “After the operation I was out of bed, on my crutches, up and down the stairs and then back home. The scar is really neat, and I can see it through the invisible bandage. I had a shower when I got home, which was nice to be able to do.

“My friends who have had knee replacements have stayed in one or two nights in hospital – but I left home 06:45am and was back at my door at 3.45pm, which shows how quickly I got the hang of things.”

Caroline Hirst

Mrs Hirst had to shield for two weeks before she was admitted, in order to keep herself safe from Covid-19 and reduce the risk of introducing the virus to the clean hospital. Before admission, she was given a sheet of exercises to do by the physiotherapist so she could improve her muscle strength and get familiar with the post-recovery exercises she would be doing when she returned home.

She arrived in theatre at 9am, wheeled into the recovery room at 10am, was back on the ward by 10.30am and on her feet at lunchtime.

She is now looking forward to getting back to her and her husband Robert’s favourite pastime of walking in the Pennines – her previous knee problem meant that walking was becoming more painful and she struggled climbing over the stiles and walking down slopes.

The couple have lived in Yorkshire all their lives and have their children and grandchildren nearby. For Mrs Hirst, it was important that she was able to get back to fitness quickly for them, and says she was thankful she had health insurance and was able to pay privately for her operation.

Mr Walsh said that patients are initially surprised that what is considered a major operation could be completed in 45 minutes, while the patient is awake, and with the potential to be in and out of hospital within a few hours. 

“You used to stay in hospital for eight days or so with a knee replacement,” he said. “However, it’s normal now for our knee replacement patients to have their operation as a day case.

“Other hospitals ask us to tell them how we do it – the key really is in how the team work together; it’s a case of culture. It doesn’t happen straight away; it’s taken us 10 years to be able to do this, and it has challenged our team’s perceptions and the expectations of patients.”

The protocol involves the whole hospital team from admission to discharge is based on psychology as much as it is surgery. Everyone – from the patient to the hospital team – needs to feel confident about the procedure, about everyone’s roles, to be clear that the patient will be going home, and that the patient knows what to expect. The patient is sedated and with a spinal anaesthetic, rather than a general anaesthetic, and will have already practiced their post-operative exercises before the day. They are up on their feet as they leave hospital and go home safely and confidently with a small dressing rather than large bandages. The size of the dressing is important from a perception and reassurance point of view.

About BMI The Huddersfield Hospital

BMI The Huddersfield Hospital, in Birkby Hall Road, is owned and operated within the Circle Health group of more than 50 hospitals. It is a 29-bedded hospital with two operating theatres and employs around 280 staff from the local area, led by executive director Sarah Agnew.

A private hospital, BMI The Huddersfield Hospital provides services for insured patients, for self-pay patients and for patients who are funded through the NHS. During the peak of the recent COVID-19 crisis, the hospital was commissioned by the NHS to provide additional resilience for Calderdale and Huddersfield NHS Foundation Trust. Many of the consultant specialists work in both sites – including Graham Walsh in this article.

Learn more about BMI The Huddersfield Hospital

View Graham Walsh’s profile.

Date: 14th August 2020