Trust joins forces to reduce infections for patients having hip and knee replacement surgery

Harrogate and District NHS Foundation Trust has joined forces with 30 organisations across the NHS to reduce infections from MSSA for patients having hip and knee replacement surgery.

This unique collaborative, called QIST (Quality Improvement for Surgical Teams), will drive forward improvements for patients by ‘scaling up’ interventions, such as screening and the use of bodywash and nasal gel treatments for patients carrying the bug, to reduce infections and save lives.

MSSA is a common cause of infection in joint replacement surgery. Research has shown that interventions – such as decolonisation using nasal gel and body washes – can reduce the risk of infection from MSSA by 60 per cent in some cases.

These interventions have already been tested by Northumbria Healthcare which has adapted a MSSA ‘care bundle’ or ‘checklist’ to meet the needs of patients having joint replacement surgery. Before and after data for the 9,000 patients cared for at the trust shows that a real difference is being made.

Mr David Duffy, Orthopaedic Consultant and Lead Surgeon for QIST at Harrogate and District NHS Foundation Trust, said: “We are delighted to be part of this unique programme which will help us to improve care for our patients and support further adoption across the NHS so many more patients can benefit in the future too.

“If, through this collaborative, we can prevent even just one infection – which can be devastating and life changing for any patient and their loved ones – that will be fantastic. By joining forces and working collaboratively I am confident that being part of this project will benefit far more patients than that, and beyond our local area too.”

Clinical director for trauma and orthopaedics at Northumbria Healthcare and chief investigator for the QIST infection collaborative Professor Mike Reed said: “The overall ambition of this collaborative is to prove the case we can successfully introduce these interventions and improve care for patients having joint replacement surgery so that they become routine clinical practice across the NHS. By joining forces and sharing best practice, I strongly believe we can make a real difference to patients across the NHS.”

The project is part of the Quality Improvement in Surgical Teams (QIST) collaborative which was established by Northumbria Healthcare NHS Foundation Trust in 2013. QIST infection is a partnership between Northumbria Healthcare, British Orthopaedic Association, University of York trials unit and NHS Improvement.


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Paul Widdowfield, Communications and Marketing Manager, [email protected] and 01423 557470.

Notes to editors

  • The QIST collaborative has been shortlisted for a prestigious 2018 HSJ award in the acute sector innovation category.
  • Meticillin Sensitive Staphylococcus Auerus (MSSA): MSSA is a type of bacteria (germ) which lives harmlessly on the skin and in the noses, in about one third of people. People who have MSSA on their bodies or in their noses are said to be colonised. However MSSA colonisation usually causes them no problems, but can cause an infection when it gets the opportunity to enter the body. MSSA can cause serious infections called septicaemia (blood poisoning) where it gets into the bloodstream.

An 80 year old Guiseley man has recovered from keyhole knee surgery for a torn cartilage to win the British Masters Decathlon Championships in his age group – breaking an amazing five British records in the process.

Tony Bowman underwent knee surgery with specialist surgeon Mr David Duffy at Harrogate District Hospital for a torn cartilage (meniscus) that was preventing him from competing.

Since then Tony, who lives with his wife of 50-plus years Betty, has broken British records for his age group in the Decathlon as a whole, 100m, 400m and the high jump as well as the British and European records for 80m hurdles.

His time in the 100m was 15.1 seconds, and in the hurdles 15.2 seconds.

He has been active throughout his life, from school sports days on the Twickenham Rugby Stadium pitch where he grew up, to playing hockey and tennis and competing at county level in his speciality, hurdling.

Tony said: “I love the feeling of being fit. I have a young outlook on life and I get a lot of enjoyment out of being active. As well as athletics I also dance, grow vegetables and paint watercolours. I get a kick out of being alive!

“Surgery was a big worry given my age, but I was unable to compete before it. I get on very well with Mr Duffy who is friendly and has looked after me well. He’s done a good job.”

He is now aiming for the World Championships in Perth, Australia, next year and the European Indoor Championships in Ancona, Italy, before that.

Mr Duffy, Tony’s surgeon, is a specialist knee surgeon with particular expertise in sports injuries and knee replacement surgery. He has extensive experience in performing anterior cruciate ligament (ACL) reconstruction, arthroscopic surgery and knee replacements.

His busy NHS practice is based at Harrogate and District NHS Foundation Trust where he treats general orthopaedic trauma and has an elective practice that is tailored to knee complaints.

He said: “For patients in their late 70s or 80s it is unusual to actually have this injury at all. It is more common for the knee to be arthritic at that age and keyhole surgery would do very little.

“However, Tony’s symptoms were consistent with a sporting injury for someone 40 years his junior so I decided it was worth performing the operation.

“We are increasingly seeing an older more active population whose expectations for life are higher. Having said that, Tony’s story is exceptional in what he continues to achieve. Naturally, I am delighted that he has returned to competing at such a high level so quickly.”