Pioneers in patient care: consultants leading change
North East
Innovation: Telemedicine – a telecommunications link between the hospital, the telemedicine base and three and accident and emergency units allows accurate diagnosis and transfer of patients who have suffered maxillo-facial trauma, major injury to the face and jaw
John Lowry
Royal Bolton Hospital and Blackburn Royal Infirmary
Job title: Consultant oral and maxillofacial surgeon
Specialty: Oral and maxillofacial surgery
If a patient has suffered a major injury to the face and jaw, accurate diagnosis and transfer to a specialist unit is vitally important. For children, delayed transfer to a specialist unit can be particularly damaging. Consultant maxillofacial and oral surgeon John Lowry has pioneered and developed the use of telemedicine to enable the right decisions about transfer to be made promptly.
When the patient arrives at the accident and emergency units in Bolton, Burnley and Bury, pictures of the patient are beamed over to the telemedicine base at the Blackburn Royal Infirmary where they can be assessed by specialist surgeons. The service was established two years ago with money from the Modernisation Fund, topped up by local hospital trusts.
Mr Lowry says that the telemedicine service allows much greater precision in remote diagnosis and assessment and therefore clinical care for the patient can be planned and delivered much more appropriately.
"Before we had the telemedicine link, we relied on hasty conversations about a patient suffering trauma, with huge potential problems if we made the wrong decision. Specialist facilities for treating face and jaw injuries are very limited, so you do not want to refer patients unnecessarily but you do want to organise prompt attention for those who
need it."
Patients have reacted favourably to the innovation and a continuous audit of cases has been conducted since the start of the service.
Mr Lowry remains frustrated over the current resourcing of the NHS. He faced funding problems and communication barriers at the start of his telemedicine service but the major problems he faces now are bed shortages and insufficient time with his patients.
"My patients are facing quite complex surgery and treatment. I feel I need more time with them to ensure fully informed consent. Clinics get rushed and, even worse, operating sessions are often cancelled because of bed shortages. It is quite common for four patients from an operating list to be cancelled at the last minute, even in the summer. In winter sometimes the whole elective list has to be cancelled." The new money for the NHS has not made it through to John Lowry’s front line yet, though negotiations have started with the local primary care trust and health authority.
Nevertheless John Lowry, who is qualified in both medicine and dentistry, would still recommend medicine as a career. "The pressure is huge, the frustrations mount up but the job satisfaction is enormous. When you rebuild a patient’s face and jaw, you are helping them rebuild their whole life after a traumatic and life threatening injury or illness. It is tremendously rewarding."