UHSussex making a difference out in Africa

Gambia has become the first country in the world to have a nationwide virtual fracture clinic, using a system first developed in the UK by doctors at University Hospitals Sussex in Brighton.

The clinic at Brighton was set up at the Royal Sussex County Hospital back in 2013 and was designed as a patients focused alternative to traditional fracture clinics.

Over 4000 patients are now seen every year across the Trust’s hospitals, reducing outpatient visits by 50%, saving the NHS £250,000 a year, and seeing a reduction in harmful carbon dioxide emissions by 3.8 tonnes a year.

The same doctors involved in the launch of the UK clinic, Dr Rosie Scott and Dr James Gibbs, have now teamed up with a former colleague, to set up the clinic in Africa.

Dr Scott is also a founder member of Falmer-based digital health company, Definition Health, while Dr Gibbs is a member of the charity, Gam Med (Gambian Medical UK Partnership).

Both these organisations were pivotal in setting up the clinic on a week-long trip to The Gambia, with Definition Health donating equipment and Dr Scott training the Gambian medics in how to use it, and through Gam Med they were joined up with trauma and orthopaedic surgeon Kebba Marenah who completed his orthopaedic registrar training at the Brighton hospital.

They hope that the virtual fracture clinic will save about half of The Gambia’s patients with broken bones from having to travel long distances – up to 100 miles – for treatment.

Many patients with injuries are reported to use traditional medicine and healers – and fractures are often bound with sticks and go on to mend poorly, resulting in permanent deformity.

Adding to this challenge, many patients travel long distances to a hospital in the Gambian capital, Banjul, or one of five satellite hospitals, because healthcare provision outside the capital is often limited.

It means that their treatment is often delayed in clinics that are overwhelmed and contributes to disappointing outcomes for patients.

Now, Gambian medics can assess patients remotely using a digital “pre-op health assessment app” called LifeBox ePOA, created by Definition Health.

This will enable remote care, monitoring and planning for patients between Dr Marenah in Banjul and the satellite hospitals.

They can also use the app to seek help with diagnosis and treatment from colleagues based in Britain.

Dr Scott, a radiologist at UHSussex, said: “It is the first national virtual fracture clinic in the world to run off a single digital platform and already data is showing that it will prevent 50 per cent of patients having to travel long distances for treatment.

“It was my complete privilege to work with the medical team in The Gambia and to offer them support with our Definition Health digital platform which allows them now to record conditions and treatment as well as monitor patients from a distance.

“For some patients, this saves them a journey of over 100 miles. I hope we can continue to support their everyday appointments with their patients, wherever they may live, and then with safe and efficient onward referral to the specialist where necessary.

“I feel happy that our technology is creating the greatest benefit where it is most needed.”

She took part in the week-long trip with Gam Med founder James Gibbs, a local orthopaedic surgeon, who had previously joined Dr Marenah in The Gambia on an outreach programme.

After the outreach programme, under the auspices of the West African College of Surgeons, Mr Gibbs and another local orthopaedic consultant Lisa Leonard were involved in setting up the Gam Med charity.

Mr Gibbs, who is an Orthopaedic Consultant at UHSussex, said: “The patient portal that is used in this gives them far more information than you’d ever get through a single clinic appointment because they can log on to the dashboard of their injury and they can see videos of how to recover and what needs to happen next.”

“There is also a two-way chat facility, so if people have any questions or queries we can pick that up. Essentially, we’re just trying to recreate the service that works well in Sussex out in Africa.

“The distances people have to travel over there, the poor infrastructure. People haven’t got any money. They haven’t got a car necessarily, so they have to get a taxi. So, this is massive thing for the country. “