Trauma and Orthopaedics

What is Musculoskeletal Community Specialist Service (MSK CSS)? 

The Musculoskeletal (MSK) Service provides assessment, diagnosis and non-surgical treatment for adults with muscle, bone, joint or soft-tissue problems affecting the shoulder, elbow, hip, knee, ankle, foot or spine. These symptoms can arise from injuries, overuse, long-term conditions or degenerative changes.  
 
We work closely with MSK however, this service is provided external to Royal Berkshire NHS Foundation Trust and as a community-based service ran by Berkshire Healthcare NHS Foundation Trust and led by Advanced Physiotherapy Practitioners. 
For more information, please look at Berkshire Healthcare NHS Trust’s website here. 

The Virtual Fracture Clinic is designed to allow patients to receive expert review of their injury quickly and conveniently. For many patients, there’s no need to attend the hospital in person, and the Virtual Fracture Clinic is designed to ensure expert consultant-led clinical oversight of all concerns, quickly.   

Why a virtual clinic? 

Coming to a traditional fracture clinic in the first few days after an injury is often unnecessary and can be difficult if you are in pain or have limited mobility. With our Virtual Fracture Clinic, you get an expert consultant opinion without leaving home. 

How it works:

• After a referral, for instance, from your GP, A&E or Minor Injuries Unit, your X-rays and clinical notes are reviewed by one of our specialist orthopaedic consultants using a secure system.
• You do not need to come to the hospital for this assessment.
• Once the review is complete, an orthopaedic nurse will call you to explain your treatment plan. This may include advice and information or arranging an appointment at the most appropriate in-person clinic if required.
• The nurse will call between 9am and 5pm, so please keep your phone nearby. If you miss the call, we will leave a message if possible.
•  A letter summarising your assessment and treatment plan will be sent to you and your GP.

This service helps you get the right care quickly, while avoiding unnecessary hospital visits or appointments. 

Our Fracture Clinic provides specialist care for patients with bone and joint injuries, including fractures, sprains, wound care and cast/splint management.  
 
We hold Adult and Children’s (Paediatric) Fracture Clinics from our outpatient's department in Royal Berkshire Hospital and West Berkshire Community Hospital.  
 
More information on what to expect at our Children’s Fracture Clinic here. 

Royal Berkshire Hospital Location

Trauma & Orthopaedic Outpatients Department,  
Level 2 South Block,  
Royal Berkshire Hospital, 
Craven Road, 
Reading, 
RG1 5LE.  

West Berkshire Community Hospital Location

Outpatients  
West Berkshire Community Hospital 
London Road,  
Benham Hill, 
Thatcham,  
RG18 3AS.

Our Trauma service provides expert care for people who have sustained acute injuries to their bones, joints, muscles, ligaments or tendons. This includes injuries from falls, accidents or sports activities that require urgent assessment and treatment.

We work closely with Accident & Emergency (A&E) and urgent care services to ensure that patients with traumatic injuries receive prompt and specialist care when they most need it.

Please see information about our Trauma ward, Hurley Ward, here.

When you attend the clinic, you may notice that the team gives priority to patients who need urgent care or depend on hospital transport. Although we aim to see everyone in a timely way, you may experience some delays, particularly in cases in which further investigations are needed, such as an X-ray. 

As part of your care, you may be asked to visit our Plaster Room, where casts, splints or supports can be applied, adjusted or removed. Our plaster room team includes experienced orthopaedic practitioners, nurses and clinical trainees, all trained to provide safe and effective care. 

We run a Complex Fracture Clinic on Thursday mornings, dedicated to patients with more complicated injuries or treatment needs, which may find it challenging to find appropriate alternative appointments for other times in the week.  

If unable to attend your appointment, please let us know by calling our admin team on 0118 322 7415 as soon as possible, so that we can give the appointment to someone else. 

Waiting for surgery can be a challenging time, but there are important steps to take to prepare physically and mentally.  
 
Preparing well before a procedure can improve your recovery, increase the likelihood your surgery is a success and reduce the chance of complications after your operation, allowing you to make a faster return to everyday activities.  
 
There is strong evidence that improving your overall fitness, nutrition and wellbeing before surgery, which is also called Prehabilitation, leads to better outcomes after your procedure. 

How You Can Prepare for Surgery

Below are four key areas where you can take positive steps while you wait: 

1. Improving Physical Fitness 
   Keeping as active as possible before surgery is crucial for training and preparing your body for the extra work it will need to do while you are healing.  
   Find more ways to get active here
2. Eating a balanced diet 
   Maintaining a healthy weight can reduce strain on your joints and improve outcomes from your surgery. A balanced diet including food from all food groups makes sure your body works well.  
   Find more support on how to eat healthier here
3. Managing Wellbeing and Sleep 
   Having an operation is a stressful time in anyone’s life and it is natural to feel worried. Managing your anxiety, encouraging positive thinking and developing your coping skills may have a positive impact on your recovery and outcome after surgery. 
   Find resources to support your mental wellbeing and Sleep here
4. Stopping Smoking and Limiting Alcohol Consumption 
   Smoking and high alcohol consumption are linked to slower healing and more complications after surgery.  
   If you smoke, stopping before your operation can significantly improve your chances of a smooth recovery. Reducing or avoiding alcohol in the weeks before surgery is also recommended. 
   Find support to help you make these changes here

For more detailed advice on preparing for surgery, including exercises, diet tips and wellbeing guidance, please visit our Surgical Prehabilitation page.  

You can also watch this video for more information. 

Pre-operative (Pre-Op) Assessment Clinic

You will attend a Pre-Operative Assessment Clinic which will assess your fitness ahead of your surgery.

Depending upon your individual fitness and the type of surgery you are having, you may go through various assessment stages. Part of your pre-op assessment may take place over the phone.  

Once you have had a pre-op assessment, it will then be decided whether you are well enough for surgery and whether it is the best treatment option for you. The clearing process will happen after you leave from your pre-op appointment, so please wait to hear from our Orthopaedic admin team to arrange a date for your procedure. Our Orthopaedic admin team will call you once you have been cleared for surgery.

Find out more about your pre-operative assessment here. 

We want your visit to hospital to be as safe, comfortable and well prepared as possible. This information outlines what to expect and how to prepare before you come in. 

Before You Come In

Check your appointment letter carefully, as it will include important details such as: 

• Your admission date and time
• Where to go when you arrive
• Any specific instructions, including fasting (not eating and drinking) before your procedure, if advised.

If you become unwell in the days before your admission (for example, with a cough, high temperature or infection), please contact the T&O team as soon as possible so we can advise you on whether your procedure can safely go ahead. 

Arranging Support and Transport 

If you are having a day procedure, you will usually go home on the same day once you have recovered from anaesthetic and your clinical team are satisfied you are safe to do so.  

• Arrange for someone to take you home and stay with you for the first 24 hours after sedation or anaesthesia.
• You should not drive yourself home or use public transport after a general anaesthetic or sedation. 

• How long will I have to wait for my procedure? 
  Waiting times vary depending on the procedures and individual clinical needs. We prioritise seeing patients based on clinical need, which means those who require urgent care are seen first. Unfortunately, due to ongoing high demand for orthopaedic care, some patients will wait longer than expected. Before a confirmed procedure date is offered, we can only provide an estimated waiting time, as this depends on many factors.  
  We understand that waiting for treatment can be difficult, and we apologise for the delays some patients may experience, despite significant work across the department to reduce our waiting times. 
• How long will I have to wait for my outpatient appointment?  
  Waiting times for outpatient appointments vary depending on the reason for referral and the type of clinic you need. Some sub-specialities are currently experiencing delays, which may affect when you are seen.
  We understand that waiting for an appointment can be difficult, and we apologise for the delays some patients may experience, despite significant work across the department to reduce our waiting times. 
• How long will I wait for my X-ray, CT or MRI scan? 
  Scan waiting times vary depending on the type of imaging required and clinical urgency. You will be seen by the Radiology department. For more information, please visit our Radiology webpage.
• Where is my appointment? 
  We hold clinics across four locations. Please check your appointment letter to confirm the date, time and location of your appointment. 
  Our sites include: 
   
  Royal Berkshire Hospital 
  London Road
  Reading  
  RG1 5AN 
   
  West Berkshire Community Hospital  
  London Road 
  Benham Hill 
  Thatcham 
  Berkshire  
  RG18 3AS 
   
  Townlands Memorial Hospital 
  York Road 
  Henley-on-Thames 
  Berkshire  
  RG9 2DR 
   
  Bracknell Healthspace 
  York Road 
  Henley-on-Thames 
  Berkshire  
  RG9 2DR 
• How do I get to my appointment? 
  Most patients are expected to make their own transport arrangements when they can. Information on travelling to our hospital sites by car or public transport is available here.
  If you can use public transport or arrange to be dropped off, this will help reduce congestion and delays to your appointment.As we are a busy hospital in a location near the centre of Reading, parking is often limited. If you need to drive to your appointment, we recommend leaving earlier than usual to ensure you get a space and arrive on time for your appointment.
  Hospital transport is available for patients who have a medical need that prevents them from using private or public transport. Eligibility criteria and further information can be found here.
• What is the recovery time for my procedure? 
  Recovery time depends on the type of procedure you have and can vary from person to person. The team will discuss what recovery is likely to look like for you during your appointment, including when you may be able to return to normal activities. 
• How long will I need to take off work for my procedure? 
  The amount of time you need off work will depend on:
  
  • The procedure you are having 
  • Your general health before surgery 
  • The type of work you do (for example, desk-based or physically demanding work)
  • The team will be able to give you more tailored advice during your appointment. 
• What can I do to prepare for surgery? 
  There are several steps you can take before surgery to help improve your recovery and overall outcomes, including staying active, stopping smoking and managing long-term conditions where possible. Visit our Waiting Well page for practical advice and support. 
• What should I do if I need an interpreter for my appointment?  
  If you require an interpreter, please call our Trauma & Orthopaedics admin team on 0118 322 7415.  
• What should I do if I need to cancel or rearrange my appointment? 
  Please call our Trauma and Orthopaedic clinical admin team as soon as possible on 0118 322 7415.  
  A significant amount of work goes into organising our clinics, so having as much notice as possible can help us ensure another patient is seen or valuable time is saved, which can reduce delays. 
• What do I need to pack before coming in for surgery? 
  If you are staying in hospital overnight, you should think about bringing in:
  
  • Day and Night wear – It is important to get out of bed, get dressed and start to move as soon as
  • your operation allows to reduce risk and improve recovery, 
  • Toiletries – e.g. toothbrush and toothpaste, 
  • Footwear – which is sturdy but easy to put on, 
  • Hearing aids or glasses if you need them, 
  • Medication if you have a regular prescription.  
  • Temperatures in the hospital can vary, so some layers of clothing can be useful.
• There is more information on how to prepare for surgery in this short video.  

• What should I do with my walking aids when I am done with them? 
  Please return any crutches, walking sticks or frames you were given by the hospital so they can be cleaned and reused for other patients. 
   
  Returned walking aids can be dropped off at: 
  Orthopaedic Outpatients (Fracture Clinic), Level 2 South Block, RBH, 
  Physio East (opposite Craven Road multi storey car park),  
  Adjacent to main reception desk on Level 2 Main Entrance, Craven Road, 
   
  Alternatively, you can return your walking aids when you attend your follow-up appointment at Orthopaedics Outpatients (Fracture Clinic). 

  There is a short video showing these locations and explaining why it is important to bring them back here. 

  Thank you for saving the NHS money and supporting the continued care of other patients.