Nick Mason meets an award-winning consultant transforming the lives of limbless patients in the North West.
Dr Fergus Jepson must have a very good secretary.
Fergus is one of the rising stars of the NHS and, as such, is a man in demand.
His day job is as Leader of the Specialist Mobility Rehabilitation Centre for Lancashire Teaching Hospitals NHS Foundation Trust.
His multi-disciplinary team is responsible for 1,950 amputees, 23,000 wheelchair users and 12,000 orthotic patients. In addition to Fergus, the team comprises prosthetists, orthotists, nurses, physios, gym instructors, occupational therapists, psychologists, technicians, rehab engineers and a number of other professionals.
One very important group of patients are British war veterans returning from conflicts including Iraq, Afghanistan and Libya.
In 2010, the Government announced plans to invest £15million to support and improve prosthetic services for military veterans and the SMRC in Preston was one of only a handful across the UK to benefit from the funding.
The centre’s war veteran status has enabled it to open a state-of-the-art gymnasium, something that has benefited all patients. Among the team working in the gym is a double amputee war veteran.
The SMRC has very close links with Blesma, the national Army charity for servicemen and women who have lost limbs while serving their country. In nearby Blackpool, there is a residential care home for the most disabled and infirm.
Fergus took up the consultant’s job in Preston in 2007 but he did not initially set out to work in rehabilitation. His father was an orthopaedic surgeon and Fergus initially followed the same path.
He explained: “I found that I loved the rehabilitation side of my work and it was after a conversation with my father over dinner that I decided I had to follow this route as opposed to orthopaedics.
“We are responsible for taking people on a journey from becoming an amputee and helping them come to terms with a life-changing condition.
“Everything we do is about improving a patient’s independence and mobility. The changes they can make in their lives are hugely impressive.
“Eight years ago, we worked with 1,200 amputees but since then our service has expanded and our reputation has grown.
“When I started at Preston, we were in a much smaller unit but the Trust has invested in the development of our services.”
One of the constant challenges Fergus and his team face is the financial constraints of the NHS.
Fergus says: “We are trying to ensure that our standards don’t drop in the face of austerity. We have a large expense on components and they are getting more and more expensive each year.
“Losing a limb is like a bereavement and we are constantly trying to think outside of the box given the financial climate.”
In addition to running the SMRC team, Fergus is a member of the management board for the hospital, lectures at Manchester and Salford Universities and works at a national level with NHS England.
In 2014, his achievements at Preston were recognised when he was named Clinical Leader of the Year in the prestigious HSJ Awards.
One example of Fergus and his team thinking outside of the box has been in ensuring the centre is as friendly and welcoming an environment as possible.
He explains: “It can seem a scary place with patients missing limbs or limbs leaning against chairs. I want people to leave here with happy memories.
“We hold parties at Easter and Christmas and work hard to get patients, particularly children, to feel more comfortable about being here. We have also developed a dedicated paediatric corridor including a playroom funded by donations.
“I feel passionately about patients being respected and treated as individuals. I am usually late because I want to give the best possible service and experience.”
Fergus’s team has done a lot of work understanding how the unit works and how to make it as effective as possible given the huge volume of patients they are seeing annually.
By working in a flexible and responsive way they can go a long way to ensuring patient satisfaction. For example, a patient might come to the centre for an appointment with a prosthetist but the prosthetist may then ask if Fergus is available to also see the patient, perhaps if they are in pain. Often, the process is reversed with Fergus asking for an alteration to be made to a patient’s prosthetic limb thereby triggering another ad hoc appointment.
Fergus adds: “Having such a flexible and responsive multi-disciplinary team, we are able to minimise patient appointments and transport requirements. Often, patients cannot drive and can be coming from some distance away. We are helping to minimise the impact on our patients’ lives.”
Another innovation in the last couple of years has been the running of regular diabetic clinics, working in conjunction with the Trust’s diabetes specialists.
Fergus says: “Around 40 per cent of amputees are diabetic and we are seeing quite resistant conditions in some younger people.
“Working in a more multi-disciplinary way is helping to reduce the number of amputations.”
In his spare time, Fergus is a British Athletics classifier for disabled sport, regularly attending track meetings across the UK helping to determine what classification athletes should be.
Fergus reserves his final comments for the administration team in Preston, who he describes as the “unsung heroes of the NHS” and the small number of specialist suppliers working in the prosthetics and orthotics industry.
Fergus concludes: “Together, we are all responsible for helping our patients come to terms with life-changing conditions. We understand what is important to them and then we help them achieve it. Sometimes this could be something day-to-day such as managing pain, sometimes it could be finding a better way of doing something. I am passionate about the work we do and incredibly proud of the team I am fortunate enough to lead.”
- To find out more about the work of Blesma, please visit blesma.org