P18 Components of the ideal spoke vascular surgery unit

Abstract

Abstract Introduction The ‘Hub and Spoke’ system consists of a leading unit that offers all services (Hub), supported by peripheral units providing less extensive services (Spokes). Cases requiring more complex interventions are often transferred from Spoke Units to the Hub. We wish to shed light on the factors that comprise an ideal Spoke Unit. Methods We did a retrospective review of the Peripheral arterial and Venous cases at our Spoke unit, and analysed patient records, took note of the contributions of various specialities and teams within the unit, allowing us to provide optimal care. Results We found that over an 8-month period (5th April 2022- 1st December 2022), the spoke unit undertook 105 lower limb venous procedures, and 55 arterial revascularisations, as day cases. This was possible due to the support we have from the podiatrists, vascular scientists, interventional radiologists, anaesthesiologists, physiotherapists, clinical specialist nurses and allied nursing teams as well as vascular unit managers. In cases where the hub may be overburdened, the Spoke unit can provide support by managing patients within their domain. Our main Hub Unit has an estimated capacity of 70-80 patients per week at any given time. When referrals to the Hub exceed the capacity, the spoke unit supports them to ensure optimal patient care and avoid physician burnout. Conclusion Having a strong multidisciplinary team contributes to an ideal spoke unit. Creating the ideal spoke unit is essential to optimise patient healthcare within a Hub and Spoke system, but also in preventing physician burnout.