Trauma and orthopaedics

This information relates to Barnet Hospital and Royal Free Hospital only. Please read the North Middlesex University Hospital section for details on their service.

Some more complex injuries will require a review at a virtual fracture clinic. You will be told in urgent care if you have been referred to a virtual fracture clinic and an information leaflet will be provided (also available below). You do not need to attend the hospital for the assessment to take place.

Clinicians will look at your x-rays and medical notes and an orthopaedic physiotherapist or nurse will telephone to discuss your treatment and management. Following the phone call, you may be discharged by phone or if you require further specialist help you will be referred to the most appropriate clinic to meet your needs. If you are not available on the telephone a message will be left where possible.

Patients and their GPs will receive a letter outlining the assessment and outcome.

If you are having difficulty at any stage, please call the team:

Barnet Hospital

Tel: 020 8216 4445

Royal Free Hospital

Tel: 020 7472 6222

Referrals are welcome from GPs through the e-referral service. Fracture clinic appointments may be made by referral from our accident and emergency departments and urgent care centres or from a GP.

The North Middlesex Virtual Fracture Clinic is a telephone clinic service. Patients referred to this pathway will receive a call in the late afternoon after their booking appointment time with their management plan.

Referral information

This service is for all patients with any acute orthopaedic injury excluding:

• Those who require surgical intervention.
• Wounds and infections.
• Neurovascular concerns.
• Patients requiring hospital admission.
• Patients who are not suitable for a telephone clinic (based off clinical judgement).
• When the clinician has uncertainty.
• Back pain and long-term conditions such as arthritis (or those usually managed via our elective services).

Please discuss with our on-call team if you feel a referral via their pathway is more appropriate.

North Mid emergency department internal referrals 

1. Completion of the careflow clinical note "virtual fracture clinic (VFC) new referral form."
2. Booking the patient into the careflow VFC clinic facilitated via the receptionist.

External referrals

Complete the North Mid VFC external form

Many patients who come into an emergency department or urgent care centre with a musculoskeletal injury or fracture can be treated and safely discharged without the need for further review. These patients will be provided with information about their injury (also available below), any rehabilitation exercises required and who to contact if they have any concerns or queries post-discharge.

The Royal Free London shoulder unit delivers multidisciplinary shoulder expertise across north London. Outpatient services are offered at Barnet Hospital, Chase Farm Hospital, Edgware Community Hospital, Finchley Memorial Hospital and the Royal Free Hospital.
Elective surgery is performed at the Elective Orthopaedic Centre based at Chase Farm Hospital.

Our team comprises surgeons, consultant physiotherapists, an extended scope practitioner and two teams of specialist shoulder therapists. A consultant radiologist with experience in shoulder imaging provides direct clinic and elective radiology support. All clinical staff are members of the British Shoulder and Elbow Society (BESS).

The shoulder unit provides specialist opinion and intervention for patients, while placing an emphasis on teaching, training and academic advancement through research, both local and national. We consult with over 1,000 elective referral patients and manage 500 fracture patients each year. Surgery is performed on over 600 patients each year. Procedures performed range from arthroscopic shoulder surgery to primary and revision joint replacements, all of which are reported to the National Joint Registry.

Shoulder therapists manage the rehabilitation of these patients and treat elective referrals from the shoulder clinics, primary care clinics and offer expert opinion for complex rehabilitation issues. Clinics are multidisciplinary and are offered as ‘one-stop’ as much as possible, with on-the-day radiology and injection where appropriate.

Listed below are websites that you may find useful when looking for further information. 

• British Orthopaedic Association
• American College of Rheumatology

Please note that the Royal Free London is not responsible for the content of external sites.

• Fitting a boot
• Fitting a knee brace
• Using crutches
• Using a humeral brace
• Living with a sling