THE future of orthopaedic services in Gwent is likely to involve major investment in more surgery and outpatient clinics at Abergavenny's Nevill Hall Hospital.

Work begins on a multi-million pound orthopaedic centre at St Woolos Hospital, Newport, next month, but Gwent health bosses are looking beyond its completion in a year's time.

While St Woolos will have a big part to play in the war on waiting times, any future proposals to bring down maximum waiting times to nine or six months, or even less, will require more dedicated orthopaedic beds, theatres and staff.

The 2003 Edwards Review of orthopaedic services in Gwent initially proposed a seven-figure investment at Nevill Hall along with a scheme at St Woolos to help slash waiting times for hip, knee and other joint surgery, and boost outpatient capacity.

Only the St Woolos scheme was taken forward however, a 6.7m capital investment that will provide two new orthopaedic operating theatres and 36 beds.

Patients should not have to wait more than 12 months for such surgery by the end of March, a target Gwent Healthcare Trust and other NHS trusts in Wales are striving to achieve, though it will only be possible through the continued practice of sending patients who are willing to English hospitals for their operations, or having them treated in the private sector but paid for by the NHS.

The St Woolos scheme will allow the vast majority of Gwent patients to have their orthopaedic treatment closer to home, but managers admit even more capacity will be required.

"We need to begin looking at the Nevill Hall option in terms of the future," said Reyna MacDonald Birch, the trust's orthopaedic services manager.