When trauma and orthopaedic patients in Cardiff faced long waits and poor experiences, Consultant Trauma and Orthopaedic Surgeon Oliver Blocker saw a better way. Drawing inspiration from successful medical models of Ambulatory Emergency Care (AEC), he developed a new approach to deliver same-day trauma and orthopaedic care — improving outcomes for patients while reducing system pressure.
Supported by the Bevan Exemplar Programme, Oliver’s project established Wales’s first dedicated Trauma Ambulatory Care Unit at the University Hospital of Wales, creating a blueprint that has since been adopted and adapted across multiple health boards.
The Challenge
Before the project began, trauma and orthopaedic patients — particularly those with hand injuries — often faced inefficient pathways and unsuitable environments. External factors further accelerated the need for change: public attention following social media posts about poor patient experiences and a Health Inspectorate Wales review that confirmed the need for urgent change.
Oliver recognised that these patients did not always require full admission but did need timely, specialist assessment and treatment. Inspired by the medical AEC model, he proposed a dedicated trauma ambulatory care pathway where patients could receive rapid evaluation, minor procedures, and follow-up within a single, purpose-designed space.
The Innovation
The project aimed to redefine how trauma care was delivered, creating a safe, efficient system for same-day assessment and treatment. With the support of hospital management, an appropriate space was identified within the newly redeveloped area of University Hospital of Wales.
The proposal coincided with national momentum around the Same Day Emergency Care (SDEC) agenda — a national policy shift to manage more urgent cases without admission.
Supported by the Bevan Commission and with external factors driving the change, the new unit opened its doors within a year— a remarkable turnaround for a service redesign of this scale. The speed and success of the launch exceeded expectations, but the real test came when the world changed.
Lasting Impact
When the COVID-19 pandemic struck, the unit’s flexibility and focus on safe, same-day care became invaluable. It played a pivotal role in maintaining trauma services safely when hospitals across Wales faced significant disruption. The model proved so successful that it was later showcased in the Journal of Trauma and Orthopaedics.
When Oliver moved to Betsi Cadwaladr University Health Board (BCUHB) as a consultant, he took the model north as part of the Bevan Commission’s Adopt and Spread Programme, securing £45,000 of funding to support implementation. There he quickly became SDEC project lead. He established a new SDEC service in Bangor, expanded a surgical SDEC in Glan Clwyd, and helped develop similar models in Wrexham.
The results were transformative, reshaping how urgent orthopaedic care was delivered and experienced. Patients benefited from faster access to treatment and fewer unnecessary admissions. Staff reported better workflow, improved teamwork, and increased job satisfaction. The trauma ambulatory care model also demonstrated measurable improvements against national benchmarks and significantly enhanced the patient experience — a testament to the power of clinician-led innovation.
Enablers and Lessons Learned
Oliver credits the Bevan Exemplar Programme as a crucial enabler. The structured support, coaching, and networking opportunities provided the confidence and practical tools to turn an idea into reality.
“The Bevan Commission gave me everything I needed — the skill set, support, and problem-solving expertise to build the original project,” he reflected. “That same project document is now being used by other health boards to develop their own services.”
The £45,000 of Bevan funding also allowed protected time for engagement, planning, and evaluation — an essential factor in proving the model’s value. As the approach became established within routine practice, not all of the planned funding was needed, demonstrating excellent value and sustainable transformation.
He notes that timing and national alignment were key. “It almost perfectly fitted with the ideas I already had,” he said. “When you’re in the right place at the right time, with the right support, you can move mountains.”
Reflections on the Bevan Exemplar Experience
Oliver describes his time as a Bevan Exemplar as “transformational” — shaping not only his project but his professional identity.
“It’s changed me completely,” he said. “I wouldn’t be the same consultant without it. It’s given me the insight into how the NHS really works and the tools to make change happen.”
He explains that the programme offered far more than project support — it provided a deep understanding of systems, strategy, and the art of navigating complex structures. “It gives you that insight into how the system really works and how to work around the barriers that usually drive people to frustration,” he reflected.
He likens the experience to gaining an elite skill set. “It’s like moving from being a soldier to a Navy SEAL,” he said. “Everyone can do their job well, but this gives you that extra level of understanding that lets you do things differently. People ask how I’ve managed to make things happen — it’s because I know how, because I was trained.”
That ability to see the system clearly, anticipate challenges, and navigate them strategically, he believes, is what makes Bevan Exemplars stand out as leaders of change across health and care in Wales.
He also highlights the value of the Bevan family — a continuing network of innovators who share challenges, solutions, and encouragement across Wales. “It’s that community of people who’ve been through it before — people who get it,” he explained. “We still support each other, years later.”
Those lessons and connections have continued to shape Oliver’s approach to change, influencing new models well beyond Cardiff.
Wider Adoption and Influence
Since its inception, the trauma ambulatory care model has attracted interest from other Welsh health boards and even colleagues in England. The original project documentation has been shared with Hywel Dda University Health Board to inform the development of their own service, and national orthopaedic networks continue to reference the work as an example of good practice.
Oliver’s experience also informed his leadership of high-volume, low-complexity surgical pathways in Abergele, establishing cross-site collaboration that now enables around 20 surgeons from across North Wales to deliver elective procedures more efficiently. This model is now informing broader transformation plans within the health board.
What’s Next
While Oliver has since stepped back from his formal SDEC leadership role, the impact of his work endures. The units he helped to establish continue to deliver faster, more efficient care for trauma patients, and the infrastructure remains in place for future growth.
He is now focusing on innovation in theatre productivity, exploring new surgical techniques and workflow redesigns to increase capacity and reduce waiting times for joint replacement surgery — building once again on the skills and mindset developed through the Bevan Exemplar experience.
A Lasting Legacy
From a single idea in Cardiff to implementation in North Wales, Oliver Blocker’s journey exemplifies the power of clinical innovation, strategic alignment, and perseverance. His work continues to inspire others to reimagine care — proving that with the Bevan Commission behind you, there really are no limits to what can be achieved.
