Proposing a carpal tunnel treatment centre: The Shouldice model revisited

The Shouldice Hospital prides itself with excellent hernia repair outcomes. The Shouldice concept exhibits a unique, successful business model, and is a clear example of the concept of a highly innovative value proposition. Exploring Shouldice's fundamental principles and extrapolating them to other settings might help healthcare professionals offer improvements to patient care. Carpal tunnel syndrome (CTS) is the most common elective hand disorder, which can be debilitating for patients. Surgical intervention is extremely effective when necessary. It would be prudent to develop efficient pathways for the treatment of CTS, and other common disorders in the future. This review aims to explore the successes behind the Shouldice model, cross-fertilise surgical and management grounds by familiarising surgeons with the Shouldice model to help generate key ideas for the future, and extrapolate key information to postulate the ‘carpal tunnel treatment centre’ as a potential enterprise that can be designed on the basis of the Shouldice model. Optimal healthcare delivery while improving the patient journey, in a cost-effective manner, requires careful planning and execution. It is important to further explore and capitalise on this knowledge, to improve our service to patients and the multidisciplinary healthcare workforce, particularly in light of restructuring of the NHS and the reduction in training opportunities for surgical residents.