Barts Health is a group of five sites where several centres of excellence exist, or are in development, as well as new models of care for MSK patients. The Royal London Hospital is the busiest Major Trauma Centre in Europe which for high-energy trauma treats the most severely injured patients (ISS 15+). We undertake the full range of Orthopaedic subspecialties in trauma and elective care, including complex spinal work, pelvic reconstruction and limb reconstruction. Whipps Cross University Hospital treats a high volume of non-elective and elective orthopaedics, including a high number of older adults. Barts Health Orthopaedic Centre (BHOC)is an expanding orthopaedic elective service where the majority of arthroplasty work takes place.