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Hip replacements and rationing in the NHS

Here’s a story from the Daily Telegraph about rationing of hip replacement surgery. Lots of people are choose to bypass waiting lists by having their surgery done privately. By doing this, you can choose not only where and when to have surgery, but more importantly, who will do it. There’s very good evidence to show that outcomes of surgery are better when it is done by high volume specialists working in units which do hundreds of joint replacements a year. All of the hospital in which I operate are high volume centres, and I do only hip surgery. Please get in touch if you would like more information.

Hundreds of thousands of elderly people are needlessly suffering in pain while they wait for hip operations because care is being rationed by the NHS, leading doctors have warned. The waiting list for hip, knee and other orthopaedic operations has risen by a quarter over the past eight years to more than half a million in 2016. One in 10 people must wait more than 18 weeks for surgery amid rising concern that NHS is deliberately delaying treatment because it is not seen as life threatening.

Those forced to wait for surgery suffer extreme pain as their bones wear away and are left increasingly immobile, often unable to climb stairs or go outside. It comes as hospitals have been ordered not to schedule any more major non-urgent operations over the next month to avoid a meltdown. Routine operations could be cancelled because regulators say that beds are too full and wards must make space for emergency patients coming in over the festive period.

For NHS managers hip replacements and knee replacements can generally wait because they are not life threatening. They are easy targets for rationing. Steve Cannon, Vice President of the Royal College of Surgeons, warned that people waiting for hip replacements are being left with little more than painkillers for comfort.

He said: “For NHS managers hip replacements and knee replacements can generally wait because they are not life threatening.  They are easy targets for rationing. But they are very painful, they can severely inhibit peoples’ lifestyles. The longer you wait the worse the hip becomes, day by day by day. The cartilage gets worn away and the bone becomes exposed. It then slowly wears away.” He said that the operations could be life-changing.

He said: “Any doctor would like in an ideal way to do any life-improving surgery extremely quickly. When you have the skills available you want to use that to the benefit of your patients. It transforms lives. It makes the immobile mobile, it can give you the ability to climb stairs. It can allow you to walk very good distances if the rest of you is OK.”

According to NHS England the waiting list for non-urgent orthopaedic operations referrals- the bulk of which experts say are comprised of hip and knee operations – has risen from 376,000 in October 2008 to 505,957 this year. More than 60,000 of them were not treated within the 18-week maximum guaranteed by the NHS constitution. The figures also suggest that there has been a huge rise in the waiting list for cataract operations, with the “ophthalmology” waiting list from 242,193 in 2008 to 385,000 this year.

The figures show that a total of 3.7million people in the UK are now on the waiting list for non-urgent operations, up from 2.4million in 2008. More than 360,000 of them have been on the waiting list for more than the minimum waiting time of 18 weeks, equivalent to one in 10. It means that one in 14 people living in England is now on an NHS waiting list.

Dr Sarah Wollaston, the Conservative MP and chairman of the health select committee, is calling on Theresa May to increase health funding.

She said: “There has been a strong increase in demand.  The longer you live, the more likely you are to end up with joint problems. We had a 35% increase in the number of people living to 85 or older over the last decade. At the same time, we also have an unprecedented level of financial challenge for the NHS. At a time when you have an unprecedented increase in demand you have also got an unprecedented squeeze on finances. Either we spend more or we will see increased waiting lists and all the markers of decline. We have some tough decisions to make. We need all parties to discuss how to fund this fairly.”

Katherine Murphy, Chief Executive of The Patients Association, said: “The Patients Association is concerned about the rise of waiting times for elderly people expecting hip operations and cataracts. Delays in hip surgery prolongs the pain and lack of independence for elderly patients. Delaying cataracts surgery can complicate the operation and allows the condition to worsen leaving the patient increasingly unable to maintain their independence. Moreover, delays to treatment means that patient recovery times lengthen and surgery itself may be more invasive.”

An NHS England spokesman said: “Actually the number of NHS-funded hip and knee operations is rising year on year, and more patients will be offered these treatments this year than last. But with a million more over 75 year olds over the next few years, demand is of course likely to continue to rise.”

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Types of treatments available at Latham Hip Surgery
  • Treatments
  • Hip Replacement

    Total Hip Replacement or THR is one of the most successful hip operations in orthopaedic surgery. Tens of thousands of hip replacements are performed each year…

    Click here to find out more
  • Hip Resurfacing

    Hip resurfacing was developed to treat painful arthritis in younger and active patients. It’s now an established technique, and the results are usually excellent in carefully selected patients…

    Click here to find out more
  • Revision Hip Surgery

    Hip replacement surgery can be life changing for those dealing with pain on a daily basis. Unfortunately, even a replacement hip can wear out…

    Click here to find out more
  • Hip Replacement

    Total Hip Replacement or THR is one of the most successful hip operations in orthopaedic surgery. Thousands of hip replacements are performed each year…

    Click here to find out more
  • Hip Resurfacing

    Hip resurfacing was developed to treat painful arthritis in younger and active patients. It’s a relatively new technique, but the results are usually excellent…

    Click here to find out more
  • Revision Hip Surgery

    Hip replacement surgery can be life changing for those dealing with pain on a daily basis. Unfortunately, even a replacement hip can wear out…

    Click here to find out more