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Royal College of Surgeons response to restrictions on hip and knee surgery

23 Feb 2017

The Times is reporting today that patients will be barred from hip and knee replacement surgery unless they are in intense and persistent pain, under new restrictions by Rotherham CCG. Under the restrictions, patients with osteoarthritis have to wait until they are in almost continuous pain, unable to cook, bathe or dress themselves without difficulty, and need a walking stick or crutches. They also must have a BMI below 35.

Commenting on the proposals, Steve Cannon, Vice-President of the Royal College of Surgeons said:

“Rotherham commissioning group’s policy is the most punitive we have seen to date for hip and knee operations. According to their own description, the commissioning group requires patients to wait for surgery until they are in intense to severe persistent pain for at least three-quarters of the day, or if the patient has had to resort to walking sticks or crutches. This is terrible for patients and makes no clinical sense as, at this stage, a patient will not only be at greater risk of falls and depression, but they will struggle to get maximum benefit from any procedure due to the seriousness of their disability.

“It is also hard to see how this policy saves money in the long-term. Osteoarthritis is not a condition that improves, so this policy simply delays surgery and patients will be requiring painkillers and potentially other social support in the meantime.

“Hip and knee surgery is increasingly being targeted for cuts by the cash-strapped NHS, yet it remains one of the most cost and clinically effective types of surgery for improving a patient’s quality of life. We urge NHS England to set out the value of such surgery and be clear that this type of decision is unacceptable for patients.”

Notes to editors

The Royal College of Surgeons of England is a professional membership organisation and registered charity, which exists to advance surgical standards and improve patient care.

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