Hip replacements: an update
Hip replacements are one of the most common and most effective major surgical procedures performed in the NHS, with over 43,000 are carried out each year. This report updates developments on elective hip replacement in the NHS, three years on from a previous NAO report (HCP 417, session 1999-2000; ISBN 0105567493). It finds that there has been significant progress made over this period, although it will take time for developments to take full effect and more remains to be done to ensure improved quality of patient care. The effectiveness of replacement hips remains a central issue, and whilst the majority of consultants use prostheses which comply with standards set by the National Institute for Clinical Excellence, 11 per cent are still using prostheses without adequate evidence of effectiveness. The establishment of a National Joint Registry should provide valuable information on choice of replacement across the country. The average wait for a hip replacement, following an outpatient appointment, is eight months, substantially better than the NHS target of a maximum of 12 months. However, concerns are noted that one in ten orthopaedic consultants prioritise their patients mainly on the basis of the need to meet waiting time targets, rather than on clinical urgency. Recommendations made in the report include the greater use of integrated care pathways, as a means to improved quality of care and reduced length of stay; and the need for procedures to verify that all consultants are complying with NHS guidance on commercial sponsorship.
What people are saying - Write a review
We haven't found any reviews in the usual places.
Executive summary Part
The roles of key players in the provision
1 other sections not shown
AEA Technology April assessment British Orthopaedic Association BUPA cent of consultants Central Government Clinical Excellence guidance collecting the levy Committee of Public Comptroller and Auditor Department of Health Diagnosis and Treatment effectiveness of hip ensure evidence of effectiveness Figure funding Healthcare products Regulatory hip and knee hip operations hip prostheses hip replacement patients hip replacement surgery hip surgery infection rates Institute for Clinical integrated care pathways length of stay Medicines and Healthcare meet waiting Modernisation Agency monitoring National Audit Office National Institute National Joint Registry NHS Plan NHS Purchasing NHS trusts Nosocomial Infection number of consultants orthopaedic consultants Orthopaedic Services Collaborative osteoarthritis Paragraph patient information primary care trusts primary hip replacement private sector products Regulatory Agency programme Public Accounts Purchasing and Supply Ravenscourt Park reducing length referral revision surgery scoring system set up costs Supply Agency survey targets total hip replacement Treatment Centres waiting list