Hip replacements: an update

Front Cover
Stationery Office, Jul 17, 2003 - Medical - 38 pages
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.

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