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Knees, hip and eye surgery at lowest level 'for over five years'

Hip and knee replacements and eye operations are at their lowest levels for over five years, claims a new report into the effects of the NHS’s efficiency drive.

Health analyst company Dr Foster Intelligence warned that the number of knee operations has fallen for the first time since 2002, and that fewer cataracts operations are taking place now than in 2008.

They were unable to say whether this meant patients’ needs were going unmet, but said these data indicate that access to this type of operations were being reduced while money was still spent on treatments that experts had deemed ineffective, such as ‘knee washes’.

Dr Foster said the report was aimed at challenging GP commissioners to review whether they are making the right savings decisions in the face of austerity pressures.

Director of research Roger Taylor commented: ‘We have highlighted these figures to GPs so that throughout this period of austerity money can be spent wisely providing care for people that need it.

‘Across England as a whole, austerity has caused the NHS to be more careful about the way it spends money on planned care and to cut waste. But there are significant differences in how well commissioners are coping with the financial squeeze. The quality of the service you can expect to get from the NHS will increasingly be affected by how well your local commissioners manage their budgets.’

It comes after Pulse reported yesterday that GPs in some areas have been blocked from referring patients for bariatric surgery, because of the ‘fragmentation of services’ that commissioners claim has occurred since April.

Readers' comments (11)

  • This isn't anything to be proud about. The whole flood of cases that have been delayed by dishonest or arbitrary means will simply come back next year. You can only stall decayed hips/knees with paracetamol/co-codamol/tramadol/MST for so long.

    It's like those PCTs/CCGs that had hernia operations on low priority - a total nonsense and just a delaying tactic.

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  • totally agree with above comments
    waiting times for such ops and even to see consultants have gone up. Noone wants to talk about that as that saves money.
    pts with back pains , joint pains, those awaiting CABG , cataracts are now waiting longer. they end p turning up in GP clinics frustrated that nothing is being done about it and requests the GP to expedite the appointments. some of the appointments are now blocked with such patients creating more stress in primary care. I end up telling the pts to call the department in concern and chase the appointments and if they feel the waiting time is unreasonable they should speak to PALS team.

    locally dermatology waiting time is 3-4months, rheumatology follow ups happens 9 monthly if lucky, I can go on.

    the CCG , NHSE and government needs to be honest and explain to the pts what they can expect from NHS.
    Promising the patients unachievable service is part of the issue. Address that.

    Is there any GP who feels they are not under pressure on NOT to refer a patient even when they feel its the right direction to take?

    I plan to be save and keep away from medico-legal complaints and GMC as I know they will treat me as a criminal until proven innocent

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  • Im no apologist for any political party, but if you look at the graphs, it is very striking that during the Labour governments of 1997-2010, there is a steady rise in the number of procedures, that is preceded by a plateau under the Conservatives, and wiped out by the ConDems. And all the while, the population is growing in number and age, so the trend should be upwards.

    These are procedures that have a huge impact on quality of life and independence, and rationing them to this extent makes no clinical sense.

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  • Vinci Ho

    It is interesting to know what is going through the mind of orthopaedic surgeons these days? What have they been 'told' by 'upstairs ' ? How many of them have bowed down to these 'instructions' from 'upstairs '?
    Don't forget being honest and tell patients the truth is already part of the duty of 'candour'........

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  • Vinci Ho

    'Neither riches nor honours should corrupt you.
    Neither poverty nor lowly condition should make you swerve from principles.
    Neither threats nor force should bend you.'
    Mencius , ancient China.
    (You can call me a silly China man pretending to be a saint......)

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  • The orthopaedic surgeons have their hands tied by restrictive policies drawn-up CCGs, who will only pay for procedures under a very narrow set of circumstances.

    Mandatory músculo-skeletal pathways that fob patients off with physio, restrict X-rays and block referrals.

    Once a patient finally sees the surgeon, there are draconian exclusion criteria designed so that as many people as possible are either too old, too young, too fit or too unfit to have surgery.

    Its clearly working, look at the figures...

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  • Good too many hip replacements going on, we need to focus on healthy lifestyles and prevention balanced diets exercise

    Patients should not expect a new joint willy nilly and hip replacements aren't without risk

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  • Anon 1:58

    That's the sort of woolly-brained thinking that our CCG comes up with, but you must know it's utter nonsense.

    The person with severe OA, bone grating on bone with every step, is not the one that will benefit from a healthy lifestyle and preventative measures. Will you offer her nothing?

    Actually, there is plenty of evidence that joint replacements are not only effective at reducing symptoms, they actually prolong life. The improvement in mobility and reduction in pain have significant benefits on overall survival. Obviously it's a big operation, and has risks, but the benefits are well-proven.

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  • Vinci Ho

    Interesting question:
    If everybody needs to pay for these operations, would you think the criteria of indication will be exactly the same ?
    Unless you 100% agree to everything the Chancellor is doing with the budget , stop falling into the trap of ingratiating yourself with the hierarchy obsequiously .......

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  • The 10th Annual Report of the National Joint Register (NJR) shows a 7% increase in joint replacement, 2012 over 2011. The demand is continuing to increase - aging of population, obesity, diabetes, little exercise etc., also the number of revisions. Meanwhile more replacements are taking place in the independent sector than in NHS Hospitals (many of the independent cases are funded by the NHS). I live in a rural Bedfordshire village and daily witness the trouble some of my fellow villigers have in walking and sleeping. What is the future? Funding will become even more scarce in the years to come!

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