Hip and knee operation cutbacks contested

The Royal College of Surgeons has complained about proposed cost-cutting plans to ration hip and knee replacements to only those with ‘sever pain’.

Three clinical commissioning groups (CCGs) in the West Midlands, Redditch and Bromsgrove, South Worcestershire, and Wyre Forest, have announced intentions to change their scoring system for eligibility for hip and knee replacements, cutting the people who qualify by 12 and 19 per cent respectively.

The CCGs claim that this could prevent about 350 operations a year and save approximately £2 million annually, but the Royal College of Surgeons has argued that their is ‘no clinical justification’ for their plans.

While it would save money, the move would mean only treating ‘severe to the upper end of moderate’ cases, meaning those with a body mass index over 34, considered obese, would also be forced to wait until they had lost 10 per cent of their weight unless their problems were very severe.

Additionally, the Royal College of Surgeons say that the current scoring system used by the CCGs, which is known as the Oxford scoring system, is designed to measure outcomes of care ‘and should not be used to create barriers to care’.

Stephen Cannon, vice president of the Royal College of Surgeons, said: "We appreciate that the CCGs face significant financial challenges which now mean they are looking at which groups of patients they can target to save money.

"While the CCGs have stated they hope this policy will save them £2 million a year, it is unclear whether they have considered the costs of not treating a patient. This could include the cost of pain relief medication and a later operation when the patient does meet the required pain and weight thresholds.

"Delaying access to surgery also adversely affects a patient's quality of life and surgical outcomes, meaning the operation may not be as beneficial as if it had been carried out earlier."

A spokesman for NHS Redditch and Bromsgrove CCG said: "If a patient feels that they require this surgery but do not meet these criteria, there is a clear appeals system via individual funding requests whereby the effects can be considered upon the patient and the decision made regarding eligibility for funding."