NHS putting the squeeze on hip and knee replacements

We’re all well aware of the challenges facing funding of the NHS. With the recent election still fresh in mind, the process of how funds are allocated within the NHS has been discussed at length, with almost everyone holding an opinion about which areas are most deserving of retaining, increasing or decreasing funding levels.

With increased pressures on the NHS due to an ever-increasing older population, there is arguably a degree of management required to ensure that those who are deemed most deserving are able to receive access to treatment, ahead of those who are perhaps regarded as less suitable, or less in need of surgery.

So, how can suitability be effectively and fairly judged?

One idea that has been mooted is that those who are prepared to demonstrate that they have done everything they can to ensure that their overall health is as good as it can be, are given preferential access over those who indulge in damaging lifestyle habits. An example of this is the refusal of the NHS to offer orthopaedic treatments such as knee and hip replacements to those who are smokers, or who are classed as obese.

Access to additional NHS funding for joint replacements

When patients require certain treatments on the NHS, doctors can make a request to their local Clinical Commissioning Group (CCG) to receive extra funding for this. According to information sourced by Arthritis Research UK, tens of thousands of these requests were made in the past year, and around half of these were approved. With requests for funding growing year on year, there are a significant number each year that are not able to benefit from this additional CCG funding.

The chief executive of NHS Clinical Commissioners, Julie Wood explains that, “unfortunately, the NHS does not have unlimited resources, and ensuring that patients get high-quality care against a backdrop of spiralling demand and increasing financial pressures is one of the biggest issues CCGs face.” This is exactly why the NHS are having to impose additional criteria (such as being a non-smoker and not being obese) to help identify which patients are most deserving of funding for the operations they require.

Some CCGs have introduced guidelines to help identify the more disabled patients, which means patients will only be approved for hip and knee replacement operations if they are in such pain that sleeping and incapable of performing simple, everyday activities. The concern is that delaying surgery till that point only results in higher treatment costs overall and a less than optimal outcome for the patient.

Ultimately, despite the NHS wanting to offer support, treatment and operations to all who require them, there will always be a limit to what is achievable when demand outstrips supply. While this continues to be the case, the NHS will argue that the only way forward is to set additional stipulations and criteria in which to evaluate patients, so they can try and fairly assess how to prioritise available NHS funding for joint replacements.