The ‘time of year’ lottery faced by patients needing a knee or hip replacement on the NHS became worse in 2014, according to data from the Medical Technology Group. It suggests that timing is more critical than ever in determining how soon patients receive treatment.
Between March and April last year, hip operations fell by 13% and knee operations fell by 17% in England, implying that the financial calendar rather than patient need is still a huge factor in determining when patients are treated. There was also dramatic regional variation, with knee operations falling by 33% in London compared to just 2.5% in the Northeast.
The Medical Technology Group’s report Hip and knee replacements: combating patient lotteries revealed for the first time that the number of hip and knee replacements on the NHS in England fell dramatically from March to April almost every year from 2004 to 2013. On average, there were 498 fewer hip replacements and 641 fewer knee replacements in April than in March.
The drop in March/April 2014 coincides with the end of the financial year on 31 March, implying NHS Trusts’ financial calendars were driving patients’ access to therapy. In the public sector, organisations forecasting that they may under-spend at the end of the financial year are incentivised to spend up to their delegated limit. Therefore they conduct additional activity at the end of the financial year.
Given that the average wait for a hip or knee replacement is 15 weeks, the time of year lottery suggests that just before Christmas may be the best time to be referred, while just after Christmas may be the worst time of year.
Barbara Harpham, chair of the Medical Technology Group, said: “Getting a hip or knee replacement can dramatically change your quality of life, get you back to work and to caring for your loved ones. It also relieves the long-term costs to the NHS. But now we are seeing even more cases of the NHS scaling back these procedures depending on what time of year it is. There should be no discrepancy based on time of year and where you live. The Government should look into ensuring equal access at all times of the year.”
