Knee and hip replacement surgeries are some of the best treatments in all of medicine for restoring quality of life. Living with bad knee or hip arthritis has profound effects on patient wellbeing and the ability to participate in and enjoy life. Our research has previously demonstrated that up to one fifth of patients waiting for hip or knee replacement surgery are in the worst health related quality of life states imaginable – states termed “worse than death”. Quality of life worsens the longer you wait for life-changing joint replacement surgery, making excessive waiting times for hip and knee replacement surgery truly a false economy.
Despite this, joint replacement surgery is often deprioritized in times of stress on the NHS. This study by Wendy Bertram and the University of Bristol team, published in the Bone and Joint Journal, demonstrated that thousands of NHS knee replacement operations are cancelled at short notice every year, many for avoidable reasons. This costs the NHS millions of pounds and increases waiting times for patients, many of whom are in severe pain.
The NIHR-funded study collected information on the timing of, and reasons for, cancellation of total knee replacement surgery at 6 NHS hospitals in England, Scotland, Wales and Northern Ireland, over a period of 5 years between April 2018 and Mar 2023.
The study found that, at the 6 hospitals over the 5 years, 17,223 total knee replacement operations were completed and 9,403 cancelled – more than previously thought. This is the first study to measure total knee replacement cancellations across more than one hospital. Each cancelled operation costs the NHS a lost tariff of between £6,500 and £11,000. This adds up to over £15.5 million across the 6 hospitals, over 5 years.
A quarter of the cancellations were less than 24 hours before surgery, and nearly one third were within 2 to14 days. Cancellations the day before, or on the same day as surgery, can leave empty operating theatre spaces which are difficult to fill. Rescheduling these operations adds to already lengthy NHS waiting lists.
Read the paper here.