Views sought on hip and knee surgery eligibility criteria (Closed)

The demands on healthcare today are growing at an unprecedented rate and the NHS is under increasing pressure to deliver all that we are asking of it.

People are living longer, there are better treatments available and our modern culture and population health issues such as diabetes and obesity are adding to the demand.

In addition to healthcare interventions that tackle ill health and save lives, there is a growing demand for a range of orthopaedic procedures such as hip and knee replacements.

There is a strong body of evidence showing that for such procedures to be the most beneficial, patients requiring these interventions will need to maximise their chances of success by being fit for surgery. 

NHS Herefordshire Clinical Commissioning Group, the body responsible for buying healthcare services for the population of Herefordshire, is reviewing its Treatment Policy is proposing to change the criteria for accessing hip and knee replacement surgery. 

Why are you proposing  to change the criteria?

Clinical evidence shows that when people are physically in the best health possible prior to having a hip or knee replacement, the long-term outcome of their surgery is better. This means future operations are less likely for the patient and a reduced demand on the NHS.

What are the changes that you are making?

The new criteria for eligibility will be that patients will need to have:

  1. Participated in a weight management programme to reduce the pain in their hips and knees.
  2. Have a Body Mass Index (BMI) under 35 and an Oxford Hip Score (OHS) of below 30. BMI measures your weight when compared with your height and the OHS measures ability to undertake everyday task and the level of pain experienced. This ensures that surgery can be undertaken at the optimum time and patients are in their best physical condition for success.

What if I don’t meet the criteria, will I be refused a hip or knee replacement?

If a patient does not meet the eligibility criteria, the doctor will decide whether the patient’s mobility is so compromised that delaying surgery could have adverse health implications.

Your views are important

We asked for your feedback on our proposed changes to the eligibility criteria for hip and knee surgery by completing a short questionnaire. This consultation ended on the 30 June 2019 and the questionnaire has now been closed.