By: 19 December 2013

Medical Technology Group calls for fair access for all patients

Research from the Medical Technology Group reveals that just after Christmas may be the worst time of year to need hip or knee joint replacement – and that just after may be the best time.

Like a postcode lottery, this time-of-year lottery means the outcomes for individual patients can be radically different, in this case dependent on the financial calendar.
March is the busiest month for operations, so patients starting the average 15-week wait for a new hip or knee are better starting their wait just before Christmas. Those who start their wait after Christmas may have the longest wait.

The research shows that over the last ten years there were an average of 498 fewer hip procedures and 641 fewer knee procedures in April than in March, coinciding with the end of the financial year. The implication, the Medical Technology Group report says, is “that financial calendars for trusts are driving outcomes for patients.”

There is also new evidence of a postcode lottery in hip and knee treatments, with dramatic variation in waiting times and half of local trusts reporting patients being held back from treatment.

Barbara Harpham, chair of the Medical Technology Group, said: “If you need a new hip or knee, it shouldn’t matter when in the year it is, or where in the country you live. There is a postcode lottery and a time-of-year lottery, and it isn’t good enough for patients. It is vital that the government stops restrictions on knees and hips operations for people who need them.”

The key findings of the report are:
46,501 hip procedures were performed by the NHS in March over the last ten years – compared to 41,519 in April. This is a difference of 4,982 or 11%.
49,351 knee procedures were performed by the NHS in March from 2004 to 2013 – compared to 42,944 in April. This is a difference of 6,407 or 13%.
The postcode lottery persisted in 2012. Patients in London waited 33% longer than patients in the East Midlands for a hip operation in 2012. Londoners waited an average of 121 days compared to 91 days for patients in the East Midlands.
The Medical Technology Group is calling for Clinical Commissioning Groups to stop imposing more restrictive conditions before they refer patients. They want Trusts to ensure greater equity of access throughout the year and ask that Trusts have strategies in place to improve patient outcomes from joint replacement.

In November, 20 Parliamentarians attended an event at the Commons, with 13 so far signing a pledge, which states: “We believe it is crucially important that patients should have access to medical technologies recommended by NICE (National Institute for Health and Care Excellence) if clinically appropriate for them wherever they live in the UK.”

Barbara Harpham says: “The NHS is not adopting medical technologies as widely and as quickly as it should, and patients in the UK are missing out when compared to other countries.

“Insulin pumps are a prime example. These have been approved by NICE for the treatment of Type 1 diabetes, but uptake in the UK is currently 6%, half the target 12% recommended by NICE in 2008.

“The aim of our pledge is to highlight disparities in medical technology access and ensure that when decisions are being made about medical technologies, they are based on the value they will bring to patients, rather than how much they cost.”

Click on the link below for a full copy of the report:

 Hip and Knee Replacements – Combating Patient Lotteries FINAL