By: 13 October 2017
BOA strongly oposed to rationing of orthopaedic services

The British Orthopaedic Association (BOA) has released a statement strongly opposing arbitrary barriers being imposed to limit the number of patients receiving orthopaedic services.

The statement reads: “The BOA is aware that clinical commissioning groups (CCGs) are increasingly using local referral policies to limit certain health services, including hip and knee replacements. Individual CCGs are using patients’ BMI, smoking habit or pain scores as barriers to limit or delay referrals, even though these factors are unrelated to the patients’ clinical needs. Lifestyle changes that may contribute to better surgical outcome and general health should be supported, but clinical decisions must be made together by patient and surgeon based on individual circumstances.

“The BOA draws the attention of the CCGs to the leadership of the profession in establishing and maintaining quality improvement initiatives to optimise efficiency in orthopaedic surgery. The allocation of the NHS’s finite resources should be based on good evidence and appropriate criteria. Knee and hip replacements are among the most cost-effective surgical procedures, and can have a dramatic effect on a patient’s quality of life. There is strong evidence to suggest that very few unwarranted orthopaedic surgeries are being performed, even in those trusts without rationed services.

“We consider these arbitrary barriers to be unjust, not based on clinical evidence and liable to cost the NHS more in the long-term. We call on NHS England and CCGs to ensure that appropriate services are provided at the appropriate time, based on patients’ clinical needs and irrespective of financial constraint.”