Reduced waiting times for orthopaedic procedures, but scope for further efficiencies

In recent years, the National Health Service (NHS) in Scotland has significantly reduced the length of time people are waiting to receive orthopaedic procedures such as hip replacements and knee operations. Over 95% of patients are now treated within 26 weeks of referral, compared to only 66% in 2003. But there is scope to make savings by working more efficiently.

An Audit Scotland report, Review of orthopaedic services, says there is high demand for these services. Orthopaedic care is particularly important for older people, who have the highest rates of fractures and joint replacement.

Last year these services cost over £370 million. Over the past ten years, the level of funding increased by 68%, the number of orthopaedic consultants went up by about 50% and activity rose by 12%. As Scotland’s population ages, demand for services will keep rising. Reduced funding and shorter waiting times targets will add further pressure. In order to sustain the improvements made, the NHS has to become more efficient.

The report looks at areas worth exploring for potential efficiencies. It says moving more inpatient care to day surgery, reducing the length of time patients stay in hospital and making changes to how surgical implants are bought would all result in savings. Based on available information, it is not possible to draw clear conclusions about productivity, but the report suggests that if NHS boards with lower levels of activity were to reach the average, then an additional 3,700 procedures could be carried out each year.

Deputy Auditor General for Scotland, Caroline Gardner, said:

“Back pain, hip problems and other orthopaedic conditions can seriously affect people’s mobility and quality of life. Waiting times for hospital treatment have reduced considerably in recent years, and this is a very welcome achievement.”

“However there remains much that the Scottish Government and NHS boards can do to help improve the efficiency and effectiveness of orthopaedic services and money could be saved by better use of resources. But for this to happen, there needs to be much better information on activity, costs and what works best for patients.”