Simultaneous Joint Replacements

Simultaneous Joint Replacements
Proposal:

To stop offering simultaneous joint replacement surgery – that is where both knees, hips or shoulders are replaced at the same time. Funding for single or staged joint replacement will continue.

Rationale for change:
In simultaneous joint replacement, both joints would be replaced at the same time. Whilst there may be an advantage that the surgery is undertaken in one go, it does pose greater risks. By having both joints replaced at the same time the surgery is therefore longer which alone can increase the risk of complications.

Recovery and rehabilitation time may be increased when having simultaneous joint replacements and therefore this can place a greater demand on the body which in turn could lead to a complex and more expensive package of care being required.

The CCG’s approach to the current financial challenges is to prioritise the limited funding it has so that the local population has access to the healthcare that is most needed. This assessment of need is made across the whole population of Basildon & Brentwood CCG and, wherever possible, on the basis of best evidence on what is clinically proven to work.

The proposed change would mean that simultaneous joint replacement inserts would no longer be funded under the CCG however staged joint replacement would still be.

Impact:
It is suggested that staged joint replacement poses less risk to older patients and patients with heart conditions whilst also reducing the length of time patients are in hospital. The majority of patients having total joint replacements are over the age of 65 and whilst having staged joint replacements will mean having two episodes of surgery the main advantage is that it reduces risks of complications.

The efficiencies made by no longer funding these procedures will go towards bringing the CCG back to its statutory financial balance position which is vital in order for it to be viable organisation and fund future services for the local population.

For further information:

Download the Service Restriction Policy Review document here

Download the Equality Impact Assessment Bi-lateral Joint Replacement document

See our information on Have your say on the Service Restriction Policy Review

Download our current Service Restriction Policy here

Find more information on existing local services at http://www.nhs.uk/service-search