Published on: 14th January 2020

NCL logo.pngWe are proposing changes to how adults have surgery for bones, joints and muscles (planned orthopaedic surgery). This includes hip and knee replacements; and other surgery to hips, knees, shoulders, elbows, feet, ankles and hands. Planned surgery is when patients have an appointment booked in advance. It is planned treatment, following a referral to hospital by a GP and an assessment by specialists. It is sometimes called ‘elective’ or ‘nonemergency’ care.

The proposals will affect adults in Barnet, Camden, Enfield, Haringey and Islington (north central London) and some neighbouring areas. 

You can read some background information on the proposals to give you context to why these changes are needed and the benefits they will bring. 

We are asking for your views before we make a decision. Please visit the North London Partners website to take part in the consultation so we can hear your views.

Over 1.5 million people live in north central London and this number is expected to rise. The demand for healthcare is increasing and this will impact particularly on planned orthopaedic surgery. While many of these services are of good quality we know that patients’ experiences vary and could be better and that demand is forecast to increase.

Waiting lists are too long
• In January 2019, over 10,500 residents in north central London were waiting for planned orthopaedic surgery.
• Between January 2018 and January 2019 only 79% of patients referred for orthopaedic surgery in north central London started treatment within 18 weeks; in some of our hospitals, this fell as low as 65% in the winter months.

Too many operations are cancelled
• In 2018/19 across north central London, 530 orthopaedic operations were cancelled – 96% of these operations were cancelled on the day of surgery. This equates to 10 cancellations a week. This was due to the demands of emergency services, lack of available beds or staff. Demand for planned orthopaedic surgery is increasing
• The demand for planned orthopaedic surgery is expected to increase by around 9.5% by 2029.

Without change, it is unlikely that local hospitals would be able to reduce waiting lists; the number of cancellations would continue to grow; and we would not be well-prepared to deal with the expected increase in demand for services. If our proposals were approved, the NHS would continue to spend the same amount of money (around £37 million) on orthopaedic services, however we could make much better use of this money and improve care. Over time, this new way of working is expected to save money.

All the NHS hospital trusts who would deliver planned orthopaedic care under these proposals have been part of developing them.