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Hospitals with worst records for hip operations revealed

by Ozva Admin

Dr Ian Reckless, MKUH’s chief medical officer, said that because the data was examined over a five-year period, “it will take a few years of ‘normal performance’ for ‘outlier status’ to resolve.”

“This is particularly so given the much lower number of joint replacements performed locally and across the UK over the last few years. two and a half years as a result of the Covid-19 pandemic,” he said.

The NJR report, which also includes knee, ankle, shoulder and elbow surgery, shows that joint procedures in 2020 were about half the level of normal periods, rising 70 to 85 percent in 2021.

Hip replacement operations remained the most constant at 85 percent of normal levels, but there were nearly 50,000 fewer operations in 2020 compared to 2019, and 13,000 fewer in 2021, according to the report.

The report also revealed that women under the age of 55 had higher revision rates than their male counterparts, while women aged 80 and over had a lower revision rate than men.

Hip replacement revisions peaked at 10,508 in 2012 and dropped to 8,244 in 2019. But there was a marked drop in 2020 to 5,069 and 5,580 in 2021 due to the pandemic, the report added. The authors warn that there may be “late records” for 2021 operations, so the figure could be revised upwards at a later date.

‘The deficit represents considerable suffering’

The report cautions that since “hip replacement is performed to treat severe pain and functional limitation, this deficit represents considerable suffering for a large cohort of people nationwide.”

He adds: “With the health service having to attend to a unprecedented backlog of joint replacement With increasing pressure for cost containment, it is more important than ever that we practice evidence-based medicine and use the most effective and cost-effective treatments available.”

Dr. Reckless said that since his hospital’s inclusion on NJR’s outlier list in 2019, a review has taken place and a number of changes have been made, including “ring-fencing” beds for joint replacement surgery to reduce the risk of infection.

“Since our notification in 2019, there have only been three revisions, one of which was for dislocation and two related to post-operative infection,” he said.

“Our patient outcomes are affected by the types of patients we treat, who tend to be elderly with more comorbidities, along with other patients with a higher body mass index.

“Our team of orthopedic surgeons have developed an action plan that will be independently reviewed to ensure we have the correct processes in place to improve patient outcomes.”

‘Action plan’

A spokesperson for University Hospitals Bristol and Weston NHS Foundation Trust said their patients tend to be elderly with more co-morbidities, along with other patients who have a higher BMI.

“Our team of orthopedic surgeons have developed an action plan that will be independently reviewed to ensure we have the correct processes in place to improve patient outcomes,” he said.

A spokesman for the Northumbria Healthcare NHS Foundation Trust acknowledged their high revision rates and said they were working with the British Orthopedic Association and NJR to reduce them.

“There are a variety of complex reasons that contribute to a patient requiring hip revision and we continue to have excellent compliance with case reporting to the national joint registry,” they said.

Wansbeck Hosptial did not respond to requests for comment.

‘Complex cases carry the highest risk of review’

Other hospitals on the list include King Edward VII’s Hospital in London, a private hospital of which the Duke of Kent is currently president.

A hospital spokesperson said: “We have some of the most respected hip surgeons in the country who attract the most difficult cases. These complex cases carry the highest risk of revision, something that is not reflected in the NJR report.”

Peter Howard, an orthopedic surgeon and chair of the committee responsible for the NJR report, said: “When a hospital is identified as an outlier, it triggers closer scrutiny and audit of that hospital’s performance. There is an agreed process to enable action appropriate to be taken to review units that fall below expected performance thresholds.

“The National Joint Registry’s approach to monitoring hospital performance and outcomes ensures that hospitals are monitored in a clear and robust manner. This process reassures patients that if there are any issues, they will be identified and addressed.”

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