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FOI Request

Disclosure ID
FOI/02729
Request Date
September 24, 2018
Subject
Hip Replacement
Description
  1. How many patients (as of 1.9.18) are waiting for a hip replacement operation?
  2. How many patients per month have been added to the waiting list for a replacement hip operation from 1st September 2017 to 31st August 2018?
  3. How many patients per month received hip replacements from 1st September 2017 to 31st August 2018?
  4. How many patients were removed from the waiting list for hip replacements for reasons other than having hip replacement surgery per month from 1st September 2017 to 31st August 2018?
  5. How many hip replacement operations have been cancelled per month from 1st September 2017 to 31st August 2018?
  6. What were the causes of cancellations in point 4. per month during the same time period?
  7. What is the longest waiting wait time in weeks for hip replacement as of 24.9.18?
  8. What criteria is used to prioritise patients waiting for hip replacement?
  9. How are patients monitored by the consultant whilst waiting for a hip replacement?
Response
1 How many patients (as of 1.9.18) are waiting for a hip replacement operation? 116
2 How many patients per month have been added to the waiting list for a replacement hip operation from 1st September 2017 to 31st August 2018? We are unable to provide this information as it would involve a manual trawl to identify the procedure. This would constitute a disproportionate effort to retrieve and would exceed 18 hours. This information is therefore exempt on the grounds of cost (Section 12(1)).
3 How many patients per month received hip replacements from 1st September 2017 to 31st August 2018?
4 How many patients were removed from the waiting list for hip replacements for reasons other than having hip replacement surgery per month from 1st September 2017 to 31st August 2018? We are unable to provide this information as it would involve a manual trawl to identify the procedure. This would constitute a disproportionate effort to retrieve and would exceed 18 hours. This information is therefore exempt on the grounds of cost (Section 12(1)).
5 How many hip replacement operations have been cancelled per month from 1st September 2017 to 31st August 2018? 9 in total
6 What were the causes of cancellations in point 4. per month during the same time period? Ward bed unavailable, list overrun,

emergency took precedence (trauma)

7 What is the longest waiting wait time in weeks for hip replacement as of 24.9.18? 43 weeks
8 What criteria are used to prioritise patients waiting for hip replacement?

 

 

Further information requested:

How often are X-rays repeated to enable prioritisation of patients?

 

If for example an 85 year old had been waiting over 30 weeks and their X-rays had been done 7 months previously, how would they be assessed weekly and prioritised?

 

 

Patient functionality, X-ray changes and mobility issues are all factors that are considered to prioritise patients with an overall assessment to decide after an informed discussion with the patient.

 

X-rays are only repeated if a patient is experiencing problems and 1-2 days before surgery.

 

 

 

Once the patient has been listed for surgery they would have an x-ray 1-2 days before surgery or if they had contacted the Medical secretary to say they were having problems. Otherwise they wouldn’t be re-assessed between listing and coming in for their procedure.

9 How are patients monitored by the consultant whilst waiting for a hip replacement?

 

 

Further Information requested:

If X-rays haven’t been repeated how can non-clinical staff prioritise patients?

 

 

How are patients “booked in a clinical priority order”? and what does that mean?

 

What information and from whom is required to assess clinical priority order?

 

Would over two stones weight loss, uncontrollable pain and huge deterioration in mobility be taken into consideration when a patient is prioritised?

 

How are patients monitored on an ongoing basis prior to surgery by the consultant who is responsible for the patient’s care?

 

 

How are patients kept up to date with their treatment plan and wait time?

 

 

When waiting times (RTT) are breached what options are offered to patients and at what point in their wait?

Patients are reviewed on a weekly basis by the Directorate Support Manager and Waiting List Clerk, booked in a clinical priority order and then chronological order of patients on the waiting list.

 

Where X-rays have not been repeated mobility issues and/or patient functionality would be considered.

 

 

 

 

 

Significantly functionally impaired and/or potential structural deformities would be assessed to be prioritised sooner.

 

 

As above assessed by Clinician/Consultant/Reg.

 

 

 

Potentially yes.

 

 

 

 

No monitoring on an ongoing basis prior to surgery by the consultant, once listed they are treated in most cases within 18 weeks. If a patient makes contact with uncontrollable pain we would bring back for repeat X-rays and based on the findings, a decision would be made by the clinician/Consultant/Reg.

 

Waiting list clerks will contact the patients when a surgery or pre-op date becomes available, based on clinical priority order and then chronological order of patients on the waiting list.

 

 

At 18 weeks and over these are monitored on a weekly basis in performance meetings and in 1:1 with waiting list clerks going thorough patient level details to update a plan on when the treatment will be scheduled and any additional may be identified.

Pooling of patients is often offered to patients where we can get them in for their surgery sooner.

 

     
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