CHERRY PICKING OF PATIENTS FROM WAITING LIST FOR TREATMENT AT REMOTE CENTRES AND THE SUBSEQUENT EFFECT ON NHS BURDEN OF CARE.

Mr T N Board; D A Merve; Mr K P Boardman

doi:10.1302/0301-620X.87BSUPP_I.0870041a

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CHERRY PICKING OF PATIENTS FROM WAITING LIST FOR TREATMENT AT REMOTE CENTRES AND THE SUBSEQUENT EFFECT ON NHS BURDEN OF CARE.

Mr T N Board
D A Merve
Mr K P Boardman

CHERRY PICKING OF PATIENTS FROM WAITING LIST FOR TREATMENT AT REMOTE CENTRES AND THE SUBSEQUENT EFFECT ON NHS BURDEN OF CARE.

Board MTN, Merve DA, Boardman MKP. CHERRY PICKING OF PATIENTS FROM WAITING LIST FOR TREATMENT AT REMOTE CENTRES AND THE SUBSEQUENT EFFECT ON NHS BURDEN OF CARE.. Orthop Procs. 2005;87-B(SUPP_I):41-41. doi:10.1302/0301-620X.87BSUPP_I.0870041a

Board, Mr T N, et al. “CHERRY PICKING OF PATIENTS FROM WAITING LIST FOR TREATMENT AT REMOTE CENTRES AND THE SUBSEQUENT EFFECT ON NHS BURDEN OF CARE..” Orthopaedic Proceedings, vol. 87-B, no. SUPP_I, 2005, pp. 41-41., https://doi.org/10.1302/0301-620X.87BSUPP_I.0870041a

Board, M. T. N., Merve, D. A., & Boardman, M. K. P. (2005). CHERRY PICKING OF PATIENTS FROM WAITING LIST FOR TREATMENT AT REMOTE CENTRES AND THE SUBSEQUENT EFFECT ON NHS BURDEN OF CARE.. Orthopaedic Proceedings, 87-B(SUPP_I), 41-41. https://doi.org/10.1302/0301-620X.87BSUPP_I.0870041a

Board, M. T. N., Merve, D. A. and Boardman, M. K. P. (2005) “CHERRY PICKING OF PATIENTS FROM WAITING LIST FOR TREATMENT AT REMOTE CENTRES AND THE SUBSEQUENT EFFECT ON NHS BURDEN OF CARE..” Orthopaedic Proceedings, 87-B(SUPP_I), pp. 41-41. Available at: https://doi.org/10.1302/0301-620X.87BSUPP_I.0870041a

Board, Mr T N, D A Merve, and Mr K P Boardman. “CHERRY PICKING OF PATIENTS FROM WAITING LIST FOR TREATMENT AT REMOTE CENTRES AND THE SUBSEQUENT EFFECT ON NHS BURDEN OF CARE..” Orthopaedic Proceedings 87-B, no. SUPP_I (2005): 41-41. https://doi.org/10.1302/0301-620X.87BSUPP_I.0870041a

Board MTN, Merve DA, Boardman MKP. CHERRY PICKING OF PATIENTS FROM WAITING LIST FOR TREATMENT AT REMOTE CENTRES AND THE SUBSEQUENT EFFECT ON NHS BURDEN OF CARE.. Orthop Procs. 2005 Mar 1;87-B(SUPP_I):41-41. https://doi.org/10.1302/0301-620X.87BSUPP_I.0870041a

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Abstract

The practice of selecting patients with a low ASA(American Society of Anesthesiologists) grade to have joint replacement performed at remote centres such as DTCs (Diagnosis and Treatment Centres) and by teams of visiting surgeons is becoming more commonplace. This leaves NHS Hospitals with a patient population skewed towards the higher ASA grades. This study was undertaken to identify the extra burden that this may place on a District General Hospital.

All patients undergoing total hip or knee arthroplasty at Blackpool Victoria Hospital in the year 2002 were identified. Of 191 patients, 132 were classified as ASA grade I or II. 59 patients (31%) were classified as ASA grade III or IV. The immediate postoperative complication rate for the patients with ASA grade III and IV was found to be 25%. All complications were treated appropriately and all patients had a satisfactory outcome at 6 weeks. The reported immediate postoperative complication rate for hip and knee replacement ranges from 3–6%. It is clear from these figures that removal of fitter patients from waiting lists will effectively increase the complication rate following arthroplasty in NHS Hospitals. We feel that the Government has not identified the extra care involved in treating these higher risk patients.

The abstracts were prepared by Mr Peter Kay, Editorial Secretary. Correspondence should be addressed to British Hip Society, The Hip Centre, Wrightington Hospital, Appley Bridge, Wigan, Lancashire WN6 9EP.