Knee and hip operations

WQ.288/2023

WRITTEN QUESTION TO THE MINISTER FOR HEALTH AND SOCIAL SERVICES

BY DEPUTY R.S. KOVACS OF ST. SAVIOUR

QUESTION SUBMITTED ON MONDAY 19th JUNE 2023

ANSWER TO BE TABLED ON MONDAY 26th JUNE 2023

Question

“Will the Minister provide the following for each of the last 5 years, including to date in 2023 –

1. the number of patients waiting for knee and hip operations;
2. the length oftime patients have been waiting for such operations;
3. the number of hip and knee operations carried out;
4. the number of Jersey patients who have had hip or knee operations privately in –

1. Jersey
2. UK or elsewhere

and state, if known, how many of those were previously on the Health Service waiting list; and

5. how much each of these procedures costs the Health Service?”

Answer

The data below refer to the following hip and knee replacement procedures:

• Total Hip Replacements.

• Total Knee Replacements.

• Replacement of Femoral Head only (partial hip replacement).

• Hybrid Hip Replacements.

• Hybrid Knee Replacements.

• Uni-compartmental Knee Replacements.

Figures are provided up to 26 May 2023 at which point the HCS Patient Administration System (TrakCare) was switched off and replaced with a new Electronic Patient Record system (IMS Maxims). Statistical reporting of theatre activity and waiting lists is currently being finalised and validated as part of acceptance testing of the new system. Clinical Coding of inpatient procedures is an ongoing process, performed following the discharge of a patient from hospital, so figures are liable to change.

1. As at the 26 May 2023, there were 168 Patients on the elective inpatient waiting list for the above procedures, including patients listed for Bilateral Procedures (Twice).

When patients were listed for a procedure in TrakCare, the intended procedure was recorded in a free text format that is not machine readable. This means that identifying hip and knee replacements requires manually reviewing the waiting list. Therefore, the position is provided for the latest available date only. Improved functionality in the new EPR (IMS Maxims) means that all listings going forward will be recorded against a standardised procedure code to allow in- depth reporting in future.

2. The table below shows the number ofdays each of the above patients had been waiting as at 26 May 2023, grouped by total days waiting.

 

Clinician Priority	0-30	31-60	61-90	91-120	121-150	151-180	180-365	>365	Grand Total
Routine	9	19	9	10	7	10	43	29	136
Soon	9	9	3	3	0	1	3	2	30
Urgent	1	1	0	0	0	0	0	0	2
Grand Total	19	29	12	13	7	11	46	31	168

When patients were listed for a procedure in TrakCare, the intended procedure was recorded in a free text format that is not machine readable. This means that identifying hip and knee replacements requires manually reviewing the waiting list. Therefore, the position is provided for the latest available date only. Improved functionality in the new EPR (IMS Maxims) means that all listings going forward will be recorded against a standardised procedure code to allow in- depth reporting in future.

3. The table below shows the total number of public hip and knee replacements performed per year, to date (as of 26/05/2023):

 

Year	Count of Hip Replacement Procedures	Count of Knee Replacement Procedures
2018	274	149
2019	236	143
2020	180	69
2021	205	122
2022	129	62
2023	45	33

Data Source: Hospital Patient Administration System (TrakCare, OPCS Theatre Report CDG4H).

Note: these figures do not include hip and knee replacements referred off island. The reason is that off- island data is not recorded at procedure level, only financial tariff (HRG) codes which includes many other operations other than replacements.

4. i)The table below shows the total number of private hip and knee replacements performed per year in Jersey, to date(asof 26/05):

 

Year	Count of Hip Replacement Procedures	Count of Knee Replacement Procedures
2018	87	49
2019	70	54
2020	54	39
2021	82	68
2022	53	31
2023	17	16

Data Source: Hospital Patient Administration System (TrakCare, OPCS Theatre Report CDG4H).

Note: It is not recorded whether these patients were previously on the waiting list for a public procedure.

ii) HCS does not hold data on patients who choose to receive private care in the UK.

e) The table below shows the total cost of public hip and knee replacements performed per year in Jersey, to date (as of 26/05/2023):

 

Year	Cost of Hip Replacement Procedures	Cost of Knee Replacement Procedures
2018	£2,500,732	£1,076,630
2019	£2,172,784	£1,027,502
2020	£1,942,853	£552,155
2021	£2,080,240	£930,418
2022	Unavailable at procedure level	Unavailable at procedure level
2023	Unavailable at procedure level	Unavailable at procedure level

Data Source: HCS Person Level Information & Costing System prepared up to 2021 (PLICS).

In 2021, the average cost of a hip replacement procedure was £9,542 and the average of a knee replacement procedure was £8,536.

These figures do not include the cost of hip and knee replacements referred off island.