Need a hip op? First wear shock absorbing shoes for 6 months

PATIENTS are being denied hip replacements unless they can prove they have worn ‘ shockabsorbing shoes’ for six months.

Others are told they must have been taking painkillers four to five times a day for two months before being considered for surgery.

Health officials across England are drawing up increasingly tough rules to limit the numbers of patients eligible for hip and knee replacements.

Yesterday it was revealed that three NHS trusts in the West Midlands want to refer patients for the procedure only if their pain is so severe they cannot sleep.

The proposals by Redditch and Bromsgrove, South Worcestershire and Wyre Forest Clinical Commissioning Groups aim to save £2.1million a year and slash operations by a fifth.

But managers in trusts elsewhere have drawn up similar strict policies to limit the procedures.

They include Ipswich and East Suffolk CCG where anyone wanting a hip replacement must wear ‘shock-absorbing shoes’ for at least six months. Patients should also have tried to adjust their lifestyles to limit pain and avoid aerobics or standing for long periods.

Managers demand to see ‘ documentation’ that patients have tried all these measures before they are referred. In Lambeth CCG, in South London, those wanting hip replacements must try a two month course of paracetamol and Naxofem – a strong painkiller – four to five times a day first. They must also be over 50 as managers claim anyone younger than this is unlikely to be suffering from arthritis. Southern Derbyshire CCG requires patients to have suffered ‘leg shortening’ – a complication of arthritis – before they are referred for hip replacements.

In addition, patients should have ‘disturbed sleep’ and ‘persistent severe pain and disability.’

Labour’s health spokesman Jonathan Ashworth said: ‘It’s not right such a wide postcode lottery is opening up for non-urgent operations. Theresa May’s policy of underfunding the NHS is pushing services to the brink, with worse and more widespread pressures than in previous years. These treatments have a huge impact on people’s quality of life and the increasing waiting times are frustrating and demoralising for patients.’

A spokesman for the Prime Minister said: ‘We recognise there are significant pressures on the NHS with an ageing and growing population. But we have also been very clear the Government is committed to securing high-quality healthcare for everyone.

‘That’s why we have given the NHS the extra funding it asked for, an additional £10billion by 2020 with a front-loading of £4billion of that in the last financial year.’ But managers at CCGs are under pressure to slash millions of pounds

‘Widespread pressures’

from their budgets. The NHS has a target of making £22billion worth of ‘efficiency savings’ by 2020/21 and this is leading to some nonurgent procedures being rationed.

Yesterday a senior health boss admitted that the policies were a consequence of the increasing financial pressures.

Julie Wood, the chief executive of the NHS Clinical Commissioners, which oversees the CCGs, said: ‘Clearly the NHS doesn’t have unlimited resources.’ Speaking on Radio 4’s Today programme, she added: ‘It has to ensure patients get the best possible care against a backdrop of spiralling demand and increasing financial pressures.’

She also said policies would ‘vary in different parts of the country’ and managers would be making ‘difficult decisions’ on who needs surgery.