NHS chiefs who ration care are on £300,000 salaries

Patients who endure six months of pain before getting hip replacement ‘not treated as priority’

NHS authorities that say patients should endure “intense and persistent” pain before they can have hip surgery pay managers more than £300,000 a year, an investigation has found. Seven areas are planning restrictions so severe that surgeons have warned that patients could be left at risk of painkiller addiction.

Clinical commissioning groups (CCGS) in Sussex have proposed rationing policies for hip replacement that say patients must endure “uncontrolled, intense, persistent” pain for six months before referral for operations.

The proposals are part of wider restrictions aiming to save £20million.

The British Orthopaedic Association said patients could risk opiate addiction while waiting for surgery under the policies.

Now an investigation by Health Service Journal reveals that the cashstrapped bodies have been paying rates of more than £300,000 a year to officials in charge of making savings.

One of the seven CCGS considering the rationing plans spent more than £600,000 a year on interim officials.

Coastal West Sussex CCG employed Margaret Ashworth as interim chief finance officer at a cost of £295,000 for under 11 months in 2017-18 – equivalent to more than £330,000 a year. This could have funded around 60 hip replacement operations.

Her predecessor Neil Cook, cost £35,000 for less than two months – equivalent to £240,000 a year. It also employed Ralph Mccormack as executive lead for stabilisation and transition at a cost of £275,000 for the year.

The CCG had a deficit of £21.8million at the end of the financial year, £6.4million adrift of the original plan agreed with NHS England.

At another organisation, East Surrey CCG, interim chief finance officer Ray Davey cost £205,000 for seven months.

This rate – paid via an agency – is equivalent to £351,000 a year. The CCG had a deficit of £24.9million.

Since 2016, all off payroll staff at director level in CCGS have had to be approved by NHS England. Any interim costing more than £900 a day – about £225,000 a year – has to be approved by the NHS England commercial executive committee.

Under the rationing plans being considered in Sussex, patients would have to endure “uncontrolled, intense, persistent” pain which substantially affects their daily life for six months before being routinely referred for a hip replacement. If adopted, the policy would mean patients are expected to have taken painkillers including opioids, had physiotherapy, and tried to lose weight, if necessary, for six months before referral for surgery.

Ananda Nanu, president of the British Orthopaedic Association, said: “The restrictions are not putting patients’ needs and well-being as the priority.”