Hospitals with highest risk of repeat hip surgery named in report
HOSPITALS with the worst record for hip operations have been identified in an official register.
The National Joint Registry (NJR), which collects data on routine surgery from NHS and private hospitals, has disclosed the 10 where patients are significantly more likely to require a repeat hip operation, or revision.
High levels of infection after surgery were linked to these revisions, according to some of the hospitals included on the list.
The NHS estimates fewer than one in 100 hip operations results in infection. But when one develops, the replacement may need to be “washed out” or a new replacement may need to be fitted.
It is estimated that 8,500 hip revision procedures are carried out in England, Wales and Northern Ireland each year.
Hospitals are included among the NJR’s top “outliers” when the number of revisions is higher than expected.
Three hospitals on the list of outliers in 2014-19 are once again among the top 10 in the latest figures which cover February 2017 to February this year.
They are Wansbeck Hospital in Northumberland, Weston General Hospital, Weston-super-Mare, Somerset, and Milton Keynes University Hospital (MKUH) in Buckinghamshire.
Dr Ian Reckless, medical director of MKUH, said that because of the data being examined over a five-year period, “it will take some years of ‘normal performance’ for outlier status to resolve”.
“This is particularly so given the much lower number of joint replacements locally and across the UK over the last two and a half years as a result of the Covid-19 pandemic,” he said.
The NJR report says there were almost 50,000 fewer hip replacements in 2020 than 2019, and 13,000 fewer in 2021. “As hip replacement is undertaken to treat severe pain and functional limitation, this deficit represents considerable suffering for a large cohort of people nationally,” it warns.
Both Dr Reckless and a spokesman for the Trust that covers the Weston said patient outcomes were affected by the fact patients tended to be elderly, with more co-morbidities,while other patients have high body mass indices.
Both hospitals say their surgeons have put in place action plans which will be independently reviewed to ensure better outcomes.
Northumbria Healthcare NHS Foundation Trust, which runs Wansbeck, said it was also working to reduce revision rates, which had a number of complex reasons behind them.
Other hospitals on the list include the private King Edward VII’s Hospital, London. A spokesman said their highly regarded surgeons attracted the most difficult cases. “These complex cases carry the highest risk of revision, which is not reflected in the NJR report.”
Peter Howard, an orthopaedic surgeon and chairman of the committee behind the report, said: “The NJR approach ensures that hospitals are monitored in a clear and robust manner. This process is reassuring for patients because if there are any problems these will be identified and addressed.”