RESIDENTS risk being denied a hip replacement because Oxfordshire NHS bosses are ignoring national guidance and taking patients’ weight into account, leading surgeons have warned.
Patients should not have to complete a questionnaire that helps doctors decide if they get the operation, the Royal College of Surgeons said.
The NHS National Institute for Health and Care Excellence (NICE) and the college guidance recommends no referral threshold.
Oxfordshire Clinical Commissioning Group’s (OCCG) use of the Oxford hip score is “in explicit contravention” of these with “no clinical justification” it said.
An OCCG policy to consider a person’s weight when making decisions also goes against British Orthopaedic Association advice, it said.
The OCCG on Thursday said it was reviewing the criteria as part of a wider review into services.
A college report said: “The reliance by some CCGs on the use of scoring thresholds may withhold access to surgery for some patients, thereby denying them medical intervention that can improve their quality of life dramatically.”
It said the hip score — developed at Oxford’s Nuffield Orthopaedic Centre — should only be used to assess a patient’s condition after surgery.
Retired ambulance manager John Radburn, 64, passed the test and had a hip replacement, stemming from car smash aged 20, in February 2012.
He said: “It is probably a reasonable process, you need a measure somewhere.’’ The RCS said using the score to make treatment decisions has “never been validated and evidence suggests that the system is unsuitable for setting referral criteria”.
There is “no consistent evidence” the obese “do better or worse” than others and weight has “no bearing” on the hip prosthesis, he said.
It said OCCG is one of 16 clinical English clinical commissioning groups to use the hip score and one of seven who consider weight, out of 52 responses. Oxford East Labour MP Andrew Smith said: “Local practice will clearly need to be reviewed and changed as a matter of priority.
“Behind the statistics are individual patients, and it is unacceptable if some are being made to wait for treatment because of a scoring system being wrongly applied.”
The NICE guidance says decisions should be based “on discussions between patient representatives, referring clinicians and surgeons, rather than using scoring tools for prioritisation”.
But Jacqueline Pearce-Gervis, a member of the official NHS watchdog Healthwatch Oxfordshire, backed use of the scoring system.
She said: “Everybody should be aware that there is this service which they should take advantage of. A doctor could say ‘you don’t need one’ but if you went through the hip score, it could say you need one.”
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