The outcomes of patients returned to general practitioner after being declined hip and knee replacement.

AIM: To determine the outcome of patients waitlisted for hip and knee replacement surgery who were returned to GP due to resource constraints.

METHODS: Prospectively gathered data of all patients returned to GP was analysed, including demographics, clinical prioritisation scores and patient-reported scores. Subsequent outcome was collected from departmental records and the National Joint Registry.

RESULTS: Between November 2013 and December 2015, 374 patients were returned to GP care. At minimum 12-month follow-up, 215 (57.5%) had undergone or had certainty for surgery, 36 patients (9.6%) had been re-referred and again declined surgery and 123 (32.9%) remained in GP care. The factors influencing the likelihood of a patient subsequently qualifying for surgery were need for hip rather than knee replacement, time from initial FSA and initial NZOA score. The mean waiting time for those patients who underwent publicly-funded surgery was 14.7 months.

CONCLUSION: Returning patients to GP delays treatment rather than reducing the need for surgery. This delay results in waste, added costs to the patient, healthcare system and society, and may reduce the benefit of surgery. There needs to be a significant increase in capacity to meet this demand.