Lord Bradley – 2014 Parliamentary Question to the Department of Health

The below Parliamentary question was asked by Lord Bradley on 2014-06-11.

To ask Her Majesty’s Government what recent assessment they have made of the adequacy of National Health Service community physiotherapy services for patients who have had (1) knee, and (2) hip, replacement operations.

Earl Howe

No assessment has been made centrally of the adequacy of National Health Service community physiotherapy services for either hip or knee replacement operations.

The commissioning of community therapy services is a matter for clinical commissioning groups using the National Institute for Health and Care Excellence guidance where available.

Recently, case-mix adjusted health gain following hip and knee replacement has been added to the Clinical Commissioning Group Outcomes Tool “Commissioning for Value”. This data should facilitate conversations between commissioners and their provider trusts.

The Health & Social Care Information Centre publishes a National Joint Registry (NJR) of patient reported outcome measures (PROMs), which measures health gain in patients undergoing hip replacement, knee replacement, varicose vein and groin hernia surgery in England, based on responses to questionnaires before and after surgery.

The Best Practice Tariff for total hip and knee replacements pays for the whole episode of surgery and hospital based rehabilitation. Payment of the Best Practice Tariff for primary hip and knee replacement surgery is conditional on criteria linked to data collected through the NJR PROMs. If a provider’s NJR PROMs falls into the lowest 5% nationally in terms of outcomes the commissioner is able to remove the Best Practice Tariff funding unless a plan is made for how to improve the services.