The wait for orthopaedic surgery could rise to seven years in Scotland  

The wait for orthopaedic surgery could rise to seven years in Scotland
© iStock/Mohammed Haneefa Nizamudeen

According to the University of Aberdeen, wait times for orthopaedic surgery in Scotland could rise to seven years if the current backlog is not cleared.  

Patients listed for orthopaedic surgery in July 2022 would wait for as long as seven years in one health board area, with the average wait across all Scottish health boards rising to over two years.  

The recent study, published in the Bone and Joint Research journal, has predicted the average waiting times using both current and forecasted factors.   

Current wait times are significantly below government standards

“If the barriers to significant expansion of current activity are not addressed urgently, then waiting lists will continue to deteriorate and patients will continue to come to harm as a result,” said Luke Farrow, Clinical Research Fellow at the University of Aberdeen. 

Farrow worked with clinical and academic colleagues across Scotland to predict waiting times, determine the mismatch between current supply and demand, and assess the feasibility of the Scottish government target of a maximum one year wait time by 2024.  

The researchers examined four possible scenarios, ranging from “worst-case scenario”, where activity remains at current levels for the foreseeable future, to “best-case scenario” where activity returns to pre-pandemic levels by November 2022. According to their calculations, there would be an almost six-year difference in potential wait times between different health boards in the worst-case scenario. 

Long wait times for orthopaedic surgery are leading to poor health outcomes

Since routine surgical activity was ceased during the pandemic, a large backlog of patients waiting for orthopaedic surgery has accumulated. The researchers found evidence linking this backlog with negative short and long-term consequences in the health and wellbeing of patients.  

The researchers used publicly available data from Public Health Scotland to make their predictions across all 14 health boards in Scotland. The calculations were based on the previous year’s activity for routine orthopaedic surgery, the number of patients waiting for surgery as of June 2022 and the number of patients added to the waiting list over one year.  

Future operative activity was also considered in the researchers’ calculations, for example additional capacity provided through the proposed launch of National Treatment Centres in 2023.  

“Our key findings suggest that there is a significant current annual case deficit that will not be resolved even in ‘best-case scenario’ conditions, which specify a return to pre-pandemic activity coupled with a 22 percent uplift in capacity should the full additional planned National Treatment Centres’ capability be applied,” explained Farrow. 

“Waiting lists are therefore anticipated to continue to grow annually, further adding to the significant backlog already present,” he added. 

Nationwide-wide averages reveal that in the ‘best-case scenario’, the average predicted wait times across Scotland for a patient listed for surgery in July 2022 would be just under one year and four months. In the worst-case scenario, waiting times would closer to two years and three months on average. 

“Current admissions for routine treatment are only 52.2% of 2019 activity so a return to a pre-pandemic level of operative output will require a significant change from current practice, with return of core operative capacity that has been significantly curtailed by financial limitations, staffing shortages, access to private healthcare infrastructure, and urgent-care pressures,” said Farrow.  

The researchers warn that figures were formed before any consideration for increased future demand for hip and knee arthroplasty services, which could drive wait times up even more.  

“Prolonged waits for certain orthopaedic procedures can have a major negative impact on patient health. This occurs both in terms of deterioration in quality of life whilst awaiting surgery, as well as potential negative connotations for post-operative recovery and longer-term health in addition to reduced independence and increased social care needs,” concluded Farrow. 

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