Waiting for a knee replacement? Jim Newman offers an update on NHS and private waiting times.

I can’t speak for every NHS trust, but at Mid Yorks, where I work, things are slowly moving on the elective knee surgery front.

Surgery is more complex than it was pre-Covid. Every patient must be Covid-swabbed within 72 hours of coming into hospital and needs their results back before we can operate, which places additional pressure on NHS staff. In addition, and as we explain in this post, operations are often more complicated and time consuming than they were pre-pandemic.

Addressing the backlog

Because each hospital’s core capacity (the number of procedures it can perform in regular operating hours) is reduced, many trusts have added additional capacity. Mid Yorks NHS Trust is operating seven days a week right now. In part, that helps to eliminate the effect of losing an hour each day during the week, but it also enables us to start nibbling away at those backlogs. At time of writing, waiting lists are coming down a little – albeit far slower than we and you would prefer.

The private knee surgery position

In the private sector we are seeing a huge number of referrals from patients who don’t wish to wait 12-18 months on the NHS and can manage to pay themselves. This is presenting something of a challenge for knee surgeons – there are only so many of us to go around – and as we work extra hours in the NHS our private patients have also seen their waiting times rise a little, although the difference remains stark. At present, your wait time for private knee surgery is likely to be just 4-6 weeks.

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How to lower your NHS wait time

Of course, private knee surgery simply isn’t an option for many, so is there anything you can do to reduce your NHS wait time?

The answer to that question is ‘yes’. It’s all down to P codes, priority codings that are used by the NHS to assess the urgency of a patient’s operation. A patient classified as P1 will need their operation in 72 hours (these people might typically have been involved in a road accident). P2 patients will need their operation within four weeks. P3 should be done within 12 weeks. P4 codes will take longer.

Codings are based on clinical conditions. Pre-pandemic, although waiting lists were sizeable, we weren’t generally seeing major shifts in the condition of patient knees as they waited for surgery. For some patients, the pandemic has changed that. As wait times have increased, so clinical conditions have worsened to the extent that some patients who may previously have been categorised as P4 may now be P3 or even P2.

It’s important to realise, however, that your consultant won’t know that – and won’t be able to change your priority coding – unless you book an appointment to be reassessed. So if you feel your condition has become worse during your wait – and especially if you notice a ‘progressive deformity’ (i.e. the limb is becoming a strange shape) – talk to your GP or consultant’s secretary about getting reassessed. You could find your wait time significantly reduced.

If you’d like to explore private knee surgery, find more about self-pay and private insurance options here.

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