Huge increase in number of Scots waiting for hip surgery

NHS Lothian has experienced the second largest increase of 378%, with the number on its waiting list soaring from 420 to 2,008.

Four other health boards - Ayrshire & Arran, Fife, Grampian, and Tayside - have recorded increases of between 211% and 290% in the size of their elective hip operation waiting list.

Number on elective waiting list for hip surgery (Image: Reform Scotland)

The figures are based on freedom of information responses set out in a report today from the think tank, Reform Scotland, which calls for a "mature, constructive debate" on measures to "future-proof" the NHS in the run up to its centenary in 2048.

It asked each of the health boards to provide figures for the number of people waiting as of May 30 for every year from 2019 to 2023.

In total, there were nearly 10,400 people in Scotland waiting for hip surgery by the end of May this year compared to 3,114 at the same point in 2019, and 8,493 in 2022.

The average length of time from a consultant referral to an operation taking place ranges from 189 days in Forth Valley to 386 in Greater Glasgow and Clyde.

Fife has experienced the steepest increase in its average waiting time, however, from around 38 days in 2019 to six and a half months now.

The figures do not include the time spent waiting to see a consultant following a GP referral.

Orthopaedics procedures were among the worst hit by the suspension of elective surgery during the pandemic, and have been much slower to recover as theatre and bed resources were prioritised towards the most urgent surgeries.

Average (mean) waiting time for elective hip surgery (Image: Reform Scotland)

Jacqui McMillan, a consultant orthopaedic surgeon in Ayrshire and former deputy chair of the BMA's Scottish consultants' committee, said the statistics were a "stark warning of how bad things have become".

She added: "As an orthopaedic surgeon I am working as hard as ever, and yet my waiting list seems to be growing longer.

"Seeing my patients in pain and knowing how long they are likely going to have to wait for their operation breaks my heart.

"Having to tell patients they could be waiting for more than a year for an operation they need in order to get through a day without pain is really difficult.”

• READ MORE: Elective NHS activity yet to return to pre-Covid levels 
• READ MORE: What's really going on behind the Scotland-England waiting list divide?
• READ MORE: Private hospital treatment rising faster in Scotland than UK 

A growing number of Scots have been turning to private hospitals to skip the NHS queue. In 2022, a record 2,966 hip and 1,638 knee procedures were carried out by the independent sector, of which 94.5% were either self-funded or paid for by medical insurance cover.

The price tag for a private hip replacement starts around £12,000, excluding the costs of an initial consultation and any diagnostic tests.

The total number of people waiting for an elective orthopaedic procedure on the NHS has more than doubled from just over 19,000 to nearly 44,500 over the past four years.

Average (mean) waiting time from consultant referral to treatment (Image: Reform Scotland)

Among the mainland NHS regions, the average waiting time ranges from 137 days in Forth Valley to 448 days in NHS Highland. In 2019, the longest average wait was 214 days.

Dr Iain Kennedy, chair of BMA Scotland, said the health service is "bursting at the seams, with a workforce running on empty". 

He added: "There are not enough of us to give our patients the time and care they need and deserve.

“The time for platitudes has long passed – we need action, and we need it now. We are in a year-round crisis with our NHS and workforce planning is abysmal.

"The Scottish Government must move forward with their commitment to have a cross-party national conversation on the future of our health service – an open and honest discussion that also involves the profession and the public.”

Chris Deerin, director of Reform Scotland, said: “We need a mature, constructive debate to identify and build consensus around specific measures that will help our health and care services in both the short and long term.

“The electorate can cope with this discussion. They know that the health service is ill - they live with the consequences every day.

"Are the politicians up to it, though? Can they set aside petty party differences and work together to save this vital public service?”

A Scottish Government spokesman said: “Long waits of this nature are unacceptable. We remain committed to eradicating long waits, which have been exacerbated by the pandemic, to ensure all people receive the treatment they need as soon as possible.

"The First Minister has announced new annual funding of £100 million, subject to the Budget process, to help reduce inpatient and day-case waiting lists by an estimated 100,000 patients over the next three years.

“We have met our targets to reduce waiting times of over 2 years in most specialities, with 83% of outpatient specialities and 57% of inpatient/day-case specialities now having fewer than ten patients waiting more than two years.

"Waits of over 78 weeks have also reduced by 40.6% for new outpatients since June 2022. This is welcome progress but we know there is still more to do.”