The Health Information and Quality Authority (HIQA) has today published for consultation draft recommended thresholds that patients should meet before they are referred for certain scheduled orthopaedic procedures.

This latest phase in a series of health technology assessments (HTAs) focuses on thresholds for hip and knee replacement and key-hole surgery of the knee and shoulder.

HIQA’s Director of Health Technology Assessment Dr Máirín Ryan said: “The purpose of these HTAs is to ensure that the right patients receive referral and treatment at the right time and, in particular, that unnecessary referral is avoided in those people who are unlikely to get additional benefit from surgery over other treatment options.”

An aging population and increases in both obesity and chronic disease are placing increasing pressure on the Irish healthcare service, with demand for both out-patient appointments and scheduled surgical procedures continuing to exceed available capacity.

Fair and equal access to these surgeries as well as the needs and expectations of individual patients need to be balanced with the requirement to maximise health gain for the population as a whole.

“It is intended that these reports will provide clarity around referral for GPs, other referring doctors and their patients. The draft reports have been developed based on a comprehensive review of the international literature and in consultation with an expert advisory group. Public consultation on the draft recommendations is therefore important and we will revise the reports as appropriate based on feedback received,” Dr Ryan said.

The consultation on these draft recommended referral thresholds for scheduled orthopaedic procedures will run until 28 May 2014. 

The completed reports will be submitted to the HSE and to the Minister for Health.

Further Information: 

Please contact: Marty Whelan, Head of Communications and Stakeholder Engagement 01 814 7480 / 086 2447 623 mwhelan@hiqa.ie

Notes to the Editor: 

• HIQA is the statutory organisation in Ireland with a responsibility to carry out national health technology assessments (HTAs) and to develop guidelines for the conduct of HTAs across our healthcare system.
• The procedures which are included in Phase III of a series of HTAs include:
  • Hip arthroplasty
  • Knee arthroplasty
  • Knee arthroscopy
  • Shoulder arthroscopy
• Supporting documents include the ‘Background and Methods – Phase III’ and ‘Ethical Analysis’ documents.
• Osteoarthritis is the most common form of arthritis, and is the underlying reason for surgery in over 90% of people who have a hip or knee replacement.
• Hip arthroplasty refers to any of those procedures in which an artificial hip or hip part (prosthesis) is implanted. These include total hip arthroplasty, hemiarthroplasty and hip resurfacing arthroplasty.
• Knee arthroplasty is an umbrella term for a number of surgical options, namely total knee replacement – where the whole joint is replaced, and partial knee replacement – where only the most affected parts of the joint are replaced.
• Knee and shoulder arthroscopy are operative techniques which facilitate visualisation of structures within the joint using a variety of fibre-optic telescopes, with images relayed to a screen. They may be performed in the day-case or in-patient setting and may be employed for diagnostic and/or treatment purposes.