Orthopaedics | Elective Services

PATHWAYS

Orthopaedics

Elective Services

Orthopaedic referrals are prioritised by Senior Medical Officers based on the information contained within. Additional information should be attached where available. The priorisation tool used to triage referrals can be found below under Access Criteria.

All accepted referrals will be seen within a maximum waiting time of 4 months, unless there is a clinical reason for delay.

Referral acceptance is a follows:

First Specialist Assessments:
Priority 1	Accepted
Priority 2	Accepted
Priority 3	Declined
Priority 3A (Hip/Knee Joints Only)	Accepted
Priority 3B	Accepted
Priority 3S	Accepted
Priority 4	Declined
Priority 5	Declined

At First Specialist Assessment (FSA), patients are assessed by a specialist and if surgery is required, patients are then prioritised using the National Orthopaedic CPAC tool. A 0-100 score is allocated to each patient.

Prior to acceptance for surgery, patients are assessed in Anaesthetic preassessment clinic to ensure they are fit for surgery.

All patients accepted for surgery will be treated within a maximum waiting time of 4 months, unless there is a clinical reason for delay.

Surgery acceptance is as follows:

Surgery List
CPAC 55+	Accepted
CPAC Below 54	Declined

Access Criteria

Category	Criteria
Immediate Priority 1	Suspected malignancy Disc prolapsed with significant neurological deficit Extreme functional impairment - community living at risk Trauma not requiring immediate intervention Major risk of permanent disability through delay
Urgent Priority 2	Severe functional impairment - requiring considerable assistance ADL Severe pain - sleep regularly disturbed, poor analgesic control Serious congenital condition in infants Significant risk of permanent disability through delay Employment seriously restricted
Semi Urgent Priority 3 Subset: Priority 3A Priority 3B Priority 3S	Moderate functional impairment - some assistance required ADL Moderate pain - some sleep disturbance, modest analgesic control Moderate risk of permanent disability through delay Employment maintained Rapidly progressive deformities Osteoarthritis of major joints (Hip/Knee/Wrist/Elbow/Shoulder/Ankle) Patients suitable for Mega clinic only ie Carpal tunnels, trigger finger etc Lower priority referrals requiring special consideration due to the nature of the patient's condition.
Routine Priority 4	Mild/moderate functional impairment - no restriction of leisure activity no assistance for ADL Mild/moderate/episodic pain - satisfactory analgesic control Low risk of permanent disability through delay Employment being maintained Slowly progressive deformities
Low Priority Priority 5	No/minimal functional impairment - no restriction of leisure activity no assistance for ADL No/minimal/episodic pain - analgesics seldom required No/minimal risk of permanent disability through delay

Last updated : Tuesday, August 30, 2016
Next review date : Wednesday, August 30,2017

Disclaimer: This site is intended to be flexible and frequently updated. While every effort has been made to ensure accuracy, all information should be verified.