Structured OA Hip / Knee Assessment pathway
NB. Attached is a detachable feedback sheet and we would welcome your comments about these
pathways.
>>>Please tear off the feedback sheet and hand back to the event organisers.
Why refer to the OA Hip/Knee community pathways?
Evidence from NICE (CG59) has indicated structured exercise, information and education toward
self-management whilst managing the patient’s expectations would initially be of greater benefit for
some patients than surgery as the first option.
Patients needing surgery are referred after their initial assessment and are then prepared for
surgery with pre-operative education, walking aids and one to one physiotherapy.
What are the OA Hip / Knee pathways?
The services comprise two stages:Stage 1, Moderate pain/discomfort designed to help patients self-manage their hip/knee pain
without surgery through group and individual physiotherapy sessions. They offer GPs another
alternative to referral to secondary care.
Stage 2, severe pain/discomfort helps patients who do require surgery to prepare by making sure
they are fit and ready for surgery resulting in the best possible outcome.
X-Ray
Consultation with GP
Structured OA Hip/Knee Assessment Service
Refer to assessment service
(2 -4 weeks)
Stage 1 – Moderate OA of Hip / Knee
Conservative Management
-
Physiotherapy led
4 (hip) or 5 (knee) weekly group
or individual sessions
Education & information
Stage 2 – Advanced / Severe OA of
Hip/Knee
Assessment by
Physiotherapist
Referral & Preparation for surgery
-
Assessment updated
If not improving
Improved pain &
function
Follow-up after 1
and 3 months
Patient can self-refer
back into the service at
any time.
Physio led
3 individual sessions
Education & information
What are the benefits of the OA pathways?
- The conservative management pathway (stage 1) providing physiotherapy and education
helps patients to understand their condition and learn to self-manage.
- Patients get the time and information to make an informed choice about when to proceed
with surgery and their expectations are well managed.
- Patients can choose where they have their community assessment and to which secondary
care setting they may want their procedure.
- Pathways meet NICE guidance.
- Patients receive a robust / consistent programme available at various Suffolk locations.
- There is growing evidence that pre-operative preparation such as weight management,
managing expectations and education about the patient’s condition can result in improved
patient reported outcomes (PROMs).
Referral methods – to the OA Hip / Knee pathways
Method
Choose and Book
Fax / Letter
Self-referral
Required
Attach referral form, patient medical & drug history only + XRay report if possible.
Include referral form, patient medical & drug history only + XRay report if possible.
Hand patient a provider business card who will then contact the provider.
Subsequently the physiotherapist will request the referral form, patient medical & drug
history only + XRay report if possible.
Who provides the service and where are they based?
IHT
AHPS
– Knee service, Ipswich Hospital
– Hip and Knee service; Ipswich (Riverside), Aldeburgh, Woodbridge, Hadleigh, Eye, Stowemarket
Frequently Asked Questions (FAQs)
Q. Are the services delaying the inevitable (surgery)?
A. No. Initial assessment happens within 2-4 weeks of referral and, if the patient requires surgery they will be
referred directly to an Orthopaedic Consultant whilst undergoing preparation for surgery to ensure best
possible post-operative outcomes.
Q. Will I be notified if my patient is referred to secondary care?
A. Yes. A copy of the orthopaedic referral is sent to the patients GP at the time of referral.
Q. What if attending group sessions is difficult for the patient
A. The patient may be offered individual sessions. These will cover the same content as the groups but will be
tailored to the patient’s specific requirements.
Q. What happens if the patients hip / knee pain flares back up after having completed the programme?
A. The patient can refer themselves back into the service at any time.
If you have any questions feel free to contact us:Commissioner, IESCCG: Dean Onno – 01473-770-228, Mob 07946-316-901
Provider, AHPS (Hip & Knee Service): Philip Dale – 07940-473-314, Grace Allston - 07950-824-857
Provider, Ipswich Hospital (Knee service only): Sue Voules or Claire Tricker - 01473-703-318.
FEEDBACK
Please record your feedback on the OA Hip / Knee Assessment Pathways here and return to the event organisers!
What you like / dislike about the pathways?
What further information you might need about them?
What might stop you referring to them?