NHS post-op care/support after private hip replacement?
Discussion
After a bit of advice… about a year ago my mum (76, riddled with arthritis and osteoporosis) had a fall at home breaking her right hip. Despite it being a seemingly “minor” fall in her bedroom, the surgeon described the trauma as being what he’d expect to see from a car crash…
Anyway, the following morning she was rushed into a hip replacement, and a week later was back home and a relatively efficient care package was in place, with various bits of equipment delivered and carers popping in daily to change her DVT socks (she was already able to do most other personal care things herself)
Over the next 10 months made quite a good recovery with that hip, but the left (“good”) hip increasing became more painful. The surgeon basically said that she’ll need that replaced too.
In the last couple of months shes been in so much pain shes on increasingly strong painkillers and the mobility she’d been regaining over the right hip has been lost due to the left. She now cant walk for more than a few minutes, and then in severe pain.
Last week I came back from a week away to be told shes in so much pain she’d agreed to do it privately, blowing a big chunk of her savings, and its all booked for this Wednesday. However, the “package” shes paying for is just the operation and 3 (at a push, 4) nights in the private hospital, and then you are out the door.
Shes called various departments in the NHS to ask how she goes about getting the same aftercare as before (a few bits of equipment – toilet raisers, “elephant feet” for the sofa, a frame, and also the daily visits from the carers to change the socks) and basically been told by some people “yes, you are eligible” and others “you’re private – you’re on your own”.
The way I see it shes saved the NHS a big wedge of cash by paying for the op herself rather than waiting a year in pain, so why should she not have the same aftercare that anyone else does?
Not too concerned about the equipment – she still has her walking sticks from last time, and im sure I can acquire a frame off ebay or something, but last time her thigh wound became infected and if there are no visits from medical professionals im worried things wont get picked up.
She called her doctors to ask about prescribing painkillers post-op (they aren’t provided privately) and was told by the receptionist she’d have to have an appointment with the GP… first telephone appointments in June. June, FFS.
Anyone able to confirm whether she is or isn’t eligible for NHS post-op support? Thanks.
Shes in Surrey, in case that makes any difference.
Anyway, the following morning she was rushed into a hip replacement, and a week later was back home and a relatively efficient care package was in place, with various bits of equipment delivered and carers popping in daily to change her DVT socks (she was already able to do most other personal care things herself)
Over the next 10 months made quite a good recovery with that hip, but the left (“good”) hip increasing became more painful. The surgeon basically said that she’ll need that replaced too.
In the last couple of months shes been in so much pain shes on increasingly strong painkillers and the mobility she’d been regaining over the right hip has been lost due to the left. She now cant walk for more than a few minutes, and then in severe pain.
Last week I came back from a week away to be told shes in so much pain she’d agreed to do it privately, blowing a big chunk of her savings, and its all booked for this Wednesday. However, the “package” shes paying for is just the operation and 3 (at a push, 4) nights in the private hospital, and then you are out the door.
Shes called various departments in the NHS to ask how she goes about getting the same aftercare as before (a few bits of equipment – toilet raisers, “elephant feet” for the sofa, a frame, and also the daily visits from the carers to change the socks) and basically been told by some people “yes, you are eligible” and others “you’re private – you’re on your own”.
The way I see it shes saved the NHS a big wedge of cash by paying for the op herself rather than waiting a year in pain, so why should she not have the same aftercare that anyone else does?
Not too concerned about the equipment – she still has her walking sticks from last time, and im sure I can acquire a frame off ebay or something, but last time her thigh wound became infected and if there are no visits from medical professionals im worried things wont get picked up.
She called her doctors to ask about prescribing painkillers post-op (they aren’t provided privately) and was told by the receptionist she’d have to have an appointment with the GP… first telephone appointments in June. June, FFS.
Anyone able to confirm whether she is or isn’t eligible for NHS post-op support? Thanks.
Shes in Surrey, in case that makes any difference.
No she isn't eligible for NHS post-op care. Almost all my private patients discharge within 24hours of a knee or hip replacement, the odd one or two take 48 hours.
Most private providers will have a physio package post-op to utilise. My dad paid for a knee replacement and supplemented it with some private physio after a few months of recovery.
Her discharge from the private hospital will include some analgesia and anticoagulant. She will have to contact her GP to get additional pain relief once it runs out (usually get a week or two). I've no idea why she needs an appointment for a repeat prescription if shes already on strong painkillers
Most private providers will have a physio package post-op to utilise. My dad paid for a knee replacement and supplemented it with some private physio after a few months of recovery.
Her discharge from the private hospital will include some analgesia and anticoagulant. She will have to contact her GP to get additional pain relief once it runs out (usually get a week or two). I've no idea why she needs an appointment for a repeat prescription if shes already on strong painkillers
Edited by ucb on Monday 15th May 10:22
Can't comment on equipment but for post-op care that the gp normally provides (e.g changing dressings, blood tests, whatever is required) is the same whether the operation is private or NHS. The GP has a duty of care in this situation.
She will need an appointment with the GP and they will need her discharge letter from the private consultant who discharges her. No GP will do anything for post op care without an appointment and discharge letter.
The GP will look up the nhs guidance and follow that. You can get situations where the private consultant asks for follow up care that doesn't match the NHS guidelines, in this situation the GP will probably follow the nhs guidance rather than the discharge letter. But some may be more pragmatic where the discharge asks for more than the nhs guidelines.
Mrs goingonholiday had this type of situation, GP post op care was excellent and straightforward to arrange.
She will need an appointment with the GP and they will need her discharge letter from the private consultant who discharges her. No GP will do anything for post op care without an appointment and discharge letter.
The GP will look up the nhs guidance and follow that. You can get situations where the private consultant asks for follow up care that doesn't match the NHS guidelines, in this situation the GP will probably follow the nhs guidance rather than the discharge letter. But some may be more pragmatic where the discharge asks for more than the nhs guidelines.
Mrs goingonholiday had this type of situation, GP post op care was excellent and straightforward to arrange.
She absolutely IS eligible as long as the procedure would have been ordinarily funded by the NHS.
If your mum would have met the local commissioning criteria in place to have a hip replacement then she can transfer her care at *any* point in her pathway to NHS.
The guidance from the Department of Health (yes, it's old but it hasn't been replaced and is therefore still applicable) is here:
https://assets.publishing.service.gov.uk/governmen...
The pertinent bit being:
"Any care which would normally have provided in the course of good NHS practice
should continue to be offered free of charge on the NHS." (pg. 14)
If your mum would have met the local commissioning criteria in place to have a hip replacement then she can transfer her care at *any* point in her pathway to NHS.
The guidance from the Department of Health (yes, it's old but it hasn't been replaced and is therefore still applicable) is here:
https://assets.publishing.service.gov.uk/governmen...
The pertinent bit being:
"Any care which would normally have provided in the course of good NHS practice
should continue to be offered free of charge on the NHS." (pg. 14)
Thanks - interesting to see the range of responses here mirrors the responses she's been getting from the various professionals shes been talking to.
While im confident she would have met the criteria for this 2nd hip replacement (her surgeon from the first told her it was required during her follow-ups with him) i dont know whether this got initiated with the GP etc to actually get her on the NHS waiting list - presumably not. Its just frustrating that shes gone ahead without my knowledge/involvement from the get-go, but its not the first time shes done things and then its me that has to pick up the pieces - the joys of dealing with elderly parents
Anyway, she went into theatre at about 10.30 today so im waiting for a call from someone to hopefully say it went ok.
Absolutely disgusted with the private hospital though...(no names, but same postcode as St Peters NHS hospital...) as they gave her a price, pushed her to get the money transferred last week (just over £15K) then yesterday afternoon said "oh, by the way, the price is going up - what we charged you is now just covering your stay in the hospital - we're telling the surgeon and anaesthetist to bill you separately".
So theres me comforting my crying mum who only paid the money because shes in so much pain, and now is looking at another 20% extra at least.
I guess thats a subject for another thread in the SP&L forum if it comes to it though.
While im confident she would have met the criteria for this 2nd hip replacement (her surgeon from the first told her it was required during her follow-ups with him) i dont know whether this got initiated with the GP etc to actually get her on the NHS waiting list - presumably not. Its just frustrating that shes gone ahead without my knowledge/involvement from the get-go, but its not the first time shes done things and then its me that has to pick up the pieces - the joys of dealing with elderly parents
Anyway, she went into theatre at about 10.30 today so im waiting for a call from someone to hopefully say it went ok.
Absolutely disgusted with the private hospital though...(no names, but same postcode as St Peters NHS hospital...) as they gave her a price, pushed her to get the money transferred last week (just over £15K) then yesterday afternoon said "oh, by the way, the price is going up - what we charged you is now just covering your stay in the hospital - we're telling the surgeon and anaesthetist to bill you separately".
So theres me comforting my crying mum who only paid the money because shes in so much pain, and now is looking at another 20% extra at least.
I guess thats a subject for another thread in the SP&L forum if it comes to it though.
She doesn't need a GP referral to 'instigate' a transfer to an NHS pathway. If the treatment would have been ordinarily funded, it doesn't require gatekeeping. It is wholly unfair that patients who don't know their legal rights under the NHS Constitution get disregarded - equally private hospitals struggle to arrange post-operative care with LA / SS and community physio because the individuals they contact *also* haven't read the NHS Constitution or any of the legal guidelines describing private / NHS interface.
Regarding the price change, I would encourage you to contact the Hospital Director (they will be the Registered Manager on the CQC website) with your complaint. What she was quoted should be the price she paid (unless the quote was absolutely transparent).
Edit - I hope everything goes well with your Mum's procedure today.
Regarding the price change, I would encourage you to contact the Hospital Director (they will be the Registered Manager on the CQC website) with your complaint. What she was quoted should be the price she paid (unless the quote was absolutely transparent).
Edit - I hope everything goes well with your Mum's procedure today.
daddy cool said:
AlfaPapa said:
Edit - I hope everything goes well with your Mum's procedure today.
Cheers - yeah she just texted me to say shes back in her room and had a cuppa and a biscuit, so sounds promising. Will be popping over after work 
Take note of AlfaPapa advice! The way to think of it is the NHS has a duty of care, doesn't matter who operated or how you come to need their services!
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