What do local people think about proposed changes?

Healthwatch Enfield undertook research on proposed changes to planned orthopaedic services, including hip and knee replacements, across North Central London. Between August and October 2018, the research engaged 208 local residents and stakeholders to gather views on proposals to reduce the number of hospitals providing planned operations for bones and joints and instead develop specialist centres of excellence.

The report found that 58% of participants supported the proposal in principle, largely because they believed specialist centres could provide access to expert staff, better outcomes, shorter waiting times and modern facilities. However, support was conditional on clear evidence that the changes would genuinely improve care and reduce waiting times. Many respondents emphasised the importance of maintaining high-quality aftercare, person-centred care and good clinical outcomes. 

A substantial minority, 38% of respondents, opposed the proposals. The main concerns related to increased travel distances for patients, relatives and carers, worries that waiting times could actually increase, and fears that specialist centres might have reduced access to wider hospital services if complications arose. Carers of people with learning disabilities highlighted additional concerns about accessibility, continuity of care, suitable facilities and the need for specialist support staff. 

The report concluded that residents could see both advantages and disadvantages to centralising planned orthopaedic surgery. Healthwatch Enfield urged decision-makers to consider local concerns carefully before progressing to formal consultation and identified key priorities for any future service model, including easy access, shorter waiting times, high-quality specialist staff, effective aftercare, good clinical outcomes, modern facilities and care delivered as close to home as possible.