Shropshire Star

Oswestry Orthopaedic Hospital faces £2 million hit if tariff is backed

Shropshire's orthopaedic hospital could be more than £2 million out of pocket next year if a new payment tariff proposed by regulators goes ahead.

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Health chiefs at Oswestry Orthopaedic Hospital have today voiced concerns after it emerged that the hospital trust could lose out on £2.3 million if the proposed orthopaedic national tariff is agreed for the next financial year.

The tariff sets out how much the hospital is paid for each operation it carries out, and if this one goes ahead it could see the hospital's overall revenue reduced by about 2.5 per cent.

The 2017/18 and 2018/19 tariff consultation document, published by NHS Improvement, suggests providers that specialise in orthopaedic and paediatric services would face significant cuts as a result of the national price changes.

As it stands, hip revision surgery – follow-up operations on patients who have already had a hip replacement – cost the hospital an average of £10,000 but if the new tariff goes ahead, the hospital would receive an average income of £6,500 per procedure.

Mark Brandreth, chief executive at the trust that runs the hospital in Gobowen, raised fears over the consequences the proposed tariff for next financial year could have on patient care. He said: "It is widely recognised that the prices proposed in the new tariffs are flawed, and the declared intention to press ahead with imposing them will have serious consequences for specialist orthopaedic providers like ourselves, and our partners in the Specialist Orthopaedic Alliance.

"As just one example of the folly of these proposals, you need only look at the proposed prices for knee and hip revision surgery – that is to say follow-up operations on patients who have already had a hip or knee replacement and then return many years later to have it done again when the replacement joint wears out.

"These cases can be more challenging and complex than the original operation and are therefore more costly to deliver.

"We perform about 200 hip revisions a year at an average cost of £10,000 each time, and 140 knee revisions a year at an average cost of £11,000 each time. Yet the tariff for 2017/18 onwards proposes that we would receive an average income of just £6,500 for these procedures – a sum which is sufficient to cover in full just a quarter of the revision operations we undertake.

"We would be making a significant loss on approximately 255 of our revision cases each year. This adds up to a worrying and unsustainable financial burden." It comes as the hospital is projecting a £2 million surplus this year.

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