Committee calls for better quality data collection on orthopaedic services


The Scottish Government should improve the quality of data collected nationally on orthopaedic services, according to a report published today by the Public Audit Committee. This would assist NHS Boards to drive down costs and improve their productivity and performance.

The Review of orthopaedic services sets out the committee’s findings in relation to a report by the Auditor General for Scotland (AGS).

Committee Convener Hugh Henry MSP said:

“The Public Audit Committee is keen to know why, despite a significant increase in funding and a rise of 49 per cent in consultant numbers, the number of orthopaedic cases treated had only risen by 12 per cent. We are disappointed to learn that the data collected nationally could not easily explain this small rise in activity.”

“NHS Boards did not appear to be able to accurately compare their costs and productivity with other NHS Boards to identify how savings and efficiencies could be realised – this information is vital given future budget constraints. We are calling on the government to provide more information on how it will address this through its current revision of the health information strategy and its review of the health service costs – ‘the costs book’.”

The committee also said that data collection needs to become more sophisticated, with monitoring of the entire patient journey including primary, community and secondary care. This information is vital if NHS Boards are to improve their productivity and deliver best value through redesigning services.

The committee highlighted a number of other issues:

  • The national procurement contract, established to enable NHS National Services Scotland to negotiate a price reduction with suppliers at a national level, had resulted in some savings in the procurement of surgical implants. However, the committee was not convinced this had achieved best value in light of greater savings achieved by NHS Greater Glasgow and Clyde in a mini-procurement exercise.
  • It was unacceptable that people remained in hospital because of the unavailability of public transport and the committee recommended that NHS Boards examine the barriers to people leaving hospital when fit to do so.
  • The committee would like an update from the government on how it will measure the effectiveness of the new rehabilitation coordinators in monitoring the quality of rehabilitation, the provision of that service and in ensuring that patients returning home are sufficiently supported.


The Auditor General for Scotland (AGS) published his report Review of Orthopaedic Services in March 2010. The report focussed on how effectively the NHS in Scotland manages orthopaedic services, how much is spent and whether this represents value for money. The report also assessed whether there is scope to improve the efficiency of orthopaedic services in Scotland. This is the first time an AGS report focussed on the economy, effectiveness and efficiency of a particular speciality within the NHS.

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