North London Partners in health and care

Review of adult elective orthopaedic services

We are reviewing Adult Elective Orthopaedic Services

In 2016/17, north central London hospitals carried out over 23,000 adult elective orthopaedic operations across 10 sites. Adult elective orthopaedic surgery is planned (non-emergency) surgery of bones and joints, such as hip and knee replacements. 
We think there may be opportunities to improve adult elective orthopaedic surgery in north central London by consolidating services onto fewer sites and we are undertaking a review of these services to see if these improvements can be achieved.

Our review was launched, following agreement at the NCL Joint Commissioning Committee meeting on 01 February 2018.  It has been established by North London Partners in health and care

The review group (led by local clinicians, involving patients, commissioners and those who currently carry out these operations) is coordinating the development of how this kind of care could be delivered in the future. Our thinking is presented in our draft case for change.

Clinical commissioners in Barnet, Camden, Enfield, Haringey and Islington will make the final decisions on where and how future services are shaped.

Engagement on the draft case for change

In our engagement phase we invited written feedback via our online questionnaire, email and in writing.  We also worked with NHS colleagues at CCGs, local hospitals, other healthcare providers and voluntary sector partners to promote the opportunity to feed back.  We attended community events in all five boroughs and co-hosted a number of open public meetings.

Next steps

The feedback we received has been independently evaluated, and what we heard will inform the next steps of our review.  

  • The clinicians leading the review group will formally feedback to the clinical commissioning groups (CCGs) outlining what was heard during the engagement and also what is emerging as principles which could inform a clinical model.
  • The review group has shared this information with the Joint Health Overview and Scrutiny Committee (JHOSC) for north central London

You can read more about what was taken to these committees, and see copies of the reports on our engagement phase feedback page.

  • It will then be the responsibility of the CCGs to consider what the review group has found and to think through how to develop proposals for how adult elective orthopaedic services will be shaped in future. We will share this thinking with those involved in the services and local people.

We plan to contact those who participated in the review to offer an update once proposals the future services have been developed.


Download the draft case for change

Download a large print version of the draft case for change

The draft case for change document contains links to a series of illustrative graphs and tables hosted on our website. If you read the case for change on your computer or device, the link will take you to the relevant graph or table.

However, if you intend to print the draft case for change, you should also print the accompanying graphs and tables.

If you would like a printed version of the document sending to you in the post please contact us at, including your full name and address in the email.  

If you have questions or comments please

You can read the papers presented to the North Central London (NCL) Clinical Commissioning Committee meeting on 1 February 2018 here.

If you have any concerns or feedback about any specific personal orthopaedic treatment you have already received, or you are waiting to receive, please speak to your GP or the hospital who provided this service.