(Image: Getty)
A leading arthritis charity has joined surgeons, nurses and unions in raising concerns over controversial plans to overhaul orthopaedic care in Scotland, warning patients need "shorter waits, better care and a proper plan".
Arthritis UK's Scotland branch said proposals in a leaked NHS blueprint risked leaving key questions unanswered for patients, particularly about plans that could require people to travel farther from home for hip and knee operations.
The intervention follows The Herald's reporting last week on the confidential document, Transforming Elective Orthopaedic Care in Scotland 2026-2031, which proposes concentrating more planned orthopaedic surgery in specialist regional centres and National Treatment Centres.
Read More: Leaked plan reveals huge shake-up of Scottish orthopaedics
The blueprint, drawn up for the Scottish Government, also works towards a maximum 26-week wait for orthopaedic treatment by 2031, despite longstanding commitments to restore the statutory 12-week Treatment Time Guarantee.
It would require longer theatre days and weekend working and comes at a time of severe staffing pressure.
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In a letter to The Herald, Arthritis UK's Scotland head Lauren Bennie called the government's move to aim for patients to wait up to 26 weeks for treatment by 2031 a "red herring, a distraction".
She added that "The existing guarantee has yet to be met, bears little resemblance to reality and does nothing to help people waiting more than one to two years for a hip or knee replacement."
Orthopaedics has consistently been among the worst-performing specialties for waiting times in Scotland and currently has the largest treatment waiting list of any hospital specialty across all health boards.
"The existing guarantee has yet to be met, bears little resemblance to reality and does nothing to help people waiting more than one to two years for a hip or knee replacement." (Image: Newsquest)
Read More: Orthopaedic surgery plan kept secret from NHS staff
While Bennie welcomed signs of fresh investment and a national strategy, she questioned why patients and staff were learning details through leaked documents rather than formal consultation.
"We seem to have the plan and the investment, but the people at the sharp end, patients and healthcare professionals, would still be in the dark without a leaked document," she said.
After the plans were published, we reported that the Scottish Committee for Orthopaedics and Trauma (SCOT), which represents orthopaedic surgeons across Scotland, said it had not been given an opportunity to contribute.
The Royal College of Nursing and Unison also complained they had not been consulted before details emerged publicly.
Unison Scotland co-lead for health, Matt McLaughlin, accused ministers of treating a "hugely experienced workforce with contempt", while warning that any expansion of services would require substantial additional staffing.
The leaked blueprint calls for increased surgical capacity, which could require more than 100 additional outpatient clinics and roughly 15 extra theatre sessions per month. It also envisages longer operating days, weekend working and changes to consultant job planning.
However, concerns have been raised about whether the workforce exists to deliver the reforms.
NHS Scotland recorded 3,115 nursing and midwifery vacancies at the end of June, including almost 2,000 registered nurse vacancies.
Bennie also questioned how patients would be supported if they were expected to travel to regional surgical hubs, calling access to services a "postcode lottery".
"Proposals requiring people (and their families) to travel further for surgery raise serious concerns, particularly for older, disabled and rural individuals," she said.
"Access to treatment is already a postcode lottery. Will there be support? Will there be penalties for saying no to a particular site?"
The leaked plan says patients should regard travelling for surgery as "to be expected" and recommends efforts to build public acceptance of the new model.
Arthritis UK says 1.7 million people in Scotland live with musculoskeletal conditions, including around 850,000 with arthritis, yet the country still lacks a dedicated national musculoskeletal action plan.
"The real problem runs much deeper than orthopaedic waiting lists," the organisation said.
"People living with arthritis don't need longer waiting-time targets. They need shorter waits, better care and a proper plan."
The Scottish Government said it always intended to engage staff and trade unions on the draft proposals and will publish a final national orthopaedic plan in the coming weeks.
On Friday, Health Secretary Angela Constance said: "Our Programme for Government in September committed to ending waits in our hospitals and ensuring nobody waits more than 26 weeks for the treatment they need.
"To support this we have been working alongside health boards to create a new national orthopaedic plan, designed to build on the progress we've seen in long waits coming down and ensure patients get treatment at the earliest possible date. Final details of a plan will be set out in the coming weeks.
"Our reforms of Scotland's NHS boards will make the best use of capacity across Scotland, to drive down waiting times and ensure people get the right care, in the right place at the right time."