Intended for healthcare professionals

Rapid response to:

Practice A Patient’s Journey

Two hip replacements

BMJ 2010; 340 doi: (Published 29 April 2010) Cite this as: BMJ 2010;340:c1502

Rapid Response:

Something for GPs to commission

What a clear illustration of the fact that joint replacement surgery,
however good, isn't the beginning or the end of the treatment, but the
middle! What happens before and after an operation makes a huge difference
to the outcome. The essentials are all consultants adopting the same
policy, an informed patient, a multidisciplinary approach, and patients
having a post-discharge point of contact with someone who knows them. Plus
enthusiasm. That is a virtuous circle, as staff enjoy the appreciation of
patients who are benefitting from the programme.

Why is this not done everywhere? And for all standard procedures?
Where is the obstacle to implementing such programmes?

GPs are about to take on the burden of commissioning. This is just
the sort of change in practice which they can use their power to

Competing interests:
I expect to need a hip replacement some day, and I know how I hope to be cared for!

Competing interests: No competing interests

27 August 2010
Judith H Harvey
freelance GP