The Department has developed five orthopaedic commissioning pathways which pertain to musculoskeletal conditions hip pain, knee pain, shoulder pain, chronic pain back pain and carpal tunnel syndrome. These were published as part of 43 18-week commissioning pathways that reflect national good practice. These pathways highlight the types of conditions that need to be referred for specialist assessments as well as stressing clinical urgent conditions (often referred to as red flag patients) that need emergency treatment. A further pathway is currently in development for arthritis.
The pathways are high-level service models to help support and enable commissioners and service providers to challenge existing practice, utilise service improvement tools and techniques, maximise opportunities for transformational change, provide a catalyst for local discussion and challenge in order to deliver 18-week pathways.
From the 1 January 2009, the minimum expectation of consultant-led elective services will be that no one should wait more than 18 weeks from the time they are referred to the start of their treatment, unless it is clinically appropriate to do so or they choose to wait longer.