The woman in desperate need of a hip replacement that her health board cancelled by mistake

  • Video report from ITV Wales' Health Correspondent Katie Fenton

A woman from Swansea has been sharing her ordeal of being in pain for almost a decade waiting for a hip replacement, only to be forced to wait even longer for surgery due to an error by the health board.

Joanne Dix, 49, says the mistake in cancelling a pre-planned operation by the health board has left her living with bouts of depression and wanting get her pain-free life back.

Joanne was first referred to hospital in 2018 for pain in her right hip and then again in 2021 for her left.

It was found that the referral for her left hip was closed in error, however in 2023 her left hip was treated. She was then removed from the waiting list for her right hip, even though this still required treatment.

Joanne's first hip-related appointment was almost eight years ago, meaning she's been in constant pain throughout that period.

"It's difficult, it impacts on daily life, just basic things. I found a lot of impact through covid when I just wanted to go walking and you just can't go walking unless you dose up on so much pain relief.

"You push through it but then for the next week you're struggling to get in and out of bed or up and down off the sofa and it's just impacted on every aspect of daily living

"I went through a bout of depression. Doing a lot of sports and then being told you can't do as much with the kids or the family. Having to turn things down, people going for coastal walks, things like that and having to think if you can do it.

"You build your hopes up. You know that pre-assessment lasts for six months, so you're expecting to go in at that timeframe and then nothing happens and you get called for another one and you wait again for another six months and then you get called for another one and you wait again for another six months and then you get called for a third one and then you find out in the report that was an error.

"So then it becomes upsetting that it's unnecessary cost on the NHS, getting you in for pre-assessments which are not required or made in error and you're not having the surgery either.

'How many other people is it happening to?'

She says her ordeal has really taken its toll on her family, her marriage and her work life: "I was angry, I was frustrated, I was in pain, not sleeping, so then I was tired and just generally everything getting on top of me.

Joanne has said she doesn't blame the doctors or clinicians who she's dealt with already but the NHS management who have mishandled the situation.

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"If this has happened to me, how many other people is it happening to? If I hadn't gone to the Ombudsman would these failings have been recognised?"

"I just want the surgery, I just want to be out of pain, I just want to get my daily living back before I hit my 50s really and start living life pain-free.

Joanne's experience isn't one simply confined to her, with other patients also having to wait significant periods for orthopaedic surgery in the Swansea Bay area.

Two other complainants, who have chosen to remain anonymous, have also taken their cases to the ombudsman after being in similar situations to Joanne.

In the case of "Mr C", he had been assessed as needing surgery within a month but waited three years seven months whilst in severe pain.

During that time his position on the waiting list was reset in error and he was also removed from the list entirely by Swansea University Health Board.

For "Mr D", he was removed from the waiting list when he missed surgical appointments because he was in hospital undergoing treatment for another illness.  

Despite provision in the guidance for this type of situation, Mr D was removed from the list and was waiting to be “treated in turn” which appears to be outside of the process.  

Mr D received treatment in January 2024, more than five years after being added to the list for surgery. Mr D is said to have experienced a lot of pain, which affected his wellbeing significantly.

'Patients had their hopes falsely raised that surgery would happen soon'

In its findings, the ombudsman discovered that the current waiting time for orthopaedic surgery at the Health Board is more than four years. 

It also found that the Health Board has had issues including not enough staff, not enough suitable places to operate, unclear management arrangements, and unclear processes for these operations. 

It says the complainants were also put through the stress and pain of pre-operative assessments. These had falsely raised their hopes that surgery would happen soon.

Commenting on the report, the Public Services Ombudsman for Wales, Michelle Morris, has said:

"While patients are waiting for surgery on the list, they should be treated fairly in relation to the management of their place on that list, how they are communicated with about the time it is likely to take to receive treatment and to have their expectations fairly managed.

"Patients who are already facing lengthy waiting times should feel able to rely on the Health Board to manage the waiting list well and in accordance with the waiting list guidelines.

"These 3 cases demonstrate clear injustice to the patients.  

"In addition to these failings, the complainants had the unnecessary stress and pain of pre-operative assessments.  I am concerned that there appears to have been no thought for the impact of these on the patients’ wellbeing.

The Ombudsman has made the following recommendations of which the health board has agreed to implement.

  • The Health Board to review the decisions it made in respect of these complainants and their positions on the waiting list;

  • The Health Board to audit the whole waiting list to establish whether errors had been made on the waiting list times or if improper removal from the list for other patients had taken place;

  • If so the Health Board should apologise to those patients and correct the errors. 

In response to the report, Swansea Bay has apologised to the patients for the failings in how their appointments were managed.

"We have accepted the Ombudsman’s recommendations in full and they will be implemented over the next few weeks.

"We can confirm that all three patients have now received their operations. We are checking our orthopaedic waiting lists to ensure there are no other similar cases, and if there are, we will again urgently expedite their care.

"Along with scrutinising our orthopaedic waiting lists, additional staff training is in place to ensure referral to treatment time rules are followed.

"Our orthopaedic services are under huge pressure, and we are doing all we can to tackle waiting lists, including launching the new orthopaedic theatre hub at Neath Port Talbot Hospital seven months ago.

"In most cases, the orthopaedic patients who have waited the longest have had other health concerns as well, so needed their operation in Morriston Hospital. Crucially we have now re-established 10 ring-fenced beds in Morriston for this group of patients with complex health needs.

"This action, together with the new orthopaedic theatres in Neath Port Talbot Hospital, means the longest waiting times are now coming down.

"We anticipate that by the end of March there will be no patients waiting over three years for their surgery, with the majority of orthopaedic patients who do not have additional health needs being seen sooner."

In response to Joanne's claim she had not received treatment, Swansea Bay Health Board said: "We are not able to discuss individual patient cases in detail, but we can confirm that while all three patients in the Ombudsman’s reports have received orthopaedic surgery, in one case another orthopaedic operation is now scheduled. 

"We are in direct contact with this patient, who is due to have their remaining surgery very shortly. We are happy to discuss with the patient any further queries they may have."

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