Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what guidance is currently issued to NHS trusts on post operative assessment following lower limb surgery, and whether this includes consideration of referral to podiatry or orthotics services.

It is recommended that all patients receiving surgery, including lower limb surgery, benefit from a structured perioperative care programme, which includes postoperative assessment as a key component. Our Elective Reform Plan commits to enhancing perioperative care, to reduce cancellations, shorten patients’ length of hospital stay, and minimise postoperative complications.

The Getting It Right First Time (GIRFT) programme, part of NHS England, works with stakeholders to develop standardised best practice pathways for routine surgical procedures. GIRFT, along with a cross-specialty, multidisciplinary working group, has developed guidance on early screening, triaging, risk assessment, and health optimisation in perioperative pathways. This is available on the NHS England website along with further guidance for trusts on perioperative care covering clinical and operational improvement guide.

GIRFT has also produced best practice pathways for primary knee and hip replacements. Guidance is offered on best practice from patient presentation through to post-discharge care and follow-up. Podiatry and orthotics referrals are not currently included in the pathways provided. However, GIRFT regularly engages with trusts to help gain insight and understanding into care delivery across England.

National Institute for Health and Care Excellence guidelines, available on their website, include Perioperative Care in Adults guideline, reference code NG180, and orthopaedic standards including joint replacement (primary): hip, knee and shoulder guideline, reference code NG157.