How to Choose a Surgeon and a Hospital

Part of The Joint Replacement Guide — Phase 6: The Bigger Picture · Article 38 of 42 · Hip & Knee

Key Points

NHS patients in England have a legal right to choose which hospital and consultant-led team they’re referred to.
Useful sources of information include NJR surgeon profiles, hospital-level outcome data, and CQC inspection reports.
Volume and outcomes matter, but so does how well you communicate with your surgeon and how comfortable you feel with the proposed plan.
It’s entirely reasonable to ask direct questions about a surgeon’s experience with your specific procedure.

Your Right to Choose

NHS patients in England have a legal right to choose which hospital and named consultant-led team they are referred to for planned (elective) care, including hip and knee replacement, at the point of referral by their GP. This right allows you to consider factors such as waiting times, hospital reputation, location and travel, and the specific surgeon or team, rather than automatically defaulting to your nearest hospital.

Sources of Information Worth Using

The National Joint Registry, covered in detail earlier in this guide, publishes surgeon-level volume, revision rate and outcome data publicly. The Care Quality Commission (CQC) publishes hospital inspection reports and ratings covering safety, effectiveness and leadership at a hospital-wide level. Many hospitals and individual surgeons also publish their own outcome data, waiting times, and patient information directly, which can give a useful sense of how a service is run.

Volume and Outcomes — Useful, Not Everything

As discussed in the article on reading NJR profiles, higher case volume for a given procedure is generally, though not universally, associated with better outcomes, and it’s entirely reasonable to ask a prospective surgeon directly how many procedures of your specific type they perform each year. That said, these figures work best as one part of a broader picture rather than the sole deciding factor — how clearly a surgeon communicates, how thoroughly they explain your options, and how comfortable you feel with the proposed plan all matter too, and are harder to capture in a published statistic.

Questions Worth Asking

How many procedures of my specific type do you perform each year?
What implant and fixation approach do you typically use, and why, for someone like me?
What is your and this hospital’s approach to enhanced recovery and pre-operative optimisation?
What would my expected recovery pathway look like?
Where can I see your published outcome data?

In More Depth

Choice of provider under the NHS Choice Framework applies specifically to referrals for planned, consultant-led care, and the specific mechanics can vary slightly depending on your GP practice and local system — your GP or referral team can explain how it works practically for your particular situation. Where a patient has complex needs, or where a particular unit has specific expertise relevant to their case (for example, complex revision surgery, discussed earlier in this guide), a more tailored referral discussion with your GP is often worthwhile rather than choosing on general reputation alone.

This article is general information and does not replace individual clinical advice.

Sources

NHS England — NHS Choice Framework
National Joint Registry — public surgeon-level reporting
Care Quality Commission (CQC) — hospital inspection and ratings

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