The Medicines and Healthcare products Regulatory Agency (MHRA) is committed to ensuring that all medical devices on the United Kingdom’s market meet stringent safety and performance standards. It continuously monitors the safety of orthopaedic implants using data from adverse incident reports, national registries, and clinical input to identify emerging risks.

Currently, the MHRA has not identified a safety signal to suggest that cobalt chrome components used more broadly in hip replacements pose an increased or unacceptable risk to patients. Therefore, there are no plans to commission an independent inquiry into hip replacements containing cobalt chrome.

People have been waiting too long for National Health Service treatment, with their personal and professional lives put on hold. This is why we have committed to getting back to the NHS constitutional standard, that 92% of patients wait no longer than 18 weeks from Referral to Treatment (RTT) by March 2029. This includes patients waiting for hip replacement surgery, for which the median average waiting time in England as of 16 March 2025 was 24.7 weeks.

We have already made progress, delivering on our commitment to provide two million additional appointments and publishing our Elective Reform Plan, which sets out how we will tackle waits, increase productivity, and improve patient experience. This includes providing quicker access to common surgical procedures, such as hip replacements, by opening 17 new and expanded surgical hubs by June 2025, so more operations can be carried out.

Dedicated and protected surgical hubs are transforming the way the NHS provides elective care by focusing on high volume low complexity surgeries. There are currently 114 elective surgical hubs that are operational across England as of March 2025, with 88 of them providing treatment for the trauma and orthopaedic specialty under which hip replacements fall. These surgical hubs help separate elective care facilities from urgent and emergency care, improving outcomes for patients and reducing pressures on hospitals.

People have been waiting too long for National Health Service treatment, with their personal and professional lives put on hold. This is why we have committed to getting back to the NHS constitutional standard, that 92% of patients wait no longer than 18 weeks from Referral to Treatment (RTT) by March 2029. This includes patients waiting for hip replacement surgery, for which the median average waiting time in England as of 16 March 2025 was 24.7 weeks.

We have already made progress, delivering on our commitment to provide two million additional appointments and publishing our Elective Reform Plan, which sets out how we will tackle waits, increase productivity, and improve patient experience. This includes providing quicker access to common surgical procedures, such as hip replacements, by opening 17 new and expanded surgical hubs by June 2025, so more operations can be carried out.

Dedicated and protected surgical hubs are transforming the way the NHS provides elective care by focusing on high volume low complexity surgeries. There are currently 114 elective surgical hubs that are operational across England as of March 2025, with 88 of them providing treatment for the trauma and orthopaedic specialty under which hip replacements fall. These surgical hubs help separate elective care facilities from urgent and emergency care, improving outcomes for patients and reducing pressures on hospitals.

In the financial year 2023/24, there were 120,172 hip procedures performed at a total cost of £1,241,784,028.35, with an average unit cost of £10,333.39. There were 86,781 knee procedures performed at a total cost of £737,241,451.39, with an average unit cost of £8,495.42. There were an additional 13,811 complex cases for hip or knee procedures performed at a total cost of £220,792,075.13, with an average unit cost of £15,986.68. The total cost for 246,995 cataract procedures was £363,849,348.97, with an average unit cost of £1,473.10.

There are currently 31,323 patients waiting for a hip replacement. The average mean National Health Service waiting time for hip replacement surgery is 27.4 weeks.

The Government is working to reduce the number of patients awaiting treatment across the country. The Elective Reform Plan, launched as part of the Government’s Plan for Change, sets out how we will get back to the NHS Constitutional Standard that 92% of patients wait no longer than 18 weeks from Referral to Treatment RTT by the end of this Parliament and also ensure patients have the best possible experience of care.

We have set an ambition for 2025/26 that we reach 65% of patients waiting no longer than 18 weeks nationally, and for all trusts to deliver a minimum five percentage point improvement by March 2026.

The Elective Reform Plan has committed to providing quicker access for patients to common surgical procedures by opening 17 new and expanded surgical hubs by June 2025, so more operations can be carried out.

Dedicated and protected surgical hubs are transforming the way the NHS providers elective care by focusing on high volume low complexity surgeries. There are currently 113 elective surgical hubs that are operational across England as of February 2025. These surgical hubs help separate elective care facilities from urgent and emergency care, improving outcomes for patients and reducing pressures on hospitals.

NHS Resolution (NHSR) manages clinical negligence and other claims against the National Health Service in England. NHSR has confirmed that there is no specific NHS compensation scheme for claims relating to defective hip replacements supplied by DePuy.

While there is no specific compensation scheme for claims relating to defective hip replacements supplied by DePuy, NHSR’s website gives some general advice for claimants wishing to make a claim for clinical negligence, with further information available at the following link:

https://resolution.nhs.uk/services/claims-management/advice-for-claimants/

Anyone who is aware of complications or adverse events associated with hip replacement devices is encouraged to seek clinical advice from their responsible clinician and report the issue via the Yellow Card Scheme, which is available at the following link:

https://yellowcard.mhra.gov.uk/

The Medicines and Healthcare products Regulatory Agency (MHRA) is aware of concerns regarding modular neck hips and the risk of cobalt poisoning. We are investigating the issue with our stakeholders including the British Orthopaedic Association, British Hip Society, and the National Joint Registry to support.

The term modular neck covers a broad range of designs, and adverse incident reports of this sort typically include descriptions of symptoms rather than a definitive diagnosis of cobalt poisoning. In addition, it is not possible to uniquely identify cobalt poisoning from hip replacements in the ICD-10 coding scheme currently used in Hospital Episode Statistics.

The UK Medical Devices Regulations provide clear requirements for manufacturers to undertake post-market surveillance activities to ensure safety action is taken, when appropriate. The MHRA is working towards implementing a future regime for medical devices regulation. This will put in place strengthened legal requirements for how manufacturers monitor and report on their devices once they are being used in the real world.

In the NHS Lincolnshire Integrated Care Board, as of 25 August 2024, there were fewer than five patients waiting more than 12 months for knee replacement surgery, and six patients waiting more than 12 months for hip replacement surgery.

In the East Midlands, as of 25 August 2024, there were 479 patients waiting more than 12 months for knee replacement surgery, and 244 patients waiting more than 12 months for hip replacement surgery. The data captures patients waiting in the NHS Derby and Derbyshire Integrated Care Board, NHS Leicester, the Leicestershire and Rutland Integrated Care Board, the NHS Lincolnshire Integrated Care board, the NHS Northamptonshire Integrated Care Board, and the NHS Nottingham and Nottinghamshire Integrated Care Board.

The information is not held in the format requested.

Hospital Episode Statistics is a database containing details of all admissions, accident and emergency attendances and outpatient appointments at National Health Service hospitals. Initially this data is collected during a patient's time at hospital as part of the Commissioning Data Set. However, the data that is requested in this question is not available in the format requested. Waiting time data at trust level is not available by specific condition/treatment.

Hospital Episode Statistics is a database containing details of all admissions, accident and emergency attendances and outpatient appointments at National Health Service hospitals. Initially this data is collected during a patient's time at hospital as part of the Commissioning Data Set. However, the data that is requested in this question is not available in the format requested. Waiting time data at trust level is not available by specific condition/treatment.

Hospital Episode Statistics is a database containing details of all admissions, accident and emergency attendances and outpatient appointments at National Health Service hospitals. Initially this data is collected during a patient's time at hospital as part of the Commissioning Data Set. However, the data that is requested in this question is not available in the format requested. Waiting time data at trust level is not available by specific condition/treatment.

Hospital Episode Statistics is a database containing details of all admissions, accident and emergency attendances and outpatient appointments at National Health Service hospitals. Initially this data is collected during a patient's time at hospital as part of the Commissioning Data Set. However, the data that is requested in this question is not available in the format requested. Waiting time data at trust level is not available by specific condition/treatment.

The Blue Badge scheme is primarily about helping those with permanent mobility issues access the goods and services they need to use. Anyone may be entitled to a badge if they meet the eligibility criteria. The Department for Transport sets the legislation that governs the Blue Badge scheme local authorities are solely responsible for administering the scheme and issuing the badges.

The information is not held centrally in the format requested.

However, the following table shows the average unit cost of all Healthcare Resource Groups (HRGs) which include hip procedures in each year from 2015/16 to 2020/21. The data for 2021/22 is currently being collected and centrally validated and is expected to be available by November 2022. An HRG consists of patient events which have been determined to consume a similar level of resource.

The most recent available data shows that in 2021/2022, the average waiting time for a hip replacement operation is 198 days in Oxfordshire and 237 days in England.

The information requested is not held centrally.

The number of people waiting for hip and knee replacements is not captured separately but is a sub-set of trauma and orthopaedic data.

The number of people in South East London CCG waiting 18 weeks or more or 52 weeks or more for trauma and orthopaedic treatments in each month from February 2020 to July 2021 has been presented in the table below.

Data is only available from April 2020 as this was the point that the South East London CCG was formed.

The number of people waiting for hip and knee replacements is not captured separately but is a sub-set of trauma and orthopaedic data.

The number of people in South East London CCG waiting 18 weeks or more or 52 weeks or more for trauma and orthopaedic treatments in each month from February 2020 to July 2021 has been presented in the table below.

Data is only available from April 2020 as this was the point that the South East London CCG was formed.

As announced in September, an additional £1 billion has been provided this year as part of the Elective Recovery Fund, which can be accessed by local trusts if they meet the eligibility criteria to tackle the backlog. A further £8 billion was announced to transform elective services and increase activity across the following three years. The Department has also committed to £5.9 billion of capital funding to further support National Health Service in reducing the backlog of people waiting for procedures, tests and scans, including £1.5 billion for increased bed capacity, equipment and new surgical hubs.

The NHS is improving the efficiency of joint replacement surgery, using lessons learned from the high-volume low acuity approach piloted in London and developed by the Getting It Right First Time programme to streamline processes and utilise surgical hubs. NHS England and NHS Improvement continue to work with Versus Arthritis and are evaluating patient support and developing regional and system strategies focused on those waiting for elective surgery and their health and wellbeing.