The information could only be provided at disproportionate cost.

Decisions on eligibility for procedures are a matter for local National Health Service commissioners and clinicians, taking account of relevant National Institute for Health and Care Excellence (NICE) guidance and the individual needs of the patient. The Department expects access to NHS services to be based on clinical need and informed clinical judgement.

NICE has produced a guideline on joint replacement that covers care before, during, and after a planned knee, hip, or shoulder replacement. The guideline does not make any recommendations on the use of body mass index (BMI) thresholds in determining eligibility for orthopaedic procedures.

As with all surgery, BMI should be considered as part of a holistic, personalised perioperative evaluation of the risks versus clinical need for joint replacement surgery of an individual patient. However, BMI should not be considered in isolation and in and of itself should not act as a barrier to surgery.

As part of the Elective Reform Plan, we expanded Advice and Guidance services, which enable general practitioners and other clinicians to get quick specialist advice from consultants about non-urgent patient care, helping decide on treatment plans, test results, or if a hospital referral is needed. From October 2026, providers are expected to ensure that all appropriate requests and referrals, excluding urgent suspect cancer, flow through a Single Point of Access model, acting as a single ‘front door’ to support clinical triage to the most appropriate service or outcome, supporting faster specialist assessment and meaning clearer next steps for patients.

All providers of healthcare, including independent sector providers, are regulated by the Care Quality Commission and follow a set of fundamental standards of safety and quality, below which care should never fall. The safety of all patients, whether they are treated in the NHS or the independent sector, is a top priority for the Government.

Decisions on eligibility for procedures are a matter for local National Health Service commissioners and clinicians, taking account of relevant National Institute for Health and Care Excellence (NICE) guidance and the individual needs of the patient. The Department expects access to NHS services to be based on clinical need and informed clinical judgement.

NICE has produced a guideline on joint replacement that covers care before, during, and after a planned knee, hip, or shoulder replacement. The guideline does not make any recommendations on the use of body mass index (BMI) thresholds in determining eligibility for orthopaedic procedures.

As with all surgery, BMI should be considered as part of a holistic, personalised perioperative evaluation of the risks versus clinical need for joint replacement surgery of an individual patient. However, BMI should not be considered in isolation and in and of itself should not act as a barrier to surgery.

As part of the Elective Reform Plan, we expanded Advice and Guidance services, which enable general practitioners and other clinicians to get quick specialist advice from consultants about non-urgent patient care, helping decide on treatment plans, test results, or if a hospital referral is needed. From October 2026, providers are expected to ensure that all appropriate requests and referrals, excluding urgent suspect cancer, flow through a Single Point of Access model, acting as a single ‘front door’ to support clinical triage to the most appropriate service or outcome, supporting faster specialist assessment and meaning clearer next steps for patients.

All providers of healthcare, including independent sector providers, are regulated by the Care Quality Commission and follow a set of fundamental standards of safety and quality, below which care should never fall. The safety of all patients, whether they are treated in the NHS or the independent sector, is a top priority for the Government.

Reducing waiting lists, including for trauma and orthopaedic (T&O) services, is a key part of the Government’s Health Mission. As set out in the Plan for Change, we are committed to returning by March 2029 to the National Health Service constitutional standard that 92% of patients wait no longer than 18 weeks from referral to consultant-led treatment. We are on track, hitting our first interim target of 65% in March 2026.

Since July 2024, performance in T&O services has improved, as the waiting list has reduced by 7,016 and the percentage of T&O pathways waiting within 18 weeks has increased by 3.0%. Despite this improvement, T&O performance against the 18-week standard, at 59.1%, remains below the national average, of 65.0%. We know that to meet our target of 92% we must see significant improvements across all specialties, including T&O, and we know that there’s more to do to drive that improvement.

The Elective Reform Plan sets out the productivity and modernisation efforts needed to reach the 92% standard by March 2029. This includes expanding the number of surgical hubs, where T&O is a key specialty, over the next two years to increase surgical capacity and deliver faster access to common procedures. Also, through the Getting It Right First Time programme, we are also supporting trusts to improve pathways, including through best practice guidance and multidisciplinary support for hip and knee replacement services.

Personal Independence Payment (PIP) awards, including the rate payable and the duration, are set on an individual basis, based on the claimant’s needs and the likelihood of those needs changing. Regular reviews are a key feature of the benefit and ensure that payments accurately match the current needs of claimants. Award durations can vary from nine months to an on-going award, with a light touch review at the ten-year point.

For most claimants over 25, their first review will be a minimum of 3 years and, assuming they remain entitled, 5 years for their next review.

We know PIP can be improved, which is why we launched the Timms Review, working with disabled people and their organisations to ensure the benefit is fit for the future. We launched a Call for Evidence that closed last week and are beginning to carefully consider and analyse the responses provided. We have also outlined a varied approach to evidence gathering so people can share their views on how the benefit should be reformed.

We are committed to returning by March 2029 to the National Health Service constitutional standard that 92% of patients wait no longer than 18 weeks from referral to consultant-led treatment, across all specialties, including trauma and orthopaedics. In March 2026, we hit our first interim target of 65% performance against that standard.

In the last year, Hampshire Hospitals NHS Foundation Trust, the provider located in the Eastleigh constituency, has seen a 5.4% increase in the proportion of waits under 18 weeks and a 6.9% increase in trauma and orthopaedics, the specialism that covers joint replacement surgery.

The Department is taking a range of steps to reduce waiting times for surgery, including joint replacement surgery. There are currently 125 surgical hubs operational across England, and we are committed to expanding the number of hubs over the next three years to increase surgical capacity and deliver faster access to common procedures. In addition, the Getting it Right First Time (GIRFT) programme is supporting improvements by publishing detailed guidance for hip and knee replacements in June 2023 and leading a community musculoskeletal (MSK) programme to support improvements in the early stages of MSK pathways, so that only those who require surgery are referred into secondary care. Further information on the GIRFT programme is available at the following link:

https://gettingitrightfirsttime.co.uk/

There are many disabled people and people with health conditions in receipt of both Universal Credit (UC) and Personal Independence Payment (PIP), which means going through two separate assessments – a process that can be complex, time-consuming, duplicative and cause stress for claimants.

The Pathways to Work Green Paper outlined our plan to end the link between capacity to work and additional financial support and the binary categorisation of claimants as “can or can’t work” by abolishing the Work Capability Assessment (WCA). Instead, any extra financial support for health conditions in UC will be assessed via a single assessment – the PIP assessment (in England and Wales) – and be based on the impact of disability on daily living, not on capacity to work.

Due to its link with the Personal Independence Payment (PIP) assessment, Work Capability Assessment abolition will not take place until after the Timms Review into PIP has reported. We are currently considering how the future system will operate and will provide further information in due course.

Within the current system, some disabled people will meet the Severe Conditions Criteria (SCC).

The SCC are used to identify and apply to those with the most severe, lifelong health conditions or disabilities, who are unlikely to improve, are not expected to ever be able to work, and for whom reassessments are unlikely to provide further new information.

As the condition of a claimant who meets the SCC is unlikely to improve, they do not need to have a reassessment unless they tell us that their condition has changed or improved.

Finally, DWP and our Assessment Suppliers are committed to providing a quality, sensitive and respectful service by conducting accurate and objective assessments. Where there is sufficient evidence on which to make an assessment, the claimant will be assessed on a paper basis.

The Department has made no specific assessment of the potential impact of corridor care on patient safety for patients requiring orthopaedic treatment.

NHS England has published updated guidance in December 2025 to support trusts to deliver care in non-designated clinical spaces safely, ensuring dignity and privacy is maintained, which applies across all specialities, including orthopaedics, and which is available at the following link:

https://www.england.nhs.uk/long-read/principles-for-providing-patient-care-in-corridors/

Patients are to be seen based on clinical need, not location, with a senior clinical risk assessment and named nursing oversight.

The delivery of care in non-designated clinical areas in hospital departments experiencing patient crowding is not acceptable and should not be considered as standard. NHS England has been working with trusts to put in place new reporting arrangements related to the use of corridor care, to drive improvement. In March this year, NHS England set out a clear national definition of corridor care alongside further actions for trusts and integrated care boards, establishing the first consistent national standard and ensuring clarity of patients, staff, and providers, and setting clear expectations for immediate action. Daily reporting using the new definition began in March 2026, giving real-time visibility of pressures and allowing targeted action.

The Department has made no specific assessment of the potential impact of corridor care on patient safety for patients requiring orthopaedic treatment.

NHS England has published updated guidance in December 2025 to support trusts to deliver care in non-designated clinical spaces safely, ensuring dignity and privacy is maintained, which applies across all specialities, including orthopaedics, and which is available at the following link:

https://www.england.nhs.uk/long-read/principles-for-providing-patient-care-in-corridors/

Patients are to be seen based on clinical need, not location, with a senior clinical risk assessment and named nursing oversight.

The delivery of care in non-designated clinical areas in hospital departments experiencing patient crowding is not acceptable and should not be considered as standard. NHS England has been working with trusts to put in place new reporting arrangements related to the use of corridor care, to drive improvement. In March this year, NHS England set out a clear national definition of corridor care alongside further actions for trusts and integrated care boards, establishing the first consistent national standard and ensuring clarity of patients, staff, and providers, and setting clear expectations for immediate action. Daily reporting using the new definition began in March 2026, giving real-time visibility of pressures and allowing targeted action.

Average waiting times for elective orthopaedic surgery are not separately published in the waiting list statistics. The waiting times for orthopaedic surgery are included in the Trauma and Orthopaedic Services category. As of the latest published waiting list statistics for February 2026, the median waiting time for Trauma and Orthopaedic Services, which includes orthopaedic surgery, was 14.9 weeks in England, with further information available at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/rtt-data-2025-26/

It is the responsibility of National Health Service systems to manage the bone cement supply delays in their local context. NHS England has been working closely with systems to manage the temporary supply disruption affecting certain Heraeus bone cement products. A letter was issued to systems in February 2026 and is available at the following link:

https://www.england.nhs.uk/long-read/heraeus-medical-bone-cement-products/

NHS trusts have reviewed and clinically prioritised their orthopaedic waiting lists to ensure available stock is safely and appropriately used, taking into account patient need, staff familiarity with alternative products, and local supply constraints. Where delays to planned joint procedures are unavoidable, trusts are expected to maintain transparent and timely communication with affected patients, so they remain fully informed about changes to their care treatment pathway.

NHS England has advised trusts to make best use of any freed-up clinical capacity, including focussing on new outpatient activity, and strengthening clinical triage for patients waiting more than 18 weeks. These steps are intended to reduce the risk of knock-on effects for elective waiting time performance. Every effort is being made to sustain progress on Referral to Treatment performance while this temporary supply issue is resolved.

It is the responsibility of National Health Service systems to manage the bone cement supply delays in their local context. NHS England has been working closely with systems to manage the temporary supply disruption affecting certain Heraeus bone cement products. A letter was issued to systems in February 2026 and is available at the following link:

https://www.england.nhs.uk/long-read/heraeus-medical-bone-cement-products/

NHS trusts have reviewed and clinically prioritised their orthopaedic waiting lists to ensure available stock is safely and appropriately used, taking into account patient need, staff familiarity with alternative products, and local supply constraints. Where delays to planned joint procedures are unavoidable, trusts are expected to maintain transparent and timely communication with affected patients, so they remain fully informed about changes to their care treatment pathway.

NHS England has advised trusts to make best use of any freed-up clinical capacity, including focussing on new outpatient activity, and strengthening clinical triage for patients waiting more than 18 weeks. These steps are intended to reduce the risk of knock-on effects for elective waiting time performance. Every effort is being made to sustain progress on Referral to Treatment performance while this temporary supply issue is resolved.

The Government has very well-established processes in place to help manage disruption to the supply of medical products when it occurs, always very seriously considering the needs of individual patients.

The Department’s National Supply Disruption Response acts as the single point of contact for the medical supply industry, and has been supporting the bone cement shortage since early February this year. Together with NHS England and NHS Supply Chain we have organised a formal coordinated national incident response, including daily meetings with operational colleagues, development of clinical guidance, and close engagement with suppliers, professional bodies, and the devolved administrations.

The incident management group was able to secure additional supplies from alternative, clinically assured suppliers, which are now being actively used. Elective orthopaedic activities have resumed.

These measures ensured that trauma and urgent care continued safely during the shortage, with orthopaedic waiting lists prioritised according to clinical needs.

The Department continues to hold regular discussions with NHS England on the supply position, operational impact, and alternative products, using well-established incident coordination arrangements.

Joined up working between the Department and the National Health Service has successfully secured an alternative bone cement product for the coming weeks following the issues with Heraeus Medical’s production process. During this period, NHS providers were supported to prioritise remaining stock based on clinical guidance.

The Department has not collected data on the specific number of procedures delayed due to this supply issue centrally. Due to the speed by which alternative products have been identified the number of procedures postponed has been limited and where this has happened, trusts are seeking to reschedule affected procedures quickly.

The Department is working closely with NHS England, professional bodies and industry partners and have implemented a range of measures to resolve the shortage of bone cement.

The National Health Service has secured stock of an alternative bone cement product, which is now in the United Kingdom for onward distribution. There is sufficient supply to confidently resume elective procedures, and further deliveries are planned in the coming weeks.

The NHS also issued immediate guidance to hospitals to ensure that trauma and urgent care could continue safely.

We will keep our horizon-scanning processes under review and work specifically to identify future potential risks and safeguard continuity of future bone cement supplies.

The Department has held regular discussions with NHS England on the supply position, operational impact, and plans to secure alternative products, including through established incident coordination structures.

The Department is working closely with NHS England, professional bodies and industry partners and have implemented a range of measures to resolve the shortage of bone cement.

The National Health Service has secured stock of an alternative bone cement product, which is now in the United Kingdom for onward distribution. There is sufficient supply to confidently resume elective procedures, and further deliveries are planned in the coming weeks.

The NHS also issued immediate guidance to hospitals to ensure that trauma and urgent care could continue safely.

We will keep our horizon-scanning processes under review and work specifically to identify future potential risks and safeguard continuity of future bone cement supplies.

The Department has held regular discussions with NHS England on the supply position, operational impact, and plans to secure alternative products, including through established incident coordination structures.

The Department is working closely with NHS England, professional bodies and industry partners and have implemented a range of measures to resolve the shortage of bone cement.

The National Health Service has secured stock of an alternative bone cement product, which is now in the United Kingdom for onward distribution. There is sufficient supply to confidently resume elective procedures, and further deliveries are planned in the coming weeks.

The NHS also issued immediate guidance to hospitals to ensure that trauma and urgent care could continue safely.

We will keep our horizon-scanning processes under review and work specifically to identify future potential risks and safeguard continuity of future bone cement supplies.

The Department has held regular discussions with NHS England on the supply position, operational impact, and plans to secure alternative products, including through established incident coordination structures.

In June 2026, Basildon Hospital will open a new Acute Kidney Care Ward, providing an additional 24 beds on the site and increasing capacity for people presenting to the emergency department with kidney problems, speeding up access to urgent care.

Following this, the current renal ward will be refurbished to support more medical care beds for winter and to provide space to move patients out of older wards so that improvements can be made as part of the trust’s prioritised capital programme.

In addition, two newly upgraded orthopaedic operating theatres opened at Basildon Hospital in November 2025 following essential maintenance works to improve the advanced air handling system. Since the start of November, staff working in theatres six or seven in the main theatre department have already completed hundreds of operations and procedures, including shoulder replacements, foot reconstructions, and knee replacements.

To help reduce its waiting lists, the trust is running additional capacity theatre slots, as well as outsourcing patients to other hospitals to receive their treatment and reduce waiting times. The trust is also insourcing within the hospital providers for extra outpatient capacity.