The NZOA Executive has endorsed the clinical use of a national scoring system, initially applicable to hip and knee joint surgery, but ultimately to include all other subspecialty surgeries by way of a second tool.

NZOA representatives (practising New Zealand surgeons) have worked for a number of years to produce the Clinical Priority System, or CPS, specific to Hip and Knee Primary and Revision surgery. This tool has been trialled and modified extensively using actual case studies in an effort to produce a validated and user-friendly method of prioritising our patients for surgery.

The CPS is presented to you in this booklet (please download PDF from link below) as the tool endorsed not only by the NZOA, but also the Ministry of Health, the Health and Disability Commissioner, and other Public Advocacy groups. We would like you to use this tool in your practice when reviewing patients for hip and knee joint replacement surgery in the Public Hospital system. Use of this tool nationally will allow equity of access across New Zealand and give those with the greatest need the highest priority. It is not for use in rationing or exclusion but to set priority for patients waiting for treatment. Remember that it is only valid if the clinical criteria are used in a consistent and equable fashion.

We would expect that the data collected from monitoring the Systems support the existing funding of Orthopaedic Procedures and lend considerable weight to future negotiations. By correlating our database with the ESPI measures and outcome information such as the Joint Register, the NZOA can present a strong case whenever the need arises.

The tool is considered a work in evolution and over the next months the CPAC group would appreciate comments and feedback.

On behalf of the NZOA CPAC subcommittee I would be grateful if you would apply the tool to your practice as instructed by the booklet and support and encourage all your colleagues to do the same. It is critical to the success of this project that the NZOA has 100% commitment to this process.

Yours faithfully,

Murray Fosbender
President NZOA