CSP-backed findings reveal gaps in rehab care after surgery

A year after the CSP warned that the expansion of surgical hubs risked outpacing rehabilitation provision, a new NHS England report has exposed worrying variation in how patients access rehab following hip and knee replacement surgery – with support still differing depending on where people live and how local services are organised. 

The NHS England report, Understanding rehabilitation provision following hip and knee joint replacement, found considerable variation in referral pathways, rehab quality, digital support and coordination between surgical and community services. 

The CSP contributed to the report alongside NHS England’s Getting It Right First Time (GIRFT) programme, the British Orthopaedic Association and Edge Health. 

The findings suggest that while most surgical hubs now have referral routes into community musculoskeletal (MSK) rehab services, significant inconsistencies remain in how rehabilitation is delivered and accessed across England. 

Key findings include: 

• Most surgical hubs had direct referral pathways into community MSK services, though one in five reported referral-related challenges.  

• Two in five respondents highlighted variation in rehab provision, including therapy session numbers and treatment delays.  

• Many respondents lacked access to digital rehab support before and after surgery, while digital provision varied considerably between services. 

Sara Hazzard, assistant director at the CSP and co chair of the Community Rehabilitation Alliance, is quoted in the report, saying: ‘The findings presented here demonstrate variation in how post-operative rehabilitation is accessed and delivered, particularly where care spans organisational and geographical boundaries.'

Addressing these inconsistencies requires stronger alignment between surgical and community services, underpinned by clear referral mechanisms and shared responsibility for patient outcomes.’