Oxford Scores as a Triage Tool for Lower Limb Arthroplasty Lead to Discrimination and Health Inequalities

The NHS Outcomes Framework 2011/12 from the Department of Health states that reducing health inequalities and promoting equality is central if the NHS is to deliver health outcomes that are among the best in the world. Assessment of patient reported outcome measures (PROMS) was introduced across the NHS in April 2009 both for hip and knee replacement surgery. PROMs are applied before and after certain elective health interventions funded by the NHS. In addition to the established use in assessment of outcomes, it has been suggested that preoperative instruments might be used to assess whether referrals for elective procedures are appropriate and also to identify inequalities in heathcare. For hip and knee replacement surgery, Oxford hip and knee scores are used as the measure of pain and disability.