Update on NHS proposal to improve orthopaedic surgery in north west London

Almost 2,000 patients and local people have taken part in a 14-week public consultation on a proposal to develop a centre of excellence for inpatient orthopaedic surgery at Central Middlesex Hospital, Park Royal. 

The North West London Acute provider Collaborative, made up of the four acute NHS trusts in north west London have proposed bringing together most of their routine, inpatient orthopaedic surgery - primarily hip and knee replacements – into a dedicated site completely separated from emergency care services. The trusts, in partnership with the integrated care board for North West London, have been inviting patients and the public to share their views on this proposal during the consultation period, which closed on 20 January 2023. An evaluation of the responses written by the independent research agency Verve Communications has been published and will now be used to inform next steps.

A total of 1,959 people participated in the consultation. Overall, participants thought that the proposal for an elective orthopaedic centre for most routine surgery was a good idea and hoped that it would help to reduce waiting times for patients, while there were some people who would prefer to have all their treatment at their local hospitals for convenience. Of the 807 people who participated via an online survey, 59 per cent agreed with the proposal to develop an elective orthopaedic centre in north west London and 31 per cent disagreed; patients and carers were more likely to agree than staff or others. When asked about siting the elective orthopaedic centre at Central Middlesex Hospital, 39 per cent of people agreed with the proposal and 41 per cent disagreed with it; patients and carers were more likely to agree than staff or others.

The two main concerns raised throughout the consultation related to travel to and from the proposed site of Central Middlesex Hospital for patients, visitors and staff, as well as concerns about services at home for people after they were discharged. 

Working with community organisations, people were recruited to take part in focus groups and one to one interviews to boost the representation of groups who, at the mid-point of the consultation, were underrepresented in participation. The underrepresented groups were elderly patients, disabled patients, Black and minority ethnic patients for whom English is a second language and patients from deprived areas. 

The consultation report, available online or, on request from the trusts, in a range of accessible formats, provides a detailed breakdown of the consultation activities and feedback, including by borough. 

The North West London Joint Health Overview and Scrutiny Committee is expected to provide its feedback following formal consideration of the proposal and the consultation feedback at its 8 March meeting. NHS North West London, the integrated care board for the sector and North West London Acute Provider Collaborative are considering the consultation feedback to help inform the development of a ‘decision-making business case’. Under the current timetable, the decision-making business case is due to go for decision-making to the NHS North West London Board meeting on 21 March. 

Dr Roger Chinn, chair of the group developing the proposal and Chief medical officer for Chelsea and Westminster Hospital NHS Foundation Trust, said: “I am grateful to everyone who gave up their time to take part in our consultation.

We are now carefully considering all the views and ideas shared with us as we develop recommendations for the next stage of this programme – and, more broadly, how we can best work collaboratively across our hospitals to tackle long waits and improve quality for all patients in north west London. We are particularly grateful to patients, staff and other stakeholders who are interested in continuing their involvement in this programme and we would very much like to expand involvement further once next steps are clear. ”


  • The four NHS acute trusts that make up the North West London Acute Provider Collaborative are Chelsea and Westminster Hospital NHS Foundation Trust, The 
    Hillingdon Hospitals NHS Foundation Trust, Imperial College Healthcare NHS Trust and London North West University Healthcare NHS Trust. They manage a total of 12 hospitals across the eight boroughs of north west London. 
  • The consultation on the proposed elective orthopaedic centre for north west London has been supported by NHS North West London, which has formal responsibility for ensuring effective public consultation on significant service change proposals.