The Hip and Knee Pathway, an innovation from the RCSI HSE National Clinical Programme for Trauma and Orthopaedic Surgery and two pilot sites in Meath and Waterford, has been awarded the HSE’s CEO Choice Award at the Spark Summit which took place today.

Funded through the Department of Health’s Sláintecare Integration Innovation Fund, the integrated care pathway was tested between January 2023 and June 2025 at Our Lady’s Hospital, Navan, University Hospital Waterford and within the Community Healthcare Network regions of Carlow, Kilkenny and Meath respectively.

Evidence based and co-designed with patients, clinicians and the HSE, the pilot pathway focused on improving timely access to conservative management (physiotherapy and dietetics) in the primary care setting for patients presenting with mild to moderate symptoms of hip and knee osteoarthritis. This approach is in line with Sláintecare principles, providing the right care in the right place at the right time by the right team.

Mr Finbarr Condon, Joint Clinical Lead for the National Clinical Programme for Trauma and Orthopaedic Surgery, said: “This Award is a fitting recognition of the innovation that underpins this pathway. We set out to think in an entirely new way about how to improve access to the kind of care that we know reduces the need for surgery. The evidence shows that by intervening earlier and coordinating care more effectively, we’re not only improving quality of life for people living with osteoarthritis but also easing pressure on outpatient clinics and making better use of specialist expertise.”

Between April 2023 and June 2025, more than 2,000 patients were managed through the pathway. 1,059 (51%) were direct GP referrals, from 67 GP practices participating across the two pilot sites. 72% of the patients who were cared for through the pathway reported positive changes in terms of pain reduction and improved function.

58 (5.5%) patients required a specialist outpatient appointment with an orthopaedic surgeon and only 25 (2.36%) patients went on to undergo a surgical intervention. More than 130 group sessions and education classes were delivered in seven community-based locations across the pilot sites during the project period. 1,197 (58%) patients participated in group-based interventions which were facilitated within ten weeks of referral and over 85% reported a high level of satisfaction with these interventions.

Prior to the introduction of this model, the average time patients were waiting for a first orthopaedic appointment was 16 months at University Hospital Waterford and 27 months at Our Lady’s Hospital, Navan. The pathway has delivered significant financial efficiencies, generating estimated cost savings of €220,220 through the avoidance of 1,001 outpatient appointments. The reduction in repeat GP attendances, more efficient use of consultant time, and the ability for physiotherapists and dietitians to work to the top of their license further contributed to the project’s success.

Mr Alan Walsh, Consultant Orthopaedic Surgeon Our Lady’s Hospital, Navan and clinical advisor for the National Clinical Programme for Trauma and Orthopaedic Surgery, said: “The Sláintecare funding has been critical in making this progress possible. It gave us the resources and flexibility to trial a new way of delivering care, one that puts patients at the centre, reduces pressure on hospitals, and makes better use of the wider healthcare team.”

Greater patient support and engagement

A dedicated patient Self-Management patient HSE App Store was developed by the National Clinical Programme for Trauma and Orthopaedic Surgery in collaboration with patients, the HSE, universities (RCSI, University of Limerick and Trinity College, Dublin), and clinical experts.

This encourages, empowers and educates patients about the self-management of their symptoms during and after participation in the pathway. For the period November 2024 to April 2026, 592 patients on the project test sites were invited to use the App with half (296) actively engaging with the solution.

The Sláintecare funding period has now concluded. Of the two pilot sites, only Our Lady’s Hospital Navan/Meath Community Healthcare Networks has secured permanent funding to continue to deliver this early intervention to the population they serve.

The National Clinical Programme for Trauma and Orthopaedic Surgery remains committed to improving patient outcomes while ensuring the sustainable use of health resources and will continue to advocate for the national implementation of this and three additional musculoskeletal condition specific pathways that have been co-designed and tested in the past three years within the HSE, one of a number of strategies to address the increasing demand for orthopaedic out patient services.

Watch a video about the Hip and Knee Pathway