Hip replacements don’t lie Do public or private providers get better health outcomes? Adjusted for case mix differences between hospitals © 2020 BMJ Publishing Group Ltd. Interactive 0.6 0.3 0.4 0.5 Change in EQ-5D score Data source: NHS Digital 2019 - patient reported outcome measure (PROM) questionnaires Each circle in this diagram represents a provider of NHS hip replacements. Their vertical position shows how much patients’ quality of life improved after their operations, on average. This is measured with the EQ-5D score, which ranges from -0.59 to 1 (perfect health). On average, across all providers, the scores increased by 0.46, but this varied widely: from 0.33 to 0.57. 1 Overall data Around 30% of NHS patients included in this dataset have their hip operations carried out by non-NHS providers. The average health gain for these patients is 0.47, which compares with 0.46for patients treated by NHS hospitals – a small but statistically significant difference. However, some of the best performing hospitals are public and some of the worst private (and vice versa). 2 Public/private Using 95% confidence limits, NHS Digital estimated that only 26 hospitals report health outcomes for their hip replacement patients which are statistically better (13) or worse (13) than the national average health gain. By fading out the 186 hospitals that are statistically no different from average, we can see that more NHS hospitals than private ones are the best performers. 3 Significance > Average Average NHS hospitals > Average Private hospitals