Keeping bunion (hallux valgus) surgeries on the NHS

It has been reported that roughly 14million people in the UK suffer from bunions. Medically known as hallux valgus, bunions are the most common deformity of the foot and can cause a variety of symptoms including pain, discomfort when exercising and difficulty wearing shoes. A recent medical review estimated that the global prevalence of hallux valgus has increased to 23% in 18-65 year old’s and 35% in those over the age of 65.

Traditionally, if someone suffered from bunions, and they were causing them significant pain and impacting their everyday life, they could be referred to have surgery at an NHS hospital. However, due to the increased pressures placed upon the NHS over the past two years, there were discussions that funding for hallux valgus surgeries would need to be cut and reallocated.

Thankfully, due to the findings in the BOFAS Registry Report 2022, a case was made that evidenced that bunion surgeries had a notable impact on a person’s overall quality of life. The most significant data revealed that there is a statistically significant improvement in all Manchester-Oxford Foot Questionnaire (MOXFQ) domain scores 6 months following surgery. It is important to note that there were also further improvements in mean score at 12 months, but the jump was less impactful.

These findings were significant enough to ensure that surgeries continued to be funded by the NHS, which was a fantastic achievement for the BOFAS Registry and reinforced the importance of collecting and reporting on patient reported outcomes measures (PROMs) and clinical outcomes.

What is the BOFAS Registry?

The British Orthopaedic Foot & Ankle Society (BOFAS) Registry is a national database of information about foot and ankle orthopaedic surgeries. The Registry helps surgeons and clinical staff to understand which operations work best by observing the outcomes of surgery, which are measured through the use of questionnaires and complication monitoring.

The BOFAS Registry began in 2014 and, over the last few years, there has been an exponential increase in the total number of cases submitted to the database, and by the end of 2021 the number of patient pathways exceeded 10,000. However, as it currently stands, the Registry only captures a small proportion of national activity, both in the Private & NHS sectors.

In order to increase their database, BOFAS have been including patient data from hospitals that use the Amplitude pro enterprise™ platform. They are also working with Amplitude to try to increase pathway consistency, particularly with the definition of procedures, to help them achieve more robust statistical analysis.