We have prepared this guidance to help patients waiting for joint replacement surgeries navigate relevant local services and access the support available in North Norfolk.

Coping with chronic pain

There are different ways to manage the chronic pain associated with hip and knee conditions, which include exercise, physical therapy, pain medication and meditation. You can ask a GP or pharmacist to review your pain medication to make sure your prescription is maximising pain relief and limiting avoidable side effects. Your GP may also consider referring you to the Pain Management Service if they think this is clinically appropriate. You can also self-refer to The Wellbeing Service, which could help you find strategies to cope with the mental and emotional aspects of living with chronic pain.

Physiotherapy and physical therapy services

If you had physiotherapy before you were added to the surgical waiting list, you may be concerned that any further hands-on therapy would be too painful for you. However, physical therapy takes an exercise-based approach where professionals educate patients on exercise for muscle strength, coordination, and balance. Research has shown that offering pre-surgery information on exercise, widely known as 'prehabilitation', can significantly improve the outcomes for patients undergoing orthopaedic surgery, as shown in the news release published by Anglia Ruskin University in 2023.

In North Norfolk, East Coast Community Healthcare is commissioned by the NHS to provide these services to musculoskeletal patients. This includes their 'Hip and Knee Escape Pain' courses that regularly take place at Holt Rugby Club and Rossis in North Walsham. The courses are once or twice a week for six weeks. To attend, you will need a GP referral.

Everyone Active also provides Escape Pain courses for older adults with back, hip or knee conditions at leisure centres across North Norfolk. To attend, your GP can refer you, or you can contact the leisure centre directly to book and pay-as-you-go. The leisure centres offering these classes are:

Accessible exercise classes for people with restricted mobility

You may want to attend a local exercise class to help you stay active but have concerns about the activity level and its suitability due to your restricted mobility. However, many local classes can be completed seated or with chair support. Instructors can also adapt exercises for individuals in classes. We always recommend discussing relevant health conditions with the instructor before taking part to make sure that they can advise and support you. You can also ask to observe the class before taking part. If you still have concerns, speak to your GP or physiotherapist for advice before participating.

Your GP may also consider referring you to an exercise scheme to support you in achieving your health goals. For instance, Active NoW is a referral coordination centre for physical activity referrals in Norfolk. They offer subsidised memberships to local gyms and classes, including the Healthy Ageing Programme, with classes available to anyone aged over 66, or aged 50 to 66 with a GP referral.

You can explore our list of accessible exercise classes for people with restricted mobility that are offered by independent instructors and local sports and leisure centres across North Norfolk. You can also contact the Community Connectors to ask a question.

Online exercises

Versus Arthritis has created online resources for hip and knee exercises, including video instructions on tailored stretching for hips and knees. In addition, the Let’s Move for Surgery toolkit consists of exercise videos and personal stories from people waiting and recovering from joint replacement surgery.

Weight management support

In preparation for joint surgery, some patients are advised to manage their weight to make sure surgery can go ahead. Weight management can also contribute to making moving about less difficult and painful. For information about the support available from Slimming World and Your Health Norfolk, visit Help with weight management on the Norfolk County Council's website.

Disability living equipment

Visit our disability living equipment webpage for guidance on equipment that may help make daily life less difficult and safer for you.

Housing adaption enquiries

If you need a major adaption to your home to promote your independence due to disability or a health condition, such as installing a stairlift or accessible bathroom, you may be eligible to apply for a government-funded grant known as a Disabled Facilities Grant. This is subject to a financial assessment unless you receive certain income-related benefits.

You can apply whether you are a tenant or homeowner. For further information, contact the Integrated Housing Adaptions Team at North Norfolk District Council on 01263 513811 or by using our online contact us form.

Claiming disability living benefits

If you are in employment while waiting for joint surgery, it is advisable to remain and stay active for as long as possible. However, depending on your job type, there may be a time when it is necessary to reduce hours, restrict duties or stop work completely. Alternatively, if you are unable to work or are retired and living with a disability, you may have extra costs, such as paying someone to help you with day-to-day living tasks. In these situations, you may be eligible to claim either:

The Department for Work and Pensions assesses claims. However, if you need advice about your eligibility or practical support to make a claim for disability living benefits, contact the Financial Inclusion Team at North Norfolk District Council on 01263 516221 for free and confidential support.

Patient transport services

Non-emergency patient transport is available to eligible NHS patients who would be unable to attend hospital appointments or planned procedures without it. ERS Medical provide this service across Norfolk, excluding James Paget University Hospitals, which are provided by E-zec Medical.

Applying for a Blue Badge

The Blue Badge is a parking permit for people with severe mobility problems caused by ongoing and substantial disabilities. Applications are assessed against government criteria by the Blue Badge Unit at Norfolk County Council. You can find out more about the process on the applying for a Blue Badge webpage.

Accessible community transport

When mobility is restricted, using public transport or getting in and out of a car can be difficult. If this is the case, you may be eligible to use North Norfolk Community Transport, a registered charity providing accessible transport options at subsidised rates. They have wheelchair-accessible vehicles, known as Access Cars, that can be booked by people with significant mobility issues to make essential journeys, such as getting to and from medical appointments. They also operate scheduled Dial A Ride services that can be booked by people with mobility issues who need door-to-door transport. This is provided in accessible minibuses to and from local towns, ideal for shopping trips and meeting friends. You can call them directly on 01692 500840 for further information.

Norfolk SWIFT Response

This is a free 24-hour service for adults living in Norfolk that you can call if someone has an urgent, unplanned need at home but does not need the emergency services. For example, if someone falls but is not seriously injured, an officer can visit and bring special lifting equipment to help move the person as safely as possible. You can call Norfolk SWIFT Response on 0344 800 8020 and select option one.

Carers assessments

You may be waiting for surgery and have a caring role for someone else with a disability or health conditions. Alternatively, you may rely on someone, such as a friend or family member, to support you while you wait for surgery and are worried about the impact on them or what would happen if they become unable to help you. In either circumstance, the person providing care may benefit from having a carer's assessment to identify their needs and any support that can be offered. Call Carers Matter Norfolk on 0800 083 1148 for more information or you can sign up for their support online.

Reablement services

If you need short-term care following surgery to help you regain your independence with daily living tasks, you may be eligible for reablement services. This is a type of short-term care that the NHS can arrange to support you following discharge from hospital. It is available for up to six weeks. It is provided at inpatient facilities or in your own home, depending on your level of need and personal circumstances. It cannot be arranged in advance as a hospital therapy team member would need to assess you following surgery. If you do not have someone who can care for and support you while you recover, discuss this with the therapy team before you are discharged home.

Waiting times and clinical enquiries

Contact the hospital directly to find out the current waiting time for your surgery:

Visit the NHS website for general information about hip and knee replacement surgery.

Contact your consultant's secretary if you have a clinical enquiry about your surgery.

Patient Advice and Liaison Service (PALS)

PALS is a confidential service designed to support patients and their carers if they have concerns about the NHS care they receive. They can offer advice and support, provide information about the Trust's services, and mediate on your behalf to resolve issues with the relevant hospital department.

If you remain unhappy with the outcome after speaking with the Patient Advice and Liaison Service or want help to make a complaint about something that happened, call POhWER on 0300 456 2370, who can offer confidential advice and complaints advocacy that is free and independent of the NHS.

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