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Rising NHS Waiting Times Are Changing How Patients Approach Hip and Knee Replacement

Kane William by Kane William
August 27, 2026
Reading Time: 6 mins read
Limb Lengthening Surgery
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The UK’s private healthcare sector has seen sustained demand in recent years, and hip and knee replacement surgery is an important part of that market. At the same time, the NHS continues to face significant demand for planned treatment, particularly across trauma and orthopaedics.

For some patients, this is creating a difficult choice: remain on an NHS waiting list or investigate whether private treatment could provide a faster route to surgery.

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Private healthcare continues to grow

The latest figures from the Private Healthcare Information Network (PHIN) show that private healthcare reached record levels in 2025.

There were 953,000 reported admissions to UK private hospitals during 2025, the fourth consecutive year in which a record number of admissions was recorded. The number of self-pay admissions reached approximately 283,000.

Although private healthcare covers a wide range of treatments, orthopaedic surgery remains an important part of the sector.

Hip replacement and knee replacement are particularly significant for self-pay patients. PHIN’s 2025 figures show that primary hip replacement accounted for approximately 15,590 self-pay admissions, while primary knee replacement accounted for approximately 8,150.

These figures demonstrate that paying privately for joint replacement is no longer an unusual route for patients who have the financial means to consider it.

Why are patients considering private treatment?

There is no single reason why someone chooses to pay for surgery privately.

For some people, the priority is simply time.

A person with advanced arthritis may find that their condition affects their ability to work, exercise, sleep, travel or look after family members. Waiting months for treatment can therefore have consequences well beyond the discomfort caused by the joint itself.

For an active person, the difference between having surgery now and waiting considerably longer can feel significant.

Someone who has stopped playing sport because of knee pain may want to return to an active lifestyle. Someone with severe hip arthritis may simply want to walk without pain again.

This can make the length of the NHS waiting period an important factor in the treatment decision.

NHS waiting lists remain a major challenge

The NHS is working to reduce waiting times for planned treatment, including joint replacement surgery.

The Government has committed to returning to the NHS constitutional standard whereby 92% of patients wait no longer than 18 weeks from referral to consultant-led treatment. In March 2026, the NHS reached an interim target of 65% against that standard.

There are also now more than 100 surgical hubs operating across England, with further expansion planned to increase surgical capacity.

These measures are designed to improve access to treatment, but demand for hip and knee replacement is substantial.

NICE has noted that hip and knee replacement demand is expected to increase significantly as the population ages and the prevalence of osteoarthritis rises.

That creates a difficult balancing act for the NHS: increasing surgical capacity while demand for joint replacement continues to grow.

The choice isn’t simply NHS versus private

It is important to remember that private treatment is not necessarily the right answer for every patient.

The NHS provides high-quality joint replacement surgery, and many patients will receive their treatment through the NHS without needing to consider private alternatives.

For others, however, self-funding treatment may be an option worth investigating.

Private treatment can offer greater choice over the timing and location of surgery, although the cost can be substantial and varies considerably depending on the hospital, surgeon, procedure and patient’s individual circumstances.

Patients considering private treatment should therefore look beyond the headline price.

They should establish exactly what is included in the package, whether the surgeon and anaesthetist fees are included, what happens if complications occur, how rehabilitation is provided and whether additional investigations or follow-up appointments incur further costs.

Knee replacement can be a significant financial decision

The cost of private knee replacement is one of the most important considerations for someone deciding whether to self-fund.

Private hospitals commonly offer package prices for joint replacement, but packages are not necessarily identical. Some may include the surgeon, anaesthetist and hospital fees, while other costs — such as initial consultations, additional investigations or physiotherapy — may be separate.

That means patients should compare like-for-like treatment packages rather than simply looking for the cheapest advertised operation.

Anyone considering self-funding should also understand what their overall treatment journey is likely to cost.

For patients researching the financial side of treatment, the costs of surgery can be an important starting point when comparing the potential expense of private surgery.

Hip replacement is part of the same changing landscape

The same pressures apply to patients with advanced hip arthritis.

Hip replacement is one of the most established operations in modern orthopaedics and can significantly improve pain and mobility for appropriately selected patients.

Yet deciding when to have surgery is highly individual.

Some patients may continue with non-surgical treatment for years. Others may reach a point where pain and restricted mobility are having such a significant effect on everyday life that surgery becomes a realistic option.

For patients who are able to fund treatment privately, the ability to choose when and where surgery takes place can therefore become an important consideration.

A more informed decision is becoming increasingly important

The growth of private healthcare does not mean that everyone should pay for their joint replacement.

Instead, it highlights the importance of patients understanding all of the options available to them.

Someone facing a long NHS wait may want to investigate private treatment. Another patient may decide that waiting for NHS surgery is the most appropriate option. Someone else may discover that their symptoms can still be managed without an operation.

The important thing is that the decision should be based on good information rather than simply frustration with waiting.

Patients should understand their diagnosis, the potential benefits and risks of surgery, alternative treatments, expected recovery and the financial implications before making a decision.

Looking beyond the operation

Joint replacement is not simply an operation followed by going home.

Recovery, rehabilitation and returning to normal activities are important parts of the overall journey.

For patients considering their options, having access to reliable information about joint replacement can help them understand what lies ahead and prepare questions for their healthcare team.

At Active Again the focus is on helping people understand hip and knee replacement, the options available to them and the practical considerations involved in making an informed decision.

As demand for joint replacement continues to rise, the distinction between NHS and private healthcare is becoming less about two completely separate systems and more about the choices available to individual patients.

For some, the NHS will remain the preferred route. For others, the prospect of waiting for treatment may lead them to investigate self-funded surgery.

Either way, the most important decision is not simply where the operation takes place, but whether surgery is appropriate, what the likely benefits and risks are, and whether the patient has enough information to make the right decision for their circumstances.

Kane William

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