PATIENTS waiting for hip and knee replacements in Ayrshire are facing delays and cancellations to their operations after the loss of two orthopaedic surgeons.

The Herald can reveal that Dr Graeme Holt, a consultant orthopaedic and trauma surgeon at Crosshouse Hospital in Kilmarnock, has been suspended pending trial in March for alleged domestic assault and threatening behaviour.

Dr Holt, 43, from Irvine, specialises in hip, knee and foot surgery, and is also the chairman of the Scottish Hip Fracture Advisory Group, which audits the quality of care annually across all of Scotland's acute hospitals.

It is understood that he was suspended in January and is due to go on trial at Kilmarnock Sheriff Court on March 2, following a preliminary hearing earlier this month.

READ MORE: Postcode lottery in Ayrshire over waiting times for hip and knee ops

The orthopaedics service at Crosshouse has also been plunged into crisis following the early retirement of one of the health board’s most experienced orthopaedic surgeons, Dr Amanullah Khan, who has stepped down to set up a new orthopaedics service in Pakistan.

Crosshouse is already failing to meet waiting times targets for hip and knee surgeries, and the health board said the posts will be filled by locum doctors until long-term replacements can be recruited.

Patients whose operations need to be rescheduled are being contacted.

A source said doctors on the ground are already under pressure and worried about the impact the latest developments will have on workload and patient care.

They said it was likely the health board will have to send patients to the private sector to clear waiting lists.

They added: “We know that Ayr won’t take them because they haven’t in the past - they don’t have the capacity and actually, I don’t think they’re very keen to take on extra patients.

“The health board is already under pressure over the difference in waiting times for north and south Ayrshire. The wheels are shaky if not coming off.”

READ MORE: One in three patients in Scotland waiting too long for hip replacements

The Herald revealed last year that patients in the region faced a postcode lottery over the length of time they would wait for treatment.

Patients in the north of Ayrshire are referred to Crosshouse for hip and knee replacements, while those in the south go to University Hospital Ayr for the procedures.

Figures leaked to the Herald last year revealed that those treated at Crosshouse over the previous three years had waited an average of 143 days - around five months - for a hip replacement, and 153 days for a knee replacement, in breach of the Scottish Government’s 12-week (84 day) Treatment Time Guarantee.

At Ayr, the average wait for both operations was 82 days.

The problem has been blamed on the fact that while both hospitals carry out elective orthopaedic surgery, only Crosshouse handles the region’s emergency cases such as car crash victims with broken bones or elderly patients with hips fractured in falls. As a result, planned operations are cancelled to free up theatre space.

Willie Coffey, SNP MSP for Kilmarnock, said the latest situation was “concerning”, adding that he has raised it directly with chief executive John Burns.

Mr Coffey said: “He has acknowledged that there are staffing issues but he can’t go into any individual case details with me.

“He has assured me though that they are doing their best to minimise delays for patients.

“I am due to visit the hospital soon and will add these issues to the wider discussion I will have with him and his chair.”

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Monica Lennon, Scottish Labour health spokeswoman, said: “This is extremely worrying.

"It’s unacceptable that patients should be waiting in pain for so long. They should not be made to suffer for a lack of workforce planning by the health board. 

Miles Briggs, Scottish Conservative health spokesman, added: “It is unacceptable for patients to be left to suffer in pain with operations cancelled or rescheduled.

“The situation at Crosshouse Hospital is yet again another example of the workforce crisis facing our Scottish NHS with little to no capacity to provide operations when vacancies arise like this.”

Between 2001 and 2019, the number of hip and knee replacements performed on NHS Scotland doubled from 7,562 to 15,091 in 2019, due to the ageing population and obesity leading younger people to develop joint problems earlier.

Surgical advances have also helped to slash the average length of time patients spend recovering in hospital from 10 to four days, helping to ease pressure on beds, but the growth in the orthopaedic surgery workforce has lagged behind the increase in demand.

NHS Scotland currently has a 5% vacancy rate for trauma and orthopaedic surgery.

An increasing number of hip and knee operations are also being carried out in the private sector, either self-funded by patients or paid for by the NHS.

In 2018, a total of 1,218 hip replacements and 884 knee replacements were performed at private hospitals in Scotland, up by 5% from 2,003 in 2017.

Of these, 84% were covered by patients personally or through their health insurance - up from 75% in 2017.

The remainder were operations paid for by the NHS.

Phil Hodkinson, interim associate medical director (acute), said: “There have been some recent changes within orthopaedic consultant staffing at University Hospital Crosshouse with a consultant retiring and another consultant surgeon that is on extended leave.

“In order to continue to provide a high quality service to our patients both of these positions have been filled on a locum basis and the board is currently recruiting. Consultant surgeons at University Hospital Ayr are also supporting treatment of patients on the waiting lists affected.

“Patients who were due for surgery in recent weeks are in the process of being contacted to discuss options available.”