A sample Wait or Pay dashboard: knee replacement
This is a real, complete dashboard, but it is not your dashboard. It is a worked example we have published in full so you can see exactly what your own free dashboard contains before you build it.
It is built for a sample patient with knee osteoarthritis living near Basildon in Essex, whose local NHS hospital is Mid and South Essex NHS Foundation Trust. Every wait time, hospital and price below is real data for that patient, drawn from the NHS figures published in June 2026. Named consultants and imaging centres are worked out from your postcode in your own dashboard, and are left out of this fixed example. If you just want the underlying NHS waits, the waiting times data for this condition sits on its own page.
A note on the name. A knee replacement is the surgery; knee osteoarthritis is the condition that leads to it. The dashboard is built from the condition, not the operation, because your options begin long before surgery is on the table, so this sample is built from knee osteoarthritis.
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Your knee osteoarthritis journey
Near Basildon SS14Mid and South Essex NHS Foundation Trust
You are waiting to be seen by a consultant. The appointment usually comes by letter, text, or the NHS App. If nothing arrives, the hospital booking team can confirm your referral was received.
How your routes compare
Your wait if you stay is 43 weeks. Waiting is sometimes the right call, and it costs you nothing. The real risk is not the wait itself, it is the wait going wrong quietly.
You can ask to move to a faster NHS hospital, and it is free. This is not the automatic choice you get when your GP first refers you, but you can still ask. Ask for it as a hospital transfer rather than a new referral, so you keep the time you have already waited rather than starting again. If you have waited more than 18 weeks for consultant led treatment, the NHS has to take reasonable steps to find you somewhere quicker.
The fastest could see you about 12 weeks sooner.
Paying privately can compress the diagnostic phase, which is often the larger part of the wait. It does not move you up the queue for the operation. Whenever you join the NHS list you wait like anyone else, and no published data measures how much time that saves overall.
Going fully private takes about 9 weeks, roughly 34 weeks sooner than staying put. It is the fastest of these paths, and the one where you pay for everything.
Most of your wait here is just getting seen. Paying to be seen privately, the option above, clears most of it and costs a fraction of going fully private.
- Consultation
- £180 to £275
- Scan
- £100 to £200
- Surgery
- £12,000 to £20,100
- Total
- £12,280 to £20,575
The surgery figure covers the surgeon, the anaesthetist, the theatre, your stay and your follow-up. Physiotherapy afterwards and any take-home medication are on top. The consultation and scan figures are typical national bands, not local quotes, and your plan prices the actual consultants and scan centres near you. The surgery figure is a sourced band either way. A real quote will land inside these bands, or occasionally outside.
My Options
My options
- University College London Hospitals NHS Foundation Trust
- Maidstone and Tunbridge Wells NHS Trust
- Whittington Health NHS Trust
- Royal National Orthopaedic Hospital NHS Trust
- Milton Keynes University Hospital NHS Foundation Trust
How to switch, and what to know
If you are already waiting: you can ask to move even if you have been on the list for months. If you will wait longer than 18 weeks, you have the right to ask to be moved to a hospital that can see you sooner. Contact the hospital you are waiting at, or your local Integrated Care Board (ICB), and ask to switch to a named faster hospital.
If you have not been referred yet: when your GP refers you, they will offer a shortlist of hospitals and you choose. Tell your GP you would like one of the faster hospitals above. You confirm your choice through the NHS e-Referral Service.
One thing to know: once you choose a hospital, it normally handles your whole course of treatment, so factor in travel for follow-ups.
On a low income, the Healthcare Travel Costs Scheme can refund travel to a hospital you were referred to; ask the hospital.
This right covers routine, planned referrals. It does not apply to urgent care, or to an urgent referral for suspected cancer, where you should be seen fast wherever you are. If your referral is urgent, speed is already the priority and switching is not the route.
Steps you've passed
- Getting referred
Later steps
- Preparing for your operation
My Condition
General information only, not medical advice. Your GP, consultant or physiotherapist will advise on your own situation.
Knee osteoarthritis
Osteoarthritis is a condition that makes joints painful and stiff. In the knee, the protective cartilage on the ends of the bones breaks down, which causes pain, stiffness and problems moving the joint. The knee may swell, feel tender, or make a grating or crackling sound when you move it. Symptoms vary a lot: for some people they are mild and come and go, for others they make everyday activities difficult. It becomes more common as people get older, and is more likely if you are overweight or have had a knee injury.
Osteoarthritis cannot be cured, but it does not always get worse, and treatment can reduce the symptoms. Most people start with regular exercise, losing weight if needed, suitable footwear and aids that take strain off the joint. If symptoms are more severe, painkillers and a structured exercise plan with a physiotherapist can help. When these no longer help, or the joint is badly damaged, a knee replacement may be offered, replacing all or part of the joint.
Discussions
Independent communities where people waiting for or recovering from the same treatment talk. Not run or moderated by Wait or Pay.
- Arthritis Action communityHealthUnlocked
After treatment
After a knee replacement, most people are helped up and walking within a day, and the hospital stay is typically one to three days. You will use walking aids for several weeks and do daily exercises from your physiotherapist, which matter more after a knee replacement than almost any other operation. Driving is usually possible after around six weeks, once your surgeon agrees. Many people return to normal activities within three months, though swelling and full recovery can take up to a year. Most knee replacements last 20 years or more.
Private costs
Private costs
Wait or Pay is independent. We are not paid by any provider or consultant listed here.
Part-private, keep your NHS place
- Get your GP referral. You still start with your GP. Ask them to refer you, since this is what puts you into the system.
- See a private consultant. Instead of waiting months for the NHS consultant appointment, you book privately and are usually seen within weeks. This is the bottleneck you are paying to clear.
- Ask the consultant to place you on the NHS list. A private consultant can assess you and place you on the NHS list for your treatment.
- Have your surgery free on the NHS. Once you are on the list, your treatment is NHS funded like anyone else's. You have paid only for the steps that got you there sooner.
Consultation and diagnosis cost. Source: PHIN, August 2026
What the NHS covers. Source: self-pay guide prices, August 2026
Go fully private
- Choose a private consultant and book directly. You do not need a GP referral to go private, though you can ask for one if you prefer.
- Have your consultation and any scan. The consultant assesses you and confirms what treatment you need.
- Book your treatment privately. You agree a price and a date, usually within weeks.
- Have your treatment, privately and quickly. Everything is paid for by you, so there is no NHS list to wait on at any stage.
Consultation and diagnosis cost. Source: PHIN, August 2026
Surgery package. Source: self-pay guide prices, August 2026
About 34 weeks sooner than waiting. Private timeline: Wait or Pay estimate, last reviewed September 2026.
The fixed-price package covers the surgery itself, but usually not the initial consultation or scan (listed separately above). Ask for a full written breakdown of every cost before you commit.
- The surgeon
- The anaesthetist
- Theatre
- Your hospital stay
- Follow-up
- The initial consultation
- Your scan
- Treating complications
You may not need to pay upfront: most private hospitals offer finance to spread the cost, subject to a credit check. Ask the hospital what they offer.
One thing worth knowing: private health insurance will not cover a condition you already have. It is designed for future, unexpected problems, not one you are already waiting on. For something you already need treated, your realistic options are paying directly or arranging finance.
If you have a complication (something that can happen even when the surgery is done well), the NHS will treat it as part of your care, free. A private fixed-price package often does not cover treating complications, so you could face extra costs, or end up going to the NHS anyway. Ask whether your package covers putting complications right.
If something goes wrong because of a mistake (negligence), the difference is bigger. On the NHS, claims are handled by a central government scheme (NHS Resolution) that is always funded, and you keep your right to NHS care while you claim. Privately, your surgeon is an independent contractor who carries their own insurance, and you would claim against that. This is usually more complex, and in rare cases a surgeon's insurer may not pay out. Before you book, confirm your surgeon holds full, current indemnity insurance.
Nearest private consultants
We could not find any private consultants listed for this specialty from your postcode right now. You can search the PHIN consultant index at phin.org.uk, or ask your nearest private hospital which consultants take NHS referrals back.
Chase & escalate
Chase & escalate
Your action checklist
- Check where you are: open the NHS App, go to Appointments, then Referrals, and find your reference number and estimated wait.
- If nothing shows within two weeks of referral, contact your GP surgery.
- If your wait has gone quiet, send the PALS letter above to confirm your position.
- If your symptoms have worsened, send the consultant's-secretary letter above.
- If you get no answer, escalate: booking team, then PALS, then your ICB.
- Keep a note of every call and letter, with dates and names, in case you need to escalate.
Are you even on the list?
One in seven NHS referrals never make it. Lost, delayed, rejected, or never sent. (Healthwatch England, 2025)
Contact your GP practice and ask:
- The date the referral was sent
- Which service it was sent to
- Whether it went via the NHS e-Referral Service or another route
Ask them to confirm it actually went, not just that it was written. You can also ask the practice to print you a copy of the referral letter for your records.
A referral can leave your GP and still not arrive. Three ways to confirm the receiving end:
- The NHS App. Look for a referral document, a referral status, or an upcoming appointment. An empty App does not always mean the referral failed. Some services don't display neatly, and some hospitals confirm receipt separately. Treat it as one signal, not the final word.
- A text, email, or letter from the hospital. Many NHS hospitals acknowledge a referral when they receive it. If you were sent a letter with a reference number and access code, use them to view the referral online through the e-Referral system.
- The hospital booking or referrals team. If nothing has appeared after a reasonable period, call them directly. Use this script:
“My GP referred me on [date] to [service]. Can you confirm the referral has been received, and tell me the current status or next step?”
- For routine e-Referral pathways, expect contact within about two weeks
- Sooner if it was marked urgent
Weeks of silence, with nothing in the App and no acknowledgement, is your cue to confirm actively, not wait
- If the hospital says it never received the referral, go back to your GP practice
- Ask them to verify the destination
- Ask them to resend it with documentation
- If your GP confirms it was sent but the hospital still can't find it, and you're being bounced between them, escalate through the hospital's PALS (Patient Advice and Liaison Service). They exist precisely to unstick this kind of limbo.
If chasing does not work: the escalation ladder
If chasing does not work, there is a ladder. Go up it one rung at a time:
- First, the booking team or consultant's secretary.
- Then PALS, if you are getting no answers.
- Then your local Integrated Care Board (ICB), which plans NHS services in your area. ICBs handle complaints about access to care and can sometimes find another route. If you have waited or will wait longer than 18 weeks, they have a duty to help you find a faster provider.
- Finally, a formal complaint to the hospital, and if that does not resolve it, the independent Parliamentary and Health Service Ombudsman.
Your letters
Copy and adapt these. Replace [brackets] with your details.
Email to your GP: requesting a private scan referral
Dear Dr [GP name], I am writing regarding my referral for [condition] to Mid And South Essex NHS Foundation Trust. I would like to explore having a private weight-bearing knee X-ray to accelerate my pathway to treatment. I understand that scan results from accredited private centres are accepted by NHS consultants. Could you confirm whether I can proceed with a self-funded private weight-bearing knee X-ray, and if so, please provide a referral letter or confirm the scan specification required. Thank you for your help. [Your name] [Your date of birth] [Your NHS number]
Email to a private consultant secretary: booking an appointment
Dear [Secretary name], I am writing to enquire about booking a self-pay private consultation with [Consultant name] regarding [condition]. I am currently on the NHS pathway at Mid And South Essex NHS Foundation Trust and am seeking a private consultation to accelerate my treatment. I would be grateful if you could advise on: 1. Earliest available appointment 2. Self-pay consultation fee 3. Whether [Consultant name] can refer me onto the NHS surgical waiting list at Mid And South Essex NHS Foundation Trust following the consultation Thank you for your time. [Your name] [Your contact number] [Your email address]
Email to NHS PALS: wait-time enquiry
Dear PALS team, I am on the waiting list at Mid And South Essex NHS Foundation Trust for orthopaedic treatment. Could you please advise: 1. My current position on the waiting list 2. My estimated treatment date 3. My options under the NHS Choice framework if my wait exceeds 18 weeks Thank you. [Your name] [Your date of birth] [Your NHS number]
Later steps
- Chasing your date
How long will you really wait, and how could you go sooner?
Your free dashboard compares all four paths for knee osteoarthritis: wait, switch to a faster NHS hospital, part-private, or fully private. It names the faster hospitals near you, shows what going private would cost, and gives you letters ready to send. You can print it or save it as a PDF. Free, and nothing is locked or paid.
See your free wait-or-pay dashboard→