Sir - Your recent report highlighted risks that the Nuffield Orthopaedic Centre (NOC) may close.

Many of our patients have contacted us worried by this possibility.

We write to reassure them that this is not the case.

The medical staff and NOC Trust Board believe passionately in the hospital and will make every attempt to ensure that we continue to offer our patients the best possible services.

The NOC has several roles: it is a local hospital treating local patients for all their orthopaedic problems; it is a specialist hospital looking after patients from far afield with very complex bone and joint conditions; it is a major teaching centre for undergraduates and future surgeons; it is the leading musculo-skeletal research centre in the country.

We are aware that the very specialised work which we do is not financially viable under the current tariff payment system in the NHS ("payment by results").

We are working with other specialist hospitals to address this problem, which is a national problem, with the Department of Health and we are working with the South Central Health Authority to review the NOC's unique role in the health system in this part of the country.

It is vital that we continue to look after our local population, and continue to teach and to research if the legacy our hospital has built over the last 80 years is to continue into the future.

Patients may now choose where they wish to be treated: we hope they will continue to choose us.

We will shortly be running a patient/public consultation to capture patient, public and other stakeholder views which will inform the long-term future of the NOC, we hope your readership will contribute to this work.

James Wilson- MacDonald, Chairman of medical staff, on behalf of the consultant staff, Nuffield Orthopaedic Centre

Dr Tony Berendt, Medical director

Jan Fowler, Acting chief executive