NHS inefficiencies ‘hinder benefits of day surgery’
The NHS could carry out an extra 74,000 operations a year if it managed day surgery more effectively, a Healthcare Commission report finds.
A study of 313 day surgeries in England and Wales finds that although the practice benefits patients by reducing disruption to their lives and cutting waiting lists, NHS trusts are not taking enough advantage of it.
Delays and cancellations result in 45 per cent of day surgery theatre time going to waste, the watchdog finds, with operating theatres used for an average of just 16 hours a week. The inefficiencies were such that, if the least efficient followed best practice, another 74,000 operations could be performed each year.
“Day surgery has considerable advantages for patients, the public and the NHS. There is scope to do much more within the capacity already available,” it finds.
The watchdog report adds: “The Department of Health should continue to support initiatives in these areas in order to help trusts move forward. It is also important that the Department of Health and strategic health authorities take urgent steps to ensure that the capacity currently available in day surgery units is better utilised.”
Increasing numbers of day surgery units comply with most aspects of good practice but there are some common failings, the research finds. These include not having a child-trained nurse present when children are being operated on and not pre-assessing patients for suitability before they arrived.
Inefficiencies arise in some trusts where facilities for day surgery are not exclusively dedicated to that purpose, while even when dedicated facilities do exist, their use can be improved by cutting down cancellations and gaps between patients.
“When patients stay overnight for something which could be done in a single day, patients are inconvenienced and resources are wasted. NHS trusts need to investigate why more day surgery is not being done and do all that they can to reduce cancellations,” said commission chief executive Anna Walker.
The watchdog’s recommendations include ensuring day surgery staff and facilities are kept separate from other facilities, investigating why more elective surgery is not done as day cases, and improving pre-assessment of patients to reduce cancellations.
