QIPP, Efficiency & Savings

04.02.19

Operating room inefficiencies costing the NHS 300,000 operations a year

Nearly 300,000 more operations could be carried out through better management of surgical lists and holiday booking, an NHS watchdog report has found.

In a review commissioned by NHS Improvement (NHSI), it was found that theatres regularly lost time due to late starts, early finishes, and delays between operations, and the regulator has urged hospitals to change to a simpler model of scheduling surgeries and booking holiday.

A third of operating lists started at least 30 minutes late and 38% finished at least 30 minutes early, meaning the 92 trusts involved in the investigation could have carried out over 290,000 more operations if hospitals improved how they plan their surgical lists – a 17% increase in productivity.

The health watchdog expressed concerns that patients are being forced to suffer needlessly long waits and cancellations because of this poor planning, and in particular because surgery lists are planned without knowing if there will be sufficient staff on duty to carry out the work.

Ian Eardley of the Royal College of Surgeon’s (RCS) said it was supportive of the findings and that each trust would need to investigate the possibilities individually.

But Eardley said that the NHS already has one of the most efficient health services in the world and “every member of staff and patient can recite examples of waste, and increased efficiency is a never-ending battle for any large organisation.”

He also stressed the challenges of bed capacity, bed blocking, and workforce shortages as a key time-waster, with staff spend time freeing up beds for patients instead of treating them.

NHSI said hospitals should switch to a model called ‘6-4-2’ where surgical staff declare their annual leave six weeks in advance and then schedule their surgical lists four weeks in advance before reviewing the plans two weeks ahead.

The report also called for trusts to implement simple changes including aligning rotas when staff need to work together, and making changes to scheduling such as moving to shorter operating sessions to reduce downtime.

Tim Briggs, the national director of clinical improvement for the NHS, welcomed the report, but paid tribute to the current work of surgical staff in delivering care.

He commented: “While waiting times for surgery are lower than they have been historically, more can be done, so it is important that we work with clinical teams to identify further solutions and share best practice.

“It is encouraging that pockets of innovation, like the 6-4-2 model, exist already across the NHS and are benefiting both patients and surgical teams.”

Image credit - HRAUN

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