NHSI calls for greater theatre productivity

The oversight body commissioned Deloitte to analyse data from trusts in 2017. The consultants found significant variations between hospitals and between different specialties.

A third of operating lists start 30 minutes or more late, with 38% finishing 30 minutes or more early. More than 111,000 procedures were completed at least an hour early and day lists of three, four-hour sessions were particularly likely to finish before scheduled.

In the 92 trusts that submitted data, theatre time that was lost to late starts, early finishes and delays between operations could have been used to perform up to 291,327 more operations (a 16.8% increase).

For the eight highest volume surgical specialties reviewed, this would have meant around:

• 30,000 more ear, nose and throat operations

• 42,000 more general surgery operations

• 32,000 more gynaecology operations

• 41,000 more ophthalmology operations

• 27,000 more oral and maxillofacial surgery operations

• 19,000 more plastic surgery operations

• 57,000 more orthopaedic operations

• 44,000 more urology operations

NHS Providers head of policy Amber Jabbal (pictured) said trusts would agree there was some scope to increase theatre productivity, even though NHS theatre productivity is one of the highest in the world. However, she insisted elective throughput could not be viewed in isolation – hospitals faced other pressures that affected their use of theatres.

‘As a result of financial and workforce challenges the number of patients waiting longer than they should be for routine surgery is growing. Addressing this challenge goes beyond how operations are scheduled,’ she said.

‘Theatres cannot be viewed in isolation and we have to be realistic about the current resources in place. Often cancellations and downtime for theatres are because of staffing levels, patient needs and the availability of beds across the system.’

Tim Briggs, national director for clinical improvement for the NHS and council member of the Royal College of Surgeons, said it was encouraging there were pockets of innovation.

‘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,’ he added.