Progress measured in sending patients home: Major increase in day surgery with minimal overnight stays is at forefront of Utopian vision for health service of the future

THE DAY surgery centre at King's Hospital in Camberwell, south-east London, is a prime example of how advances in medical techniques can be used to cut National Health Service waiting lists and eliminate the need to keep patients in overnight.

Opened in December 1991, it treated 10,000 people last year and expects to treat 12,000 this year. All require 'minor to intermediate' surgery, ranging from the removal of varicose veins, cataracts and cysts to operations for breast reduction, torn cartilage and hernias. They arrive in the morning and leave the same day.

Day surgery is not a new concept; it has been used since the turn of the century. But improvements in medical practice have made it a viable form of treatment for many more problems.

General anaesthetics are now designed to wear off faster, so patients can go home more quickly. Pain relief can effectively mask the discomfort following an operation, often by a combination of local and general anaesthetic and pain-killers. And the development of 'keyhole' surgery means that many operations have become far less invasive, reducing trauma.

King's day surgery centre relies on a further resource - the client's family or friends. Patients are only accepted for surgery if they agree to arrange to be collected after their operation. The unit also requests that they are accompanied for 24 hours afterwards, in case of an accident or if complications develop.

Where support cannot be arranged, patients may stay overnight in the main hospital.

Janetta Tullis, 48, a domestic worker from Brixton, was being picked up by her partner and children yesterday after an operation to remove varicose veins.

'I must say, I think it's superb here,' she said. 'I was really worried when I came in but I feel wonderful now. Almost straight after the operation, I felt hungry and they gave me a cup of coffee and some toast.'

Bernard Riding, 47, a site manager from Dulwich, was waiting to have a cyst removed from his neck. 'I like the fact that I don't have to stay overnight,' he said. 'What I've got isn't life-threatening so the quicker I leave, the more time the doctors and nurses have for more important cases.'

The centre carried out 55 per cent of all King's non-emergency surgery last year, with high patient satisfaction ratings and a minimum risk of cancelled operations because all beds are cleared every night.

But Mr Paul Baskerville, consultant surgeon and clinical director, gave a warning. 'This only works very well because we do not do it on the cheap,' he emphasised.

(Photograph omitted)