NHS claims operating room inefficiency wastes 290,000 surgeries, but experts say beds to blame

Surgical leaders warn lack of NHS beds and staff mean 'time is wasted’

Alex Matthews-King
Health Correspondent
Monday 04 February 2019 01:15 GMT
Better planning of surgeons rotas and double checking surgical lists could help manage operating rooms
Better planning of surgeons rotas and double checking surgical lists could help manage operating rooms (Getty)

Hundreds of thousands more operations could be done in the NHS each year by sticking to starting times and taking advantage of early finishes, the health efficiency watchdog has claimed.

NHS Improvement estimates 291,327 extra operations could be completed every year by improving operating room management – a 17 per cent increase at a time when record numbers of patients are waiting too long for treatment.

But surgical leaders warned that focusing on the symptoms of operating room inefficiency ignores the underlying cause.

They blame shortages of staff and beds, which results in surgeries being unable to start if there isn’t a suitable place for patients to recover, as well as the individual circumstances of each patient.

The study, completed in conjunction with the Royal College of Surgeons, looked at data from 92 NHS hospital trusts and found that one third of all operating lists began at least 30 minutes late.

While 38 per cent ended more than half an hour early, with 110,000 operations finishing with more than an hour left on their scheduled operating time.

The NHS currently performs around 5 million non-urgent operations a year, up from 3.7 million in 2003/4. But demand from increasing numbers of elderly patients and pressures from obesity and diabetes have added to waiting lists.

Critics have warned the 18-week target for non-urgent surgery has been “jettisoned in all but name” and only 87.3 per cent of patients were treated in that time – against a target of 92 per cent.

Pressures after last winter saw the number of patients waiting more than six months for surgery surge 50 per cent to 527,677 – with 2,432 waiting over a year.

Ian Eardley, council member of the Royal College of Surgeons, said the NHS is already among the most efficient health system in the world, but the college recognised scheduling changes could lead to further improvements.

But he said NHS leaders could not ignore that the NHS has the second lowest number of beds per 1,000 patients of every EU nation.

“Such shortages mean time is wasted by NHS staff in freeing up beds instead of treating patients,” he said. “This problem is compounded by workforce shortages.”

NHS Improvement said it was encouraging hospitals to consider a model called “6-4-2”, which is being used successfully in some NHS trusts in England.

The idea is that surgical staff agree their annual leave six weeks in advance, agree their surgical lists four weeks in advance, and double check their plans two weeks in advance.

This reduces the risk of cancellations and late starts, and means equipment, beds and staff are booked in good time, it said.

Professor Tim Briggs, NHS national director of clinical improvement, said: “As the NHS long term plan states, we need to ramp up these efforts where clinically appropriate so that they become the norm and so that we can address the variation that exists.”

Additional reporting by PA

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