Trusts cancel 10% of operating theatre sessions

Thousands more operations could be carried out in the NHS each year if operating theatres were better managed, says a report published by the Audit Commission.

Poor management information systems, failure to restructure historic patterns of allocating operating theatre time, and consultants taking annual leave at short notice have all undermined the efficient use of operating theatres, it says.

One trust in north west England could have carried out a further 3000 operations a year—the equivalent of 12 operating sessions a week.

Another, in the north east, could have carried out 685 more operations a year if it had improved its performance, says the report. Although 96% of the operations at the trust went ahead—a total of 3500 planned sessions in all—the way the time was used was poor. Only seven of the 20 specialties met their target of using 90% of their allocated theatre time—nine fell below 75% and four below 50% The trust has subsequently reviewed its policies and is now hitting 85% overall.

In another trust, the information was so poor that managers could not tell the auditors why certain theatre staff regularly failed to keep to start and finish times. Sessions regularly started late and over-ran. One trust did not even have agreed start and finish times for operations.

Another trust had cancellation rates as high as 30% in some specialties, and other specialties persistently over-ran their time schedule by 25% Only after sessions were reallocated was the trust able to use its operating theatres more efficiently.

More than three million operations are carried out in the NHS every year, although the government signed a concordat with the private sector 18 months ago for several thousand operations a year to be carried out privately, at NHS expense, because waiting lists were so long.

More patients could have operations if NHS trusts had better information, time management, and staff planning, says the guidance.

“Many operating theatres are well run,” said the Audit Commission's controller, Andrew Foster. “But there are common weaknesses that must be addressed to improve the experience of patients and their families. There is massive pressure on all areas of the NHS to use existing resources better, and this shows that simple efficiency gains would result in many more operations going ahead.”