New report highlights impact of perioperative care, pension taxation and poor IT systems on NHS productivity

A new report from the Royal College of Anaesthetists (RCoA) shows most anaesthetists (78%) play a key role in perioperative care, which is vital to improving patient outcomes and NHS productivity.  

However, the report also highlights some of the barriers that are limiting their ability to do more. One in four (26%) consultant and SAS anaesthetists report reducing their working hours because of pension taxation, restricting capacity for additional elective surgery and slowing progress on waiting lists.  

Poor IT systems are another constraint, with 89% of anaesthetists saying they limit productivity.  

The report, Improving Productivity: Perioperative Care, IT & Pensions, draws on data from our Anaesthetic Workforce Census.  

Anaesthetists are leaders in perioperative care

• The NHS faces avoidable inefficiencies: 19% of operations are postponed or cancelled and 12% result in complications that can lead to lengthy hospital stays. One reason for this is patients arriving in hospital too unfit to be able to safely undergo surgery.  
• Anaesthetists are key to delivering solutions through their central role in perioperative care – all the care that patients receive before, during and after their operation.  
• Almost eight in ten (78%) anaesthetists are involved in delivering perioperative care, and one in four (24%) lead or supervise these services.    
• Turning waiting lists into preparation lists allows patients to be assessed shortly after referral for surgery for health problems like anaemia and negative health behaviours such as smoking, and offers targeted support to address those issues ahead of surgery.  
• These interventions can reduce cancellations, cut surgical complications by up to 50%, shorten hospital stays by one to two days, support long-term lifestyle improvements in up to 74% of patients and deliver cost savings for hospitals.  

Pension taxation is limiting NHS capacity  

• More than one in four (26%) consultant and SAS anaesthetists report reducing their hours due to pension taxation.  
• This results in up to 1.5 million hours of lost anaesthetic clinical time each year – capacity that could allow up to 460,000 additional patients to be treated.
• Nearly half of consultants considering leaving the NHS say changes to pension taxation would make them more likely to stay, making it one of the most powerful levers for retaining senior doctors.  

Poor digital systems  

• Nearly nine in ten of anaesthetic staff (89%) say better IT systems would improve their productivity, including 46% who believed the improvement would be “big”.
• Slow computers were a major issue, with 58% rating them “poor” or “very poor” and 44% reporting difficulty accessing patient information quickly and easily.   
• More than half (57%) of clinical leaders said their hospitals still rely on paper patient records some of the time.  

Dr Claire Shannon President of the Royal College of Anaesthetists, commented on the report.  

“Anaesthetists are losing valuable clinical time because outdated IT systems slow everyday work, while pension taxation is driving many senior doctors to reduce their hours, or consider leaving the NHS.  

“Investing in modern digital systems, reforming the pension taxation system, and strengthening perioperative care would allow anaesthetic teams to work more efficiently; retain experienced staff, help cut waiting lists and improve patient outcomes.”