RCoA responds to Operating theatres: opportunities to reduce waiting lists

In response to the publication of NHS Improvement’s Operating theatres: opportunities to reduce waiting lists report, Professor Ravi Mahajan, President of the Royal College of Anaesthetists said: “The Royal College of Anaesthetists supports the efforts of NHS Improvement to improve theatre productivity. As the report recommends, ensuring that anaesthetists and surgeons are part of the leadership team for the theatre improvement programme in their organisation is essential.

“While the report highlights problems created by late starts and early finishes, the College also recognises the equally if not more important problem of late finishes and overbooking of lists. This adds to working pressures, unbudgeted expense, and staff fatigue. We would welcome strategies to prevent over-running, as much as measures to prevent underrunning of lists.

“However, the operating theatre does not exist in a vacuum. Bed capacity plays a key part in efficiency of the operating theatre, and some operations are unable to go ahead if there are no beds available for patients following their procedure, and this includes intensive care capacity. Workforce shortages, both in the operating theatre and in post-operative wards also have an impact on theatre efficiency. It is important not to misinterpret underutilisation of theatre lists as always a sign of poor scheduling, but recognise that all too often underutilisation is a reflection of wider deficiencies in the system.

“The College wishes to highlight the extensive work already published by our own Fellows, as key resources to improve theatre productivity, especially in the field of scheduling operations. We look forward to sharing existing resources on theatre productivity with NHS Improvement, so that some points touched upon by this report can be taken further to achieve sustainable evidence-based improvements in theatre productivity, as well as addressing the wider issues of bed capacity and workforce.”