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Chief Executive’s Message – Friday 5 May

May 5, 2023

This week I want to focus on the production plan for the year ahead. Theatres are our most expensive resource, and we aren’t using them like we used to. Our plan is to move from 94 per cent of 2019/20 activity levels last year to a minimum of 104 per cent this year. Like I’ve said many times before in this blog, the funding that we saw during the pandemic is no longer available to us, so it is important that we use our taxpayer pound as wisely as we can.

Chief Operating Officer, Jo Newens and her team are doing some great work to ensure we get it right when it comes to our theatre schedules, maximising our day case rates and ensuring our theatre sessions are not only safe, but efficient too.

Here is some of the work they are doing.

List utilisation – on average 78.66 per cent of the list over the last 12 months was used. To improve this the team have put in place the following actions:

  • Annualised job plan covering 52 weeks of theatre session.
  • Pro-actively re-cycle uncovered theatre sessions.
  • Clinical groups to publish theatre rota and adhering to 6-4-2 policy – a process where consultant leave is agreed at eight weeks from the day of surgery, theatre lists start being built at six weeks from the day of surgery, lists are signed off at four weeks from the day of surgery and at two weeks all lists are ‘locked down’ (subject to only exceptional changes).
  • Workforce gaps to be addressed within clinical groups, anaesthetists, and theatre staffing.
  • Skill mix and right equipment available to avoid any last minute theatre cancellations.
  • Patients are prepped up fully to avoid any cancellation resulting in loss of a whole session or day.

In-list utilisation – over the last year we saw an average of 71.59 per cent productivity. As a result, the team will:

  • Enhance communication and coordination among surgeons, anaesthetists, nurses and support staff to improve efficiency and ensure smooth patient flow.
  • Optimise pre-operative activities to reduce cancellations and improve readiness for surgery.
  • Efficiency on theatre pre-ward round and consent will help to improve workflow, reduce errors, and enhance overall efficiency.
  • Clinicians to specify more accurate procedure time on patient waiting list.

All the above will help ensure our lists are fully booked to 100 per cent of theatre time.

  • Skill mixes and equipment availability to avoid on the day cancellations.
  • Address issues around late start and early finishes.
  • Patients streamlined to improve turn-around between cases.
  • Avoid switching specialities between sessions and instead have a whole day for a speciality to improve efficiency.

We are confident that we will start to see a marked improvement as these measures are introduced and embedded into our processes. Indeed, if your work supports our theatres, I urge you to embrace these changes and think about what else we could do to improve the care we provide for patients. Share those ideas with your teams and managers so we can continue our improvement journey.