Delays to operating encountered by plastic surgery trauma patients

NCEPOD states that all emergency patients must have prompt access to theatres, critical care facilities, and appropriately trained staff 24 hours/day, every day of the year. The purpose of this paper is to determine waiting time for plastic surgery trauma patients and the financial implications to the NHS.

The approach was a prospective audit of emergency surgery (Lister Hospital, Stevenage) from July 2005‐January 2006. Delay times were calculated from booking time to time of operation. These were assessed on a standard of a day surgery unit, where the ideal maximum is a half day wait. Financial implications were calculated. The number of UK units without a dedicated list is highlighted.

A total of 615 operations were booked, 60 per cent of which were assessed as suitable for a DSU set up. With an ideal standard of half a day's wait, an average 22 per cent of patients achieved this, with 64 per cent of patients waiting one excess day. On average patients waited an excess of 1.3 days. An average of 24 excess bed days/week (bed cost £300/day) were used waiting for surgery. This equates to 1,400 bed days (£400,000/annum).

The paper shows how it is possible that 1,000 bed days/annum (£300,000) could be saved by a DSU type setup. With 61 plastic surgery units in the UK, 40 per cent reported no dedicated trauma list (93 per cent response rate). This is a potential saving of £8,400,000 per annum. From this audit a half day dedicated DSU list was created, and a re‐auditing process will occur.