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Theatre Right

by John Holden | Apr 6, 2022 | in Building outstanding theatre teams challenge

The Safe staffing of a operating theatre(s) using the necessary number of theatre practitioners. (Theatre Right)


Historical we have seen a variance in the number of staff allocated to minor surgical theatre sessions – amending staff in a theatre is not new but few theatre depts formalise this process early enough in advance. We wanted to  pilot a series of procedures undertaken in a operating theatre, that if the estate allowed, could be undertaken in a procedure room with a reduced staffing model. The successful pilot supported staff decompression, reduce operational pressures due to sickness, addressed skill mix challenges and supported the right qualified staffing ratios. Pilot trust (UHMBT) already operate reduced staffing models for some local anaesthesia sessions inc Maxillo Facial Surgery / Pain injections / Ophthalmology / General Surgery (Vasectomies / lumps and bumps). Theatre (Inc surgeons), booking and operational teams were highly engaged and keen to explore different ways of working. Pilot was undertaken across Orth upper limb across 2 theatre lists a week for 10 weeks. From June 2022 pilot will be expanding to 10 sessions a week across 5 specialities. Additional outcomes are: reduction in bank and agency, reduced cancelations and increased capacity. The team has the QIA and EIA, PID and process used for selection of procedure which we can share widely. Also have engaged with AfPP consistently about safe staffing levels. We have taken a bottom up approach and gone from "PID to Pilot" in 8 weeks. This works and we can support anyone interested in adopting the approach. Do not hesitate to get in touch as we have done all the heavy lifting on this and can support you through the journey .            

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Christina Harrison Apr 8, 2022

Thank you for your contribution to the #SolvingTogether platform. This completely makes sense

John Drew Apr 13, 2022

Thanks John. This looks really good and it is encouraging to see the very positive feedback from patients (100% support!), as well as how this can clearly release time and physical theatre capacity for more complex procedures. This is a good example of a "triple win"; benefitting patients who get treated quicker, staff whose workload becomes more sustainable and for taxpayers by making better use of scarce resources.
Is there a plan to estimate or model what a difference this could make if it were replicated nationally? How many extra theatre hours could be released? How many anaesthetic staff could be freed up to do other clinical work?
That would seem useful to do and a key part of making the case for this kind of change?
Did it need capital investment to prepare procedure rooms in the pilot?

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John Holden Apr 13, 2022

Thanks for the comments, those tagged are working with the NW to support further development of this model. Historically we had not placed a "releasing extra hours/sessions" on the pilot due to wanting to land the pilot in the sphere of supporting staff through decompression and reducing cancellations. I have had a conversation with our Director of Performance to indicate that further down the expanding pilot we will be able to capture the opportunities numerically. I guess this will tick more boxes. The biggest challenge so far is aggregating the model up, that's why I have joined the solving together . Staff are really busy and focused on the everyday and it take strong leadership and culture to change directions sometimes, even in the face of the barn door obvious