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Increase theatre productivity by having a dedicated acute/emergency theatre for neurosurgery
One of the main causes of delays in both elective and non-elective streams, and cancellations in the elective stream, is the arrival of emergency patients. These patients need to be operated on fast; procedures may well take longer to perform, meaning that one emergency procedure could take the allotted slot of three or four electives.
As set out in the GIRFT Programme Speciality Report on Cranial Neurosurgery by Nick Philips this is a particular issue for cranial neurosurgery which the NHS service specifications have previously sought to address by stipulating that “All units require a minimum of two fully resourced dedicated operating theatres and immediate access to an emergency theatre".
However, in practice, different providers have addressed the requirement for “immediate access to an emergency theatre” in different ways and many providers still operate on a system where all theatres have full elective lists for the day but when an emergency occurs, they simply use the first available theatre. This still has an impact on the rest of the elective list and causes practical problems for the staff, who constantly have to juggle the lists across theatres.
An alternative approach and recommendation set out in the above report is for the provider to nominate one of its theatres as the designated acute theatre. Importantly, this does not mean it is only used for emergency procedures, but rather that it is kept separate from the longer-term elective planning where procedures are booked perhaps weeks in advance. By separating this theatre, providers make sure it can be used for genuine emergencies, plus acute requirements.
Interested to hear from providers who are already implementing the above approach successfully for neurosurgery or other specialised services and any other ideas that may enhance theatre productivity
Is your idea a commercial offer , or does it have the potential to be a commercial offer?
No
Which part of the pathway does your idea focus on?
Acute elective care
This sounds like a very sensible and easy to implement idea. Does anyone have any insight into what the potential barriers may be for putting this into practice? I know that sometimes ideas that seem simple on paper can sometimes be more complex when it is implemented.
Sounds like a sensible idea for emergency treatment, and as such a space is separate wouldn't impact on elective care. Would be interested to hear from providers about this, too.
Thank you for sharing. It sounds really practical. Also really interested to hear in the barriers for putting it into practice.
This does seem like the right thing to do, in terms of elective care recovery as a goal. I wonder what would happen in practice if two emergencies arrived at the same time though? There are always unexpected scenarios and so a plan to re-deploy resources in these rare instances might need to be incorporated?
Could something like this help? https://www.england.nhs.uk/sustainableimprovement/lean-online/