Clare Marx (President of the Royal College of Surgeons) and Chris Hopson (CEO of NHS Providers) has rightly pointed out the problem of planned operation being cancelled due to lack of beds (see Sunday Times Letters 12/2/17). From the patients’ perspective, to have surgery cancelled at short notice is extremely frustrating and at worst leads to ongoing pain and deterioration, ultimately with a poorer outcome. When planned operations are cancelled, our surgical trainees sit idle when they should be honing their skills to become the next generation of consultant surgeons. Financially, NHS hospitals are hit with a double whammy; they incur the costs of laying on elective theatre sessions without the income to support them and then later in the year many will lay on additional sessions at extra cost to clear the waiting list.
What can we do then?
There is another way. Of course, we need to fund health and social care adequately. We also need to reconsider how we deliver planned surgical care within the NHS. Over the last three years, we have developed a programme to reshape the delivery of healthcare in Shropshire. This programme (called Future Fit) will see one of our two hospitals specialise in providing planned care and the other becoming a specialist Emergency Centre. The vast majority of planned surgical operations can be safely performed in a hospital which does not take emergency admissions. Separating planned surgery from emergency admissions has clear advantages including a greatly reduced risk of cancellation of surgery, better patient experience and better outcomes. A small number of specialist hospitals in the United Kingdom have, for many years, provided a high quality of surgical care with a low risk of cancellation of operations specifically because they are insulated from the pressures of emergency admissions; it is time that such services are available to the whole population.