The Audit Commission has found that many NHS Trusts could improve the way they manage day surgery. It estimates that an additional 120,000 patients could be treated each year if the poor performing trusts came up to the standard of the best performers. Inmproving performance would also mean shorter waits for patients, outcomes at least as good as for the same procedures carried out as inpatient cases, and reduced costs for the health service.The auditors identified clinicians’ preferences for inpatient surgery as a barrier to more efficient use of resources. While some trusts treat 80 per cent of inguinal hernia patients as day cases, others treat none in this way. There are also wide variations in staff productivity between trusts performing the same operations in similar circumstances. In general it was found that productivity was higher in the larger day surgery units and this was attributed better quality management.
A particularly disturbing finding was that many trusts failed to follow about half of the good practice guidelines. One third of trusts had failed to appoint a senior consultant to take charge of the day surgery unit or to telephone patients at home afterwards to check that everything is all right.