Britain Today

[EndtheMadnessNow]

London hospital cuts waiting lists with innovative system. Weeks worth of surgery in a day! It's a miracle!

Surgeons at one London hospital are performing an entire week’s operations in a single day as part of a ground-breaking initiative that could help tackle the record waiting lists in the NHS.

Guy’s and St Thomas’ NHS Foundation Trust has already slashed its own elective backlog in certain
specialties by running monthly HIT (High Intensity Theatre) lists at weekends.

Under the innovative model, two operating theatres run side by side and as soon as one procedure is
finished the next patient is already under anaesthetic and ready to be wheeled in.

Nurses are on standby to sterilise the operating theatre and instead of taking 40 minutes between cases it takes less than two, the only delay is the 30 second it takes for the anti-bacterial cleaning fluid to work.

Kariem El-Boghdadly, the consultant anaesthetist who designed the programme with his colleague Imran Ahmad, compares it to a Formula One pit stop. “They’ve got one person doing the rear right wheel, one person doing the front left wheel. It’s the same thing. The operating theatre is effectively like that.”

The lead consultant surgeon “is bouncing from one theatre to the next doing the critical phase of the
operation” with more junior surgeons assisting, he added.

At St Thomas’ hospital on Saturday, a third of the gynaecological oncology backlog was cleared in a morning during the latest HIT list. The surgical team got through 21 operations on 20 patients and finished by lunchtime. Normally they would do six such procedures and be working all day. All the operations were diagnostic, to find out whether the patients had signs of cancer.

There were two teams of theatre staff on duty, including six surgeons, four anaesthetists and 18 nurses. By 10am the surgical team were on their 13th operation. One patient had already gone home, two more were in surgery and another couple were being prepared in the anaesthetic room. “We’re flying through,” said Ahmad, the consultant anaesthetist. “We’re not rushing, we’re being efficient.”

Under the HIT list model, patients are processed in parallel rather than one after another. “The anaesthetic happens while another patient is being operated on, and as soon as patient number one is done and leaves the operating room, the second patient has come in the operating room already anaesthetised,” El-Boghdadly said.

“We delete any downtime. We get rid of any time that the operating theatre does not have a
patient in it being operated on.”

He insisted no corners were cut that might put patients at risk. “It’s all completely safe but what we’ve found with these novel models is that we can be far more efficient. In a day we’ll do two to three times more cases than we would routinely.”

Gautam Mehra, the consultant surgeon, said: “It’s very satisfying. you are able to do a lot in a short period without wasting any time. The productivity is really great. The patients are happy and there’s a lot of planning that goes on to remove any stress. It’s quite slick on the day without compromising patient safety.”

For patients who do turn out to have cancer, early diagnosis could be critical and allow them to get treatment more quickly, he added.

In August, the same method was used to operate on three months’ worth of breast cancer patients in five days. Plastic surgeons at St Thomas’ carried out reconstructive surgery on 22 patients. Many had been on the waiting list for over a year. On another occasion, eight men with prostate cancer underwent a robotic-assisted prostatectomy as the team carried out a week’s worth of operations in one day.

El-Boghdadly said the programme had been successful with many different types of surgery. “We’ve
substantially reduced our waiting lists in various specialities. Normally, you’d do three knee replacements in a day, potentially, four if you’re lucky and with the HIT model, we did 12 a day, and we finished early. We’re always finishing early, because the model is so efficient.”

Ahmad said the HIT list model could have a dramatic impact on the national elective backlog if rolled out more widely. “Every time we do one of these HIT lists I’m amazed how efficient it is,” he said. He has discussed the approach with officials at NHS England and the Department for Health and Social Care. Wes Streeting, the shadow health secretary, has also expressed an interest.

There are almost 7.8 million cases on the waiting list for planned operations, following the pandemic and industrial action by doctors.

London hospital cuts waiting lists with innovative system

I'm not sure if this is real or just theater. I prefer not to be on any industrial efficient "HIT list".



High-intensity theatre (HIT) lists