A best practice guide has been developed and published by the Getting It Right First Time (GIRFT) Academy, the Centre for Perioperative Care (CPOC) and the British Association of Day Surgery (BADS) to support and encourage NHS Trusts to increase day surgery rates for the benefit of both easing waiting lists, in the current Covid-19 era and beyond, and improving the patient experience.
The guide provides a range of background information relating to day case surgery in the UK and offers detailed advice and guidance to improve the provision of day surgery within Trusts. The guide covers developing safe and effective day surgery pathways, along with examples of best practice pathways and templates that Trusts can use to implement the changes needed. The guide is 54 pages long, but the key headlines that can be taken from it are as follows:
- Day surgery should be the default position for patients undergoing the 200 procedures identified by BADS as suitable for day surgery and more. BADS have developed a list of 200 procedures that are suitable for day surgery and the guide advises that all of those procedures should be on a dedicated day case pathway from the get go, with dedicated pathways and protocols for each. The guide also provides a list of other procedures which may also be suitable to have day surgery as the default position which includes both elective and emergency procedures.
- Default day surgery will improve patient care and satisfaction, would be highly cost- effective, improve efficiency, improve staff retention and reduce the demand for inpatient beds. Increasing day surgery can be highly efficient and cost-effective because it reduces the burden of staffing skilled out-of-hours rotas, and takes the pressure off staff trying to manage both acute and day case patients. However the expansion can only be achieved safely by following clear guidelines and creating pathways aimed at improving
- Recommended progress towards the development of dedicated day surgery units. The guide recommends that, where possible, Trusts have dedicated day surgery units. This is supported by the Department of Health, Royal College of Anaesthetists, Association of Anaesthetists and the Royal College of Surgeons of England, who suggest that dedicated day surgery units lead to significant improvements in same day discharges for patients
- The importance of the expertise of staff in the day surgery unit cannot be underestimated. It is emphasised that a collaborative team effort of highly skilled people is required to make any day unit a success, which includes the booking staff, preoperative assessment nurses, receptionists, theatre teams, recovery and discharge staff supported by the surgical multi-disciplinary team (MDT).
- Procedure specific best practice pathways and templates. The guides provides a list of elective and emergency procedures that serve as a focus for the development of day surgery pathways. To assist with this, the guide also provides the following practical information:
- Outlines the key components that can be applied to existing inpatient activity to convert to a day case approach.
- Provides essential information about the best practice management required for the delivery of a high-quality day surgery service.
- Provides action check lists for each stage of the pathway that can be
- Provides links to Trust level process pathways.
- Provides example protocols for a number of different
- Provides examples of standard documentation to be used
Click here to download ‘National Day Surgery Delivery Pack’ in full.
