FUTURE SURGE RY
Working together to recover elective surgery
High on the agenda of Future Surgery 2022 was the significant challenge around recovering elective surgery, in the wake of the pandemic. Among the hot topics included: staff retention and recruitment, the need for more day case surgery, new ways of working, and the recovery of training. Louise Frampton reports.
At Future Surgery 2022, the recovery of elective services was among the most talked about challenges for surgical teams. With waiting lists now reaching over 7 million, surgical services are under extreme pressures to tackle the backlog, while patients are having to wait in pain for life changing surgery. Theatre teams have risen to the challenge and have made some progress on tackling the longest waits, but the problem is going to be with us for some time. With this in mind, the event brought together a panel of experts to discuss the way forward and the hurdles that will need to be overcome. Chairing the debate, Professor Neil Mortensen, president of the Royal College of Surgeons of England, was joined by: Stella Vig, National Clinical Director for Elective Care; Dawn Stott, chief executive of the Association for Perioperative Practice (AfPP); Duncan Summerton, consultant urological surgeon, University Hospitals of Leicester NHS Trust; Rowan Parks, president of the Royal College of Surgeons of Edinburgh; and Prof. John Skinner, consultant orthopaedic surgeon, Royal National Orthopaedic Hospital NHS Trust.
“It feels like an unsolvable problem.
However, when you break it down, there are chinks of greatness,” commented Stella Vig. She pointed out that significant progress has been made in reducing the longest waits (of 18 months and two years), but she emphasised that reducing the wait in children’s surgery is particularly important. “A year in a child’s life is very long time,” she commented. Stella Vig added that there is still variation in theatre activity across the country, which must be addressed. Dawn Stott commented that workforce
shortages are still the biggest issue, along with low morale in the NHS: “We see some fantastic practice and we also see some people who are just going through the motions. But there are opportunities to make a difference,” she commented.
She highlighted the value of sharing and spreading best practice, as well as learning from COVID: “We need to do things more strategically and COVID taught us that we don’t have to do things the way they have always been done, but to think differently about the way we organise services,” she continued. This included embracing the use
of digital technology, she explained. Rowan Parks commented that theatre productivity could still be improved, although measures around throughput are getting better. Innovation will be key to driving further improvement – diagnostic centres and elective hubs will make a significant difference, for example.
“In Scotland they are known as National
Treatment Centres. It is a new way of working and we need to think about how we can use these most efficiently and effectively. However, I still think that the biggest issue is the workforce. There are some encouraging signs in terms of increasing nursing staff, which has been the most critical factor in productivity from a surgical perspective. “There have been a lot of efforts, but we still have many vacancies. We need to think of ways to improve recruitment, as well as retention,” he commented. On a positive note, he added: “We are getting there. It is going to be challenging, but there are opportunities around some of these new ways of working.” Prof. Skinner highlighted the problems
around Winter pressures and the impact on the recovery of the backlog: “Elective orthopaedic surgery relieves pain, which keeps people moving and restores function. The best way we can deliver this is in hubs. We need to separate urgent and acute care from elective care,” he commented. “Elective care is not ‘optional’. These people do not get better until they have had an operation – the only thing you can elect is the time when it is performed, so we must keep going all year round. We cannot afford another bad Winter. We must continue to give space for those with elective conditions, because they are waiting in pain, with disability, increasingly in poverty, and are becoming dependent,” he asserted.
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WWW.CLINICALSERVICESJOURNAL.COM JANUARY 2023
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