Executive Summary
It is generally held that around 75% of surgical procedures can be conducted as 'day surgery'. Audit Scotland conducted a review of day case surgery in 2004 and concluded that, in general, Scotland has lower day surgery rates than England and there is potential to increase day surgery rates. From analysis to date it is clear that in Scotland there is considerable variation across procedures, hospitals and boards.
The increase in day surgery rates for appropriate procedures has the potential to improve the service for patients by achieving shorter waiting times, allowing patient choice and making best use of NHSScotland capacity.
- Treating day surgery as the norm for elective procedures was identified in 'Delivering for Health' as a high impact change and is being championed by the Planned Care Improvement Programme;
- The programme promotes the measurement of same day care, made up of all procedures performed in surgical specialties in a day surgery or outpatient setting;
- On 29 September 2006 the Minister restated our commitment to a 75% same day care target across Scotland;
- Currently in Scotland around 66% of all procedures performed in surgical specialities are carried out as day case or outpatient (with a surgical procedure);
- To reach an overall 75% same day care target, approximately 40,000 elective inpatient procedures would need to be converted to day cases or outpatients each year;
- ISD estimate the cost of overnight accommodation to be £237. A reduction of 40,000 elective inpatients would result in efficiency savings of £9.5m per annum based on overnight accommodation savings alone;
- The British Association of Day Surgery has produced a directory of procedures containing aspirational targets for day surgery and outpatient surgery. This will form the basis of aspirational targets for NHSScotland;
- The Planned Care Improvement Programme will work with NHS boards to identify stretch goals based on the local capacity to improve same day case rates in identified procedures.