Day surgery rates continue to rise - still room for improvement

New figures published by Dr Foster in the British Medical Journal show that day surgery rates continue to rise, yet there is still considerable scope for improvement. These findings support a recent Healthcare Commission report showing that day surgery units are not being used to their maximum capacity.

The NHS Plan predicts that 75% of all elective operations will be carried out as day cases. According to the British Association of Day Surgery, patients prefer day surgery as it provides timely treatment with less risk of cancellation, lower incidence of hospital acquired infections, and an earlier return to normal activities.

Researchers looked at day surgery rates by using hospital episode statistics between 1996-7 and 2003-4, and comparing them against the 25 operations identified by the Audit Commission as day cases.

Overall, the proportion of procedures carried out as day surgery rose from 55.7% in 1996 to 67.2% in 2003. Cataract operations showed the greatest increase in total admissions (including day cases), rising 94.8% over the study period.

Day surgery rates varied considerably between NHS trusts ranging from 40.2% to 82.7%, with only 12% of trusts carrying out 75% or more of the 25 operations identified by the Audit Commission as day cases. The authors suggest this variation might be explained by inconsistent coding or differences in case mix between hospitals.

The conclusions are much the same as those of the Healthcare Commission: day surgery rates are continuing to improve, yet the range of performance between NHS trusts remains wide leaving considerable scope for the poorer performers to improve.