Day surgery is the admission of carefully selected patients to hospital for a planned surgical procedure, returning home on the same day. Patients having day surgery rather than inpatient surgery:
- often have shorter waiting times because more patients can be treated and they are not subject to last-minute cancellations by the hospital (as long as day surgery facilities are separate from those for emergency patients)
- spend less time in hospital
- receive care that is better suited to their needs
At the same time hospital costs are lower because day surgery is more efficient than inpatient care and there is little or no additional community support required. Moreover, outcomes are at least as good as those for inpatient surgery. The need for more day surgery is therefore widely recognised by patients, clinicians, NHS managers and the government. The Royal College of Surgeons has said that: 'Day surgery is now considered the best option for 50 per cent of patients undergoing elective procedures though the proportion will vary between specialties'.
This review reports the results of a national survey of day surgery carried out recently by the Audit Commission as part of its Acute Hospital Portfolio. All NHS trusts in England and Wales that provide day surgery services were involved in the data collection that took place in mid-2000. Over 300 individual day surgery units (DSUs) within these trusts were surveyed. The comparative data obtained forms the basis for this review. The Commission's auditors, who produce tailored performance assessments for each NHS trust, take up the detailed issues underlying the results.
This review sets out the:
- current day surgery performance of NHS trusts based on a new set of 25 procedures (Basket 2000)
- progress that has been made since 1998
- scope for further improvement in the use of day surgery and in the utilisation and management of day surgery units