This review is one of the most comprehensive assessments of NHS operating theatres since the 1989 Bevan report. Statistics on numbers of scheduled theatre sessions, and numbers of cases done within and outside them, stopped being collected in England and Wales in the mid-1990s. The Department of Health (DoH) and the Welsh Assembly Government now collect data from all hospitals on numbers and types of operations performed, and cancelled operations. These data give no information about a key resource in theatres: time. The present review provides a more comprehensive picture.
The Government's plan for progressively reducing waiting times implies that operating theatres need to increase throughput. This review is structured around the question of whether trusts can absorb the extra work within their existing resources. Key resources are theatre time (and the associated time of anaesthetists, surgeons, theatre staff and others) and physical theatre space.
The review starts by considering the use of the 84 per cent or so of theatre time that is scheduled (covering 85 per cent of patients). How much of the time is actually used for operations? This is particularly important for elective surgery, where high levels of use ought to be achievable.
If the use of sessions is high, but lack of theatre capacity is still creating a bottleneck within the wider system, the scheduling of the physical theatre space must be critically examined. Reorganisation to increase the number or length of scheduled sessions may be possible, failing which new theatres will probably be needed as a last resort. Physical space problems may affect only a few trusts at present, but this issue could become more important if theatre workloads continue to grow.
Lastly, the review considers the efficient provision of staff and equipment, and the quality of management arrangements and performance information.