John Gibson
Introduction
Following the Covid pandemic, the NHS faced an unprecedented backlog in elective surgery, particularly in Trauma and Orthopaedics and Urology. To address this, "cold" elective surgical sites were established, aimed at highvolume surgery without competing with non-elective admissions. This study assesses theatre efficiency and patient satisfaction following the relocation of our andrology service to a "cold site," in the context of day-case surgery.
Methods
Data was retrospectively collected from October 2023 to February 2025 across 82 theatre lists and 340 cases. Key operational metrics included cancellations, delayed starts, list overruns, theatre utilisation, day-case rates, and 30-day readmissions. Additionally, a survey was conducted among 70 IPP patients, with 59 respondents providing ratings on pre-operative, day-of-surgery, and postoperative experiences using a five-point Likert scale.
Results
The theatre utilisation rate was 81.2%. Operational inefficiencies included 32 onthe-day cancellations, delayed starts in 30 lists (mean delay: 21.8 minutes), and overruns in 19 lists (mean overrun: 36.9 minutes). Day-case rates were 73.5%, with 30-day readmission rates of 1.18%. The majority of cases were andrological (79.9%). Patient satisfaction for IPP procedures was high, with ratings of 4.81 for pre-operative care, 4.73 for the day-of-surgery experience, and 4.58 for postoperative care.
Conclusions
The relocation of the andrology service to a "cold site" resulted in promising theatre efficiency, with an 81.2% utilisation rate and low cancellations. While it did not meet the GIRFT target of 85%, operational performance and high patient satisfaction indicate that high-quality care can be maintained in a reconfigured service environment.
Authors
John Gibson
Manchester Royal Infirmary, Manchester, United Kingdom
Mohamed Mubarak
North East Deanery, Newcastle, United Kingdom
Vaibhav Modgil
Manchester Royal Infirmary, Manchester, United Kingdom
Ian Pearce
Manchester Royal Infirmary, Manchester, United Kingdom