Author’s reply to Datta

Datta makes some valid points that my short piece did not cover about the outcomes of day case surgery, limits to its further expansion, and the use of outpatient treatment as an alternative.1 2

On the first point, I agree that, given the current scale of day case surgery, there is less clearly scope in the future for further expansion—but it is unlikely to be zero.3

On success rates, my understanding of the evidence and various reviews is that (at least in the past and given the right patient selection) these have been as good if not better than procedures carried out as inpatients.

And on the greater use of outpatient settings as a substitute, that is clearly to be welcomed and I would not suggest that expanding day case work is the only response to the need to use scarce NHS resources more cost effectively. The more general point I tried to make in the piece was that there have been areas of tremendous improvement in NHS performance (generic prescribing is another) that may have lessons for further improvements in other areas.