Day case surgery: a good news story for the NHS
BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h4060 (Published 29 July 2015) Cite this as: BMJ 2015;351:h4060
- John Appleby, chief economist, King’s Fund, London, UK
- j.appleby{at}kingsfund.org.uk
Over the past 40 years there has been a revolution in surgery. A combination of new surgical techniques, advances in anaesthesia, the collection and publication of comparative data, and deliberate policy—including financial incentives for hospitals—has led to a large switch to day case surgery.
It is a quarter of a century since the Audit Commission published its first NHS value for money report. The 1990 review identified several interventions, including cataract surgery and laparoscopic cholecystectomy, that clinical opinion suggested could be carried out as day cases in greater numbers.
The commission’s analysis suggested that if all health authorities in England and Wales, “performed day surgery consistently at readily achievable levels for each of 20 common procedures, an additional 186 000 patients could be treated …
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