Operating theatres: opportunities to reduce waiting lists


This report provides the insight to support clinicians, managers and hospital leaders to improve how care is delivered, and how theatre resources and clinical expertise can be best used.


We've commissioned Deloitte to analyse and identify the scale of opportunity to improve theatre productivity across England. This work forms part of our an ongoing programme to help trusts reduce waiting times for patients by making better use of theatre time.

About the findings

Hospitals could carry out over 291,000 more routine operations, like hip replacements and cataract surgeries, a year by improving how they schedule their surgical lists. 

Data submitted by 92 trusts for the year January to December 2017 demonstrated variation in theatre productivity between different trusts and different specialties. Specific findings included:

  • A third of operating lists started 30 minutes or more late and 38% finished 30 minutes or more early. More than 111,000 finished at least 60 minutes early. Day lists comprising three four-hour sessions were particularly likely to finish early.
  • Theatre time lost to late starts, early finishes and delays between operations could potentially have been used by the 92 trusts to do up to 291,327 more operations (a 16.8% increase), had they been able to address their main causes.

For the eight highest volume surgical specialties reviewed, this would have meant around:

  • 30,000 more ear, nose and throat operations
  • 42,000 more general surgery operations
  • 32,000 more gynaecology operations
  • 41,000 more ophthalmology operations
  • 27,000 more oral and maxillofacial surgery operations
  • 19,000 more plastic surgery operations
  • 57,000 more orthopaedic operations
  • 44,000 more urology operations

Operating theatres: opportunities to reduce waiting lists PDF, 411.7 KB

This report looks at unwarranted variation in theatre productivity and ways to improve how care is delivered in England. We worked closely with the Royal College of Surgeons in producing this report.

‘It is thanks to the hard work of surgical staff that the NHS is ensuring more patients than ever get the care they need. 

‘While waiting times for surgery are lower than they have been historically, more can be done, so it is important that we work with clinical teams to identify further solutions and share best practice.

‘It is encouraging that pockets of innovation, like the 6-4-2 model exist already across the NHS and are benefiting both patients and surgical teams. As the NHS Long Term Plan states, we need to ramp up these efforts where clinically appropriate so that they become the norm and so that we can address the variation that exists.’

Professor Tim Briggs CBE, National Director of Clinical Improvement for the NHS and Council member of the Royal College of Surgeons.

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