NHS waiting lists ‘should be called preparation lists’

Too many patients unfit for surgery

PATIENTS are costing the NHS millions of pounds a year by turning up for surgery too unfit to go under the knife, a damning report reveals.

It says each year doctors are forced to cancel around 135,000 operations on the day, at a cost of £400 million in lost theatre time.

A third of these are for potentially avoidable clinical reasons, including patients unprepared for surgery or with unaddressed co-morbidities.

Now the Centre for Perioperative Care (CPOC) is calling for waiting lists to be renamed ‘preparation lists’, with sick Britons ordered to get themselves into shape following a referral for surgery.

Long waits for care provide an opportunity for people to increase their physical activity, improve their diet and quit smoking, the alliance of medical groups adds. Patients can also use the time to get other health issues under control and prepare mentally for the procedure and rehabilitation.

The CPOC’s ‘Blueprint for NHS efficiency’ report says: ‘The NHS has too many cancellations, complications and lengthy hospital stays – often due to patients arriving for surgery in an unfit state. These can be avoided by concerted action to turn waiting lists into preparation lists ...

‘If patients have addressable health issues they should be offered help to tackle these, includeing through “prehabilitation” programmes. This is not about erecting barriers to surgery: it is about giving patients the support they need to prepare themselves as best they can.’

The CPOC says preparation for surgery reduces complications by 30 to 80 per cent and reduces the length of time patients spend in hospital by one to two days. It also wants hospitals to focus more on rehabilitation after surgery.

The CPOC also says better discharge planning can reduce re-admissions by 11.5 per cent, which may reduce waiting lists and costs.

Dr David Selwyn, director of CPOC, said: ‘The NHS could vastly improve its efficiency, and improve patient outcomes, by turning waiting lists into preparation lists, taking simple steps to get patients drinking, eating, and mobilising after surgery and better discharge planning.’

The CPOC says these policies could save the NHS ‘millions’ but claims set-up costs are a barrier. It would like the Government to invest in a £100 million ‘NHS efficiencies transformation fund’, which would be allocated to Trusts to implement the proposals.

An NHS England spokesman said: ‘Plans for patients are offered ahead of their surgical procedure, which can include support to stop smoking and lose weight – boosting people’s chances of recovering quickly and helping to cut cancellations on the day.’

‘Giving support they need’