Patients in need of elective surgery face waits of more than a year, the Health Department has revealed – as operating theatres lost “more than a quarter” of their capacity last year due to a catalogue of failures including unusable ventilation systems and broken microscopes.
A report due to be presented at tomorrow’s Health Advisory Board meeting revealed that the waiting list for elective surgeries lengthened in the second half of 2024 – and warned that issues could continue until March 2025.
A number of equipment and facility failures caused theatres to close, and they weren’t all resolved before the report was written in December.
“During that time, almost a quarter of elective theatre capacity had been lost,” the report said.
It explained that during maintenance work in August, workers found an “issue” with the ventilation system in one of the theatres, which was taken out of use immediately.
An assessment found the ventilation to be “unsafe to maintain adequate clean air required to operate”.
During the repairs, a panel failed in another theatre, also reducing capacity.
And two ophthalmic microscopes were put out of action by a power surge “resulting in both scopes failing at the same time” – meaning no cataract surgery could be done in Jersey.
As a result, 32 patients’ surgeries were cancelled in October.
“Availability of equipment in this area is being reviewed to future-proof,” the report said.
The document also revealed that theatre utilisation in Jersey remains at less than 70%. The NHS’s ‘Getting It Right First Time’ programme – which reviewed the island’s services last summer – sets a target of 85% for English hospitals.
On-the-day cancellations had gone down significantly in December, but the report predicted that more surgeries would face last-minute cancellations in January because of increased emergency and acute patients.
It added: “Since December 2024, the hospital has experienced an increase in requirement for urgent beds, as has been the case across the UK.
“This demand for acute beds has again restricted the elective programme of work and in line with winter surge, bed capacity could well be limited until March 2025.”
Hospitals can become more efficient and utilise operating theatre capacity by carefully planning how they will be used.
One concept Jersey’s health department has looked to use is a ‘Golden Patient’ methodology.
This is where staff check up on the patient, remind them to show up on the day of their surgery, and have a streamlined process with consent forms and preparation done ahead of their time slot in the operating theatre.
This means the patient is ready to go as soon as the operating theatre becomes available.
Speaking to Express at the end of 2023, the Change Team’s finance lead Obi Hasan explained that by improving efficiency, a half-day session in an operating theatre could see four or five patients be operated on, instead of the usual two or three.
Inefficient theatre use has plagued the Hospital for years, with 2021 figures showing utilisation dipping as low as 63.4% during some months after the end of lockdowns.
In 2021, Felix Choto, a specialist theatre nurse from the UK, spent four weeks “embedded” within operating theatres as part of an internal review of the hospital’s main theatre and day surgery unit services.
He found issues requiring “urgent” improvement in relation to leadership and conflict management. The Government said it has now set up a ‘Task and Finish’ group to deal with these, and already started investing into improving operating theatre services.
Mr Choto noted the “health, wellbeing and morale of front-line workers” had been profoundly affected by the pandemic and post-pandemic recovery phase and raised issues including conflict in the workplace and “significant acts of incivility” within the department.