Health Minister Mike Nesbitt has praised innovative pre-operative assessment services at the Ulster Hospital which are helping to reduce surgical cancellations and make better use of theatre capacity.
The Ulster Hospital’s Paediatric Anaesthetic Pre-Assessment Clinic is the first nurse led service of its kind in Northern Ireland. The nursing staff have undertaken an intensive dedicated competency based training program in paediatric preoperative assessment. The innovative approach has increased theatre productivity, as the preassessment team is now able to replace 73% of late cancellations.
Minister Nesbitt said: “When patients are waiting too long for treatment, every available theatre slot matters. The holy grail is 100% utilisation of our available theatre capacity. That means having the right patient, in the right place, properly prepared and ready for surgery.
“A 73% replacement rate of late cancellations is an impressive achievement. It means a better experience for children and their families and helps ensure valuable theatre time is not lost.”
The nurse led and consultant supported paediatric service assesses children in advance of surgery, allowing potential clinical issues to be identified and managed earlier. Families are also contacted 48 hours before surgery. If a child is unwell or cannot safely proceed, the procedure can be rescheduled and, where possible, the theatre slot offered to another patient.
The Minister was shown child friendly resources used by the team, including the ‘Dennis Has an Anaesthetic’ Beano comic and visual guides which help children and families understand anaesthesia and prepare for surgery.
Consultant Anaesthetist Dr Ciara Mitchell, who has described the nursing staff as the ‘hidden heroes’ of the service, said the approach is improving patient safety and quality of care while reducing day of surgery cancellations.
Dr Ciara Mitchell, Sophie Ardis clinical senior nurse, Heath Minister Mike Nesbitt and Professor Mark Taylor.
Accompanied by Regional Clinical Director for Elective Care, Professor Mark Taylor, and Dr Rachel Deyermond, Anaesthetic Advisor to the Department of Health, the Minister also met the adult pre-operative assessment team, who explained how earlier assessment and optimisation can improve safety and reduce avoidable cancellations.
The work reflects the principles of Getting It Right First Time (GIRFT), using clinical evidence and data to improve pathways, reduce unwarranted variation and support better productivity.
Dr Damien Carson, Theatre Performance Lead and Consultant Anaesthetist, said: “Our operating theatres are among the most valuable resources in the health service and we need to maximise every opportunity to use them effectively.
“That starts long before a patient reaches the theatre door. Good pre-operative pathways and having patients appropriately assessed and optimised contribute to safer care, fewer avoidable cancellations and better theatre utilisation.
“Through Theatre Programme and GIRFT, we are focused on sharing best practice, reducing variation and improving productivity across the system. Ultimately, that means making the best use of our capacity to treat more patients.”
Dr Damien Carson, Dr Rachel Deyermond, Health Minister Mike Nesbitt, Lyn Bailie Pre-Assessment Manager for SE Trust.
Professor Taylor said: “The results at the Ulster Hospital demonstrate what can be achieved. Our focus is on learning from good practice, reducing unnecessary variation and spreading successful approaches across Northern Ireland.”
The work supports the Department’s Elective Care Framework and the Executive’s Programme for Government commitment to reduce waiting times.
Minister Nesbitt added: “We are making progress on waiting lists and must maintain that momentum. Investment must go hand in hand with reform and productivity. We need to identify what works, share it and scale it across the system. That is how we make the best use of our resources and get more patients treated sooner.”
During the visit, the Trust’s first robotic upper gastrointestinal (GI) surgical procedure was taking place. The Minister was able to see the procedure in progress and hear directly from the Surgical Team about what this technology means for patient care.
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