Nurse, Doctor, Surgeon Hospital Staff

A recent report suggested that almost 300,000 extra operations could be carried out in England if surgeons planned their holidays in advance. Yorkshire Knee Clinic’s Jim Newman agrees.

Ideally, your local NHS hospital should be able to run operating theatres 52 weeks a year. That it can’t is down to several factors – not least that there simply aren’t enough staff to run at that level, and because surgeons, anaesthetists, nurses and the entire surgical team are all entitled to time off.

But that doesn’t mean things can’t be improved, as a report by Royal College of Surgeons reported in The Telegraph pointed out recently. The chief bone of contention was that “too often surgery lists are planned without knowing if there are sufficient staff on duty to carry out the work.” That uncertainty can lead to delays, last minute cancellations and an undignified hokey cokey of bed, staff and equipment booking changes. It’s not good for patients. It’s not good for the NHS. And the report estimates the time wasted could have been used for 291,237 more operations, a 17% increase in efficiency.



One of the recommendations is that NHS trusts urgently adopt what’s known as the 6-4-2 rule, which requires surgical staff to agree leave six weeks in advance, have surgical lists approved four weeks in advance and review the list and surgical staff availability two weeks in advance. As Head of Clinical Service for Trauma and Orthopaedics at the Mid Yorkshire NHS Trust, I can say with confidence that we’ve been doing this for some time and that all our op lists are planned with meticulous diligence. As a result, we’re seeing impressive results in our theatre utilisation.

A year ago we discussed this at WYAAT, a forum of West Yorkshire health trusts, and I believe 6-4-2 is now being taken forward by all of them, which should give us even greater potential to pool some resources when necessary.


Essential Planning

It’s easy to roll your eyes at change in the NHS, but a hundred changes small and large can add up to a major effect. There’s nothing insignificant about the potential to perform more operations, so the RCS was right to raise the issue. It’s right that we implement 6-4-2. And it’s right that we keep looking for more ways to improve.


If you would like to know more about knee replacement surgery, contact Jim Newman now.

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James Newman

James Newman

Consultant Knee Surgeon at the Yorkshire Knee Clinic

“Mr Newman? He’s a genius in my eyes.”

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