Varadkar welcomes report saying surgical patients could go home on same day

More patients undergoing surgery should be sent home from hospital on the same day the procedure is carried out, according to a new report welcomed by Minister for Health Leo Varadkar.

The Comptroller & Auditor General’s (C&AG) study recommends that day surgery should be the default option for many common elective treatments unless there is a valid reason for an overnight hospital stay.

Mr Varadkar said the move should lead to long-term savings. “Making day surgery the default option for more surgical procedures should increase the number of procedures being carried out and benefit patients by helping to reduce waiting lists,” he said.

The report, entitled Managing Elective Day Surgery, states that leaving hospital on the same day should be the alternative to overnight stays for patients wherever appropriate. Valid reasons for overnight hospital stays include underlying medical conditions. "The C&AG report highlights the importance of treating patients in the appropriate setting," Mr Varadkar said.

According to the report, the potential benefits of patients returning home on the day treatment is carried out include enabling patients to recover in their own environment. The risk of hospital-acquired infection is reduced, while the pressure on waiting lists should ease due to “improved throughput of cases”.

The cost to hospitals is also reduced if the number of day surgeries increases. The HSE has estimated that day cases are on average 60 per cent less costly to perform than inpatient cases.

In 2006, the HSE identified 24 procedures suitable for day surgery and recorded the proportion that were actually carried out as day cases. Since then, the overall day surgery rate for all hospitals has increased from 57 per cent in 2006 to 74 per cent in 2012. However, there was a significant variation in performance rates between hospitals, with rates ranging from 50 per cent to 92 per cent in 2012.

Clinicians will continue to determine whether inpatient or day surgery is appropriate for an individual case. The report advocates hospitals putting in place locally agreed protocols and checklists, setting out clearly the criteria for use by clinicians when assessing patient suitability for day surgery.

Surgeries assessed as suitable for day surgery include excision of breast lumps and gallbladder removal. Tonsillectomy and haemorroid removal are also included, as are bunion operations. Repair of inguinal hernia can also be performed as a day surgery.

The report also recommends that separate targets should be set for each surgical procedure, with targets for performance being based on the current performance achieved by top-performing hospitals.