275 The Declining Elective Workload of a Consultant Surgeon

Abstract

Abstract Aim The elective workload of a consultant surgeon has changed considerably over time. We aimed to describe these changes and explore possible reasons behind them. Method All elective procedures performed by a single consultant vascular and general surgeon at a district general hospital were identified for the years 2000 and 2019. Cases were classified by complexity (major, moderate or minor) and specialty (general, vascular, colorectal, upper GI, plastics, endocrine, breast, urology or other). Results In 2000 there were 41 full and 50 half day theatre lists compared to 24 full and 47 half day lists in 2019. The total number of procedures fell by 39.25% (400 in 2000 versus 243 in 2019). The mean number of procedures per full and half day list was 5.46 and 3.50 in 2000 compared to 4.67 and 2.80 in 2019. There were 51 major (12.75%), 189 moderate (47.25%) and 160 minor (40%) procedures compared to 8 major (3.29%), 99 moderate (40.74%) and 137 minor (56.37%) in 2019. Most cases were general or vascular (82.5% in 2000, 97.53% in 2019) but the breadth was greater in 2000 (9 versus 4 specialties). Conclusions The number of lists, total procedures performed and mean cases per list are lower despite increasing demand. The breadth and complexity of cases has also decreased. The reasons for this are likely multi-factorial but may include the use of varying anaesthetic and scrub teams, the introduction of checklists, changes to consent procedures, centralisation of services, the presence of a trainee in theatre and changes to specialty training.