Apr 09 - Government Says GHA Operating Theatre Figures “Reveal Massive Improvements”

Written by YGTV Team on 09 April 2014.

Figures released by the Gibraltar Health Authority show “very significant improvements” in operating theatre performance at the GHA, according to a statement from the Government.

The statement continues:

The number of cancelled operations due to bed shortages has dropped since last summer, with only two such cancellations in the usually difficult winter season, between October and February. This compares with a peak of 70 in 2011/12, when the former management was still in place and the policies of the previous administration lingered. The average cancellations in these months this last winter were 0.4 per month, compared with averages of 9, 14 and 7 per month in the previous three winters.

Also significant is the drop in the number of patients waiting for surgery. Comparing April 2012 with March 2013 and March 2104, the total number of patients waiting was 986, 1030 and 626 respectively. This is equivalent to a reduction by about a third in the past year. If those patients already booked for surgery are removed from the list, the total drops even further, to 467. Waiting times have reduced also in general, with plastic surgery waiting time, which has traditionally been many years long, dropping to an average of 36 months.

Almost all waiting lists are falling. There was an initial overall increase in the first year of this administration, as increases in clinics identified more patients and so inflated the list, but as work continued, the lists began to fall. The one presenting the greatest challenge is orthopaedics, where the number of patients waiting has shown a small increase. This can be attributed to the departure of one surgeon and difficulties in recruitment. The post will be filled next week. Initially, the outpatient waiting list will be tackled so that, as more patients are seen and therefore diagnosed, the number awaiting surgery will show an increase. However, when the third surgeon begins his operating list, this should also decrease. By contrast, in both minor operations and ophthalmology, weekend initiatives and the recruitment of a second ophthalmologist have all but eliminated the lists.

The improvements are due to a number of factors, including more proactive management of lists and beds, and more engagement by clinicians in the direction and development of theatre activity.

Two practical actions have also had a direct effect. One is the opening of a third theatre, which had gone unused and had not been fully equipped since the opening of the hospital. Bringing it into service in early 2013 has meant that elective surgery does not need to be cancelled during emergencies or when there is additional theatre activity by visiting Consultants.

The other major factor has been the opening of a fully-fledged Day Surgery Unit. Not only does this provide excellent patient care, but its use has meant also that surgery has continued even when St Bernard’s wards have been almost full during the winter. Day Surgery now accounts for 81.5% of all surgery, compared to just 33% in January 2013. This is well above the UK average of 70%.

In addition cooperation with the Care Agency has also assisted in releasing bed space.

In other areas, the Physiotherapy outpatients’ waiting list, which had been criticised earlier in the year for having grown, has also dropped drastically. The Minister for Health explained in Parliament that this had been due to difficulties in replacing staff but that this problem had been resolved. He predicted the situation would quickly improve. This has been the case. As the following table shows, waiting time and numbers waiting are now greatly reduced:

Physiotherapy Out-patient waiting list

Minister for Health, Dr John Cortes stated, “I am extremely grateful to and proud of all the professionals, nursing, medical and administrative, for the tremendous work they are doing to improve performance in surgery and bed management. We have improved performance in many areas, reduced waiting lists and improved the quality of patient care. There are still challenges and areas where we need to make a lot more progress, but we are on the task and well up to the challenge. There are many more improvements to come”

The Chief Minister, Fabian Picardo, said: "John Cortes and every single employee of the GHA deserve congratulations from the public for the excellent work they have done and are doing. These results speak for themselves and reveal a very human reality, that patients are not suffering the stress and angst of cancellations as they did before. John's bed management and day surgery policies and our work across government, including the dedicated work of Samantha Sacramento in Social Services providing home care and more elderly care beds, is delivering a real step change in the quality of care afforded to members of our community by the GHA. My sincere congratulations from the whole of Gibraltar to each and every member of the GHA."