Nottingham Hospitals Reduce Orthopaedic Waiting Times with Dual Operating Technique

Hospitals in Nottingham have seen a reduction in waiting times for orthopaedic patients, attributed to the implementation of a novel surgical method. The elective orthopaedic team at Nottingham University Hospitals NHS Trust (NUH) has been piloting a “dual operating technique,” enabling a single surgeon to perform as many as 10 hip or knee replacements daily, a significant increase from the previous five procedures per single theatre list. This method involves the simultaneous preparation of two operating theatres for a sole surgeon, who is supported by a senior fellow and an arthroplasty care practitioner. Additionally, two anaesthetists and two distinct anaesthetic and surgical teams are involved in the process. According to the trust, waiting periods for these specific procedures were nearly double what they are now at this point last year. Currently, the majority of these operations are completed within a timeframe shorter than the 65-week target established by the NHS. The “dual operating technique” was introduced at NUH by orthopaedic consultant Benjamin Bloch. Benjamin Bloch stated, “We have four orthopaedic theatres at [Nottingham] City Hospital, and normally all of these are occupied, but sometimes you have a surgeon who’s on annual leave or sick, and you risk having an empty theatre, cancelling elective surgeries and ultimately an unutilised resource.” He further explained, “Previously you would have just lost the use of that theatre, and the surgeries planned for the day.” Bloch added, “By one surgeon completing two lists, we are maximising capacity in a safe manner and not having to cancel any operations.” Lauren Draper, the elective orthopaedic speciality general manager, commented that dual operating has been “reducing costs, avoiding unnecessary clinic closures and minimising impact on the outpatient backlog.” Draper stated, “We were able to meet the NHS England mandate of having no patients waiting longer than 65 weeks at the end of September, compared to where we were last year, with patients waiting almost double this time.” She continued, “The next mandate is having no patients waiting more than 52 weeks by the end of March next year, and we are on track to meet that as long as we retain our theatre capacity.”