363 High-Intensity Theatre Utilisation in the NHS: A Retrospective Evaluation of Operational Efficiency and Clinical Outcomes

Abstract Aim To evaluate whether high-intensity theatre lists (HITLs) at a high-volume district general hospital (DGH) improve surgical throughput and efficiency while maintaining patient safety and reducing elective surgery waiting times. Method A retrospective review was conducted on HITLs led by two consultant upper gastrointestinal surgeons over nine months at a single NHS DGH, using a dedicated theatre team. HITLs included mainly high-volume, low-complexity procedures such as laparoscopic cholecystectomy (LC) and abdominal wall hernia repairs. Data collected included demographics, ASA classification, BMI, 30-day morbidity, length of stay (LOS), and readmission rates. Results A total of 295 procedures were performed, averaging 9 cases per HITL. Procedures included 178 LCs (60%), 107 hernia repairs (36%), and 10 others. Most patients (85%) were ASA I–II with a mean BMI of 29. Same-day discharge was achieved in 91% (n=269), with a 30-day readmission rate of 6.4% (n=19). For LCs, the same-day discharge rate was 92% (n=163) with an 8.4% readmission rate (n=15); with Clavien-Dindo (CD) grade I–II (n=13) and CD IV (n=2). For hernia repairs same day discharge achieved in 90% (n=94) with a 2.9% readmission rate (n=3); with CD 1 (n=2) and CD 3 (n=1). Conclusions HITLs significantly improve surgical productivity and theatre use without compromising outcomes. The 92% same-day discharge rate for LC exceeds both British Association of Day Surgery (BADS)/GIRFT target (75%) and national average (65%). With appropriate patient selection and staffing, HITLs offer a safe and efficient approach for reducing elective surgery backlogs. Successful implementation requires effective workforce planning and clinical governance.