To ask anyone in the NHS how day surgery lists are determined?

It's really not clear by 2pm! Our afternoon session starts at 2. Theatres run for elective surgery until 6pm.

What is it you're having done?

Is it an all day list or a separate morning and afternoon day? Is there a particular surgical reason you’ll be fasted that long (that’s not standard ‘anaesthetic fasting’…6 hours for food, 2 hrs for clear fluids). If you were later in the session then it would be normally to carry on drinking at least once the list order has been agreed. Unfortunately someone has to go last, but quite often we don’t know who that’ll be until everyone’s in on the day.

Course not. But it happens. People can be left nil by mouth all day to have their ops cancelled at four. And then for it to happen again and again. It’s awful. It happened to my cousin. But just be aware it may be the case.

Please don't do this! Why would you leave? Do you understand the amount of work that goes into booking these lists? The amount of money wasted when people don't turn up/can't be arsed to wait?

If there are good reasons, you can always ask and they may consider your position on the list. I asked when I had day surgery a few years ago. I was still breastfeeding my four month old and our house move had fallen on the same day as my surgery. They very kindly put me first on the list, but of course this may not have been possible if there had been other patients to consider clinically.

The one time I had an operation on the NHS I was at the bottom of the list because I was the youngest. I was there at 7am and I think I was seen at midday.

I had a colonoscopy on the NHS late last year and was able to pick my slot, so I picked the first slot at 8.30 and I was finished by about 10.30.

Clinical need usually. Occasionally surgeon preference. Clinical need meaning generally those least able to wait. Patients who may become unstable while fasting, those who may have acute distress waiting e.g. learning disabilities. Emergencies can come along any time and take the next theatre slot, even if that theatre was being used for day case. Some surgeons prefer their shorter cases first so they don't have people waiting while the handle longer cases, or vice versa prefer to get complex ones finished first. Lots of specialities do complex and day cases on the same day. E.g. an ENT surgeon may have many minor surgeries and also a concern resection scheduled the same day.

I think the surgeon can switch it around if they want to - I was once slated first on list for an 8 hr operation, and the surgeon came to me and said they'd switched me with the lady who was supposed to be after me as hers was only an hour and it was mad for her to wait all that time. Seemed entirely reasonable to me but whatever person/software had planned it originally obviously thought the opposite!

I had day surgery recently and was first on the list (phoned the day before due to a cancellation) but it turned out that I was the only person on the list! For some reason everyone else booked for that date (start of half term) cancelled. My surgeon was both delighted to have an easy day (finished by 10am) and appalled at the number who cancelled at short notice.

I was on a day surgery ward and they had no facility to admit overnight so I guess that would make a difference? Like, giving some people longer to recover to the point of being discharged if it is a more involved surgery?

I have surgery on my ears regularly and I’m always last/nearly last on the list.

It’s a very simple/basic procedure (one surgeon told me it’s one of the first operations they do when learning) and I have no additional needs so it makes sense to put me last.

It’s better to manage complex cases first thing. If they require emergency intervention or input from other professionals, scans etc it’s much better to get it sorted before 1700 when the routine workforce goes home. The after hours staff are much fewer in number. It makes sense from a clinical safety perspective.

It would be foolish to leave early. It will be a wasted slot, and it’s not really fair to anyone to cancel on the day.

I’ve worked in several hospitals / departments. It really depends on so many factors that it’s difficult to say. Factors include additional needs, age, transport needs, complexity (or simplicity) of surgery. Sometimes the easy cases go first so the surgeon can overrun on the more complicated cases. Sometimes it’s the other way around (and the simple cases might get cancelled if they run out of time). If people have previously been cancelled, they may be prioritised over similar cases that haven’t been cancelled before etc. You could always phone the secretary and ask, but it’s often not a given until the day anyway.

Just had surgery and I was last, for a gallbladder removal, other than the stone, I’m fit and healthy no medical issues and assumed a simple one for them.

I have not had day surgery but have had endo and colonoscopies. I am ‘simple’ so always at the end after people with diabetes and heart problems. I try and be grateful for that!!

As above diabetic or complex patients will generally go 1st as if they overrun the rest will be cancelled.
Also patients that need enhanced recovery will be prioritised
A nice simple case will be easier to reschedule and or transfer to another list if needed.

DD (age 8) was having a complex surgery and went down first. All other day surgeries were cancelled that day as they were over run with pneumonia cases on the ward.

DS (age 2) routine surgery and didn’t go down until about 4pm in the end.

Not the same day or list obviously.

It depends on many factors as pp have stated, for example orthopedics they would generally do a hip replacement on a younger fitter patient to get them out the wirhin a day or 2. An older , more complex patient would be later as would likely need at least a 3 night stay. Hope all goes well OP

When I had surgery I was told I would be last due to my surname - then ended up being one of the first. Turned out it was more complicate than they expected so I guess someone had an inkling it might be and put me earlier.

I’ve always been ‘first on the list’ as I have an allergy to latex. I assume they completely ‘de-latex’ the room for me and get rid of me early, so that ‘normal service’ can resume afterwards.