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

[ScuderiaSedici]

As above

And now I’ve RTFT…. You sound like you should go private!!

is this a rage bait thread??? Even the “healthiest” individuals can have complications! I went in for a routine D&C to a day hospital when I had a miscarriage, ended up blue lighted to the big city trauma hospital!! So no it doesn’t matter if you’re “healthy” or not! Patient safety is priority!

also you do realise you can literally get to the anaesthetic room and your op get cancelled? For whatever reason ? Had that happen too!

be grateful you have the nhs to DO your op in the first place and having one day where you can’t eat what you want when you want isn’t the end of the world! The nhs is not perfect but we are lucky to have it and despite your anxiety your attitude stinks! I hope you treat the staff better!!

if you want to be in control of every step of the way and be first or second because you think you deserve to be because “you’re paying for it”
go private 🙄

That’s not necessarily the case.

I work in patient safety. There are many reasons for the order of a theatre list. As people have said, children, people with co-morbidities that may be impacted by fasting or anaesthetic will go early on the list. For daycase procedures, the ones which the surgeon thinks will recover quickest will go near the end of the list, giving the more complex or poorly/frail people more time to be monitored before discharge.

You can usually sip water up until you go to theatre - if you're worried about 'starving' then check your admission info but it may be possible to have some toast or porridge late this evening.

Some surgeons prefer to get complex patients out the way first, some prefer to do the simple cases first. The best advice is not to get all stressed out about it, it won't change anything. When you are admitted and speak to the consultant and anaesthetist in the morning before the list starts you can ask then about your likely position on the list. Please don't walk out as then that is a wasted appointment that someone else may have been desperate for.

I hope you get some good rest tonight and the procedure goes well.

I also got listed for a C section after a failed induction, was nil by mouth all day and kept getting bumped down the list but fully understandable as they must have been getting more urgent cases in, at 7pm they put me on a drip for fluids due to fasting but then cancelled me fully at 9pm, next morning waited from 7am again to go down and went down at 2pm, the year after when I had another section I arrived and was told I was 2nd but the woman before me hadn’t fasted correctly so I was moved to 1st and went down before I had even unpacked my stuff

Iv never been to a hospital where its been mixed.

Lots of hospitals mix and match a bit.

There is no guarantee you will be left waiting until 6pm, please don't go into things so riled up.

Fasting for 1 day will not cause you ongoing harm unless you are diabetic etc which you've not said you are.

Often simple daycases will go first in my trust but it is total pot luck as to who else is booked onto your list. If there are cancer cases then they will take priority as if theatre overran and they got cancelled, there is more of a threat to their health.

It absolutely isn't ideal to be waiting all day in a day surgery unit but it isn't staff not doing their jobs. It is exactly the same in private hospitals. There is a balance between patient comfort and theatre efficiency and having patients come in at multiple staggered start times has been proven to reduce theatre efficiency meaning less people get their surgeries. Its all a balancing act.

This has got to be a windup, right?

I went in at 8am and was the second from past one called in the end (around 5pm from what I can remember). I was getting quite.ancious by then and the nurses gave me a preop sedative that helped a bit.

It was annoying but why not me? Someone has to be last don't they?

I was grateful to all the hardworking staff that gave me a successful op. Not focusing on what time I went down. Being hungry for a day is a minor inconvenience, sorry but you sound awful.

Unless this is misdirected nerves about the op, in which case you're going to be fine, and chances are you will be seen in the morning if that's what they've said.

You'll just be told ''bully for you'' as I was when I explained that my 9 year old had to stop eating 2 days before his last bowel surgery and couldn't eat until 2 days afterwards.

He had a stoma reversal and even when he could eat, it was plain food only and tiny bites for the first few days. It was such a gruelling process, especially for a child but as you said, sometimes it's just what has to be done.

Also any one with allergies like latex etc is also done earlier

When I had my hysterectomy (laparoscopic robotic surgery) I was first on the list.

Went down at 8.30am and left hospital at 8pm.

Im not sure what patients they had after me but this was a gynae surgeon and my operation although major was quite “simple” iyswim?

Nobody has said you will be last. You might be First. But it’s best to go prepared knowing there may be delays.

You seem quite rigid, are you always like this? If I had an operation the next day I would be eating my food at the last minute possible!

You sound quite over the top anxious and irrational. Have you got anybody in real life you can talk to?

How does that work because paediatricians wont treat adults and the equipment used on children is about a third of the size. Iv never heard of this in any trust iv had surgery in.

It is like this in the hospital I work in, not on every list but in orthopaedics, ENT and urology it often happens. The surgeons are trained in both adults and paediatrics and they have equipment they can use on all ages in the theatre complex. The adults are booked onto the afternoon list though so come in at 12pm for admission.

I tend to organise my lists to have two routine cases inbthe morning and a complex one in the afternoon.

Very hard to cancel the list at 1pm if the morning overruns a bit, if you flip it and do the long case first, and it overruns, they'll often cancel a short case from the end.

It doesn't make me popular, but it gets more cases done.

You have no idea that you're going to be sitting until 6pm. Have you called the day surgery unit to clarify if they have separate morning and afternoon lists and what is the latest time you will get your op? If they confirm it's one list for the whole day then delay dinner the day before or have supper. You are deliberately making thing more uncomfortable for yourself.

I had an op recently. Afternoon list, so had to arrive by 12 noon. I was towards the end of the list because my op was longer than most others. However, another lady when being booked in, decided that she wasn't going to have her operation that day, so I moved up a slot. Still didn't go to theatre until 4pm. I think the gentleman going to theatre after me was an emergency so I was lucky he arrived later. Everyone involved with my care seemed to be doing the best they could to make it as pleasant as possible. I had to go to A&E recently and definitely saw a doctor quicker than expected because he thought, from looking at my notes, that I was an easy case and probably wouldn't need further tests. I trust the experts to make the best decisions for the maximum number.

so then you do the smart thing and wait for your turn, not throw a childish strop.

Are you really of the mindset that our NHS workforce are there solely to service your petulance?

Seriously, @ScuderiaSedici give your head a wobble!

eta; or go private 😂

OK iv never had any of them sort of surgeries so must be different plus I was in a seperate children's hospital until I was 16. Mine have always been cardiac, brain and vascular and been completely seperate everywhere iv been

But you’re just assuming they are.

You’re having a hissy fit over a made up situation you e decided that’s going to happen that you have no evidence is going to happen.

I get you’re anxious. Everyone is anxious before surgery. But being anxious and being rude aren’t the same thing. You’re tipping into the latter.

If youre simple you might well end up being the 'golden patient' that goes first (Google it) as theres a lot to be said for how the list starts off.

But that said, with your attitude I really hope that everyone else who is nicer, politer, and less of an arse gets to go way before you. Perhaps you can have a think about who you are as a person whilst you're sat there.

Some children’s surgeries will be done by specific paediatric surgeons, but depending on the procedure some might be operated on by ENT surgeons, general surgeons, urologists etc who will be treating patients of all different ages.

you don't need paediatricians in theatre. Some surgeons/anaesthetists do subspecialise in super-snazzy paed surgery and do most of their work on kids (tend to be in the tertiary centres that do the superspecialist stuff). Most surgeons/anaesthetists will be perfectly happy doing some operations on kids, perhaps with different age limits depending on the procedure and the child (and certainly for anaesthetists, we have to be comfortable anaesthetising kids because if they come in in a heap and need emergency intubation for whatever reason we have to be able to look after them - if a hospital takes acute paediatric admissions then theatres needs to be able to deal with all acute paed theatre emergencies at least for stabilisation and retrieval). All theatre areas will have an appropriate stock of kit for the patients they routinely look after, including paediatric stuff.

Most often a DGH type hospital will try and cohort kids having elective surgery onto specific lists so that it's only children, but occasionally it doesn't work like that. Probably the commonest thing that might cause a child to be on an adult ENT list (using this example as it's the OP's list) would be to retrieve a foreign body from a nose or ear or maybe stick in a grommet. In other areas it might be removing a k-wire from a broken bone on an otherwise adult elective ortho list. Kids turn up on emergency lists with appedicitis/testicular torsion/broken bones... all sorts. The recovery area has to have a dedicated paeds space that can be shut off from the grown-ups, and there has to be a paed bedspace and nursing staff for them to go back to, but that's not often a problem.

I am definitely rooting less for you OP to be early on the list, than I was when I started this thread. Sorry.

Not read all the replies...but it's so variable. Clinical reasons (eg diabetes or clinical urgency) first, previously cancelled on the day by the hospital are usually next. Often it can depend on the bed situation on the day too. So if beds are tight, minor, quick turnaround surgeries will go first to enable more of the list to proceed. Plus skill mix needed and anaesthetic input. Things like anxiety and LD are taken into consideration but can't be guaranteed. Mrsa positive but clinical needed, last.

My son was treated at a children's hospital too, though it is attached to the main hospital but all paeds surgeries including ortho, urology etc would be done in the children's part with paeds surgeons.

I think complex cases with children tend to be at a specific children's hospital which sounds like you were and it was the case with my son. At one point, he was under 10+ specialities. Now it is thankfully not quite as many!