This content has been automatically generated from the original PDF and some formatting may have been lost. Let us know if you find any major problems.
Text in this format is not official and should not be relied upon to extract citations or propose amendments. Please see the PDF for the official version of the document.
WQ.425/2021
WRITTEN QUESTION TO THE MINISTER FOR HEALTH AND SOCIAL SERVICES
BY SENATOR K.L. MOORE
QUESTION SUBMITTED ON MONDAY 25TH OCTOBER 2021
ANSWER TO BE TABLED ON MONDAY 1ST NOVEMBER 2021
Question
Will the Minister provide a breakdown of the number of staff (including by bank/permanent staff) available to work in the operating theatres at Jersey General Hospital for the week beginning 24th October 2021, and provide a comparison of the same week for each of the previous 4 years; and will he further provide the number of operations that have been cancelled each month of this year, with the reasons for the cancellation, along with the comparative figures for the previous 4 years?
Answer
Table 1 shows the number of individuals on the work schedule for theatres during October half-term week in each year. This has been collated from manual records as there was no system to capture these data in previous years.
It is not possible to determine from these manual records the skill mix /roles of the staff present e.g. registered nurses, operating department practitioners, theatre support staff and operating department practitioner students.
Table 1: Number of individuals on the work schedule for theatres during October half-term week in each year
| 2017 | 2018 | 2019 | 2020 | 2021 |
Individual Staff (Head count) on Work Schedule Theatre October Half-Term Week | 62 | 74 | 73 | 72 | 72 |
Manual records | Electronic records | ||||
The Association for Perioperative Practice, recognised as the industry expert, provides guidance for safe staffing level for operating theatres. Health and Community Services (HCS) abides by this guidance, which stipulates the minimum staffing ratio to run an operating theatre as 5 staff per theatre (including the recovery phase), with a blend of registered and theatre support staff. However, a higher level of staffing is required for those theatre sessions considered more technically complex and for sessions that are of a lower technical complexity, but with higher number of patients.
HCS operating theatres have seen an increase in throughput and an increase in technically complex procedures that were previously undertaken in the UK. The recent appointment of additional surgical consultants has facilitated these technically complex procedures to be undertaken on-island. Therefore, the operating department requires a higher level of theatre staffing on a daily basis than that of previous years.
Table 2 shows the number of cancelled procedures by year and month. Data are for main theatres and day surgery (excluding the endoscopy suite) and are reported to the end of the last complete month (September 2021).
Table 2: Cancelled procedures by year and month
Month 2017 2018 2019 2020 2021 Jan 38 19 34 21 17 Feb 28 19 16 23 30 Mar 37 22 30 15 27 Apr 36 22 24 17 33 May 26 32 27 8 19 Jun 35 22 16 12 25 Jul 24 18 24 26 23 Aug 22 31 16 15 20 Sep 29 34 20 18 43 Oct 26 27 20 25
Nov 24 23 37 15
Dec 23 32 25 17
Total 348 301 289 212 237
Data Source: Hospital Patient Administration System (TrakCare Report OPT0016A)
Table 3 shows a breakdown of reason for cancellation. The data are provided at annual level. Table 3: Cancelled procedures by reason for cancellation
2021 Reason for cancellation 2017 2018 2019 2020 (Jan – Sep) Day of surgery - Theatre staff or Hospital
Beds (incl Critical Care) not available 
15 
20 
14 
13 
13 Day of surgery - Patient not fasted 3 2 3 7 4
Day of surgery - Theatre unavailable (e.g.
Emergency case) or list overrunning or
Equipment Failure 52 44 47 40 30 Not Day of surgery - Theatre unavailable
(e.g. Emergency case) or list overrunning or
Equipment Failure 4 6 5 1 1
Not Day of surgery - Theatre staff or Hospital
Beds (incl Critical Care) not available 1 1 1 9 Patient Choice (declined procedure or opted
for alternative or elsewhere) 
30 
38 
30 
16 
23
Patient initiated – DNA (did not attend) 
12 
10 
11 
2 
7
Patient no longer requires procedure 
90 
70 
78 
56 
49
Patient unfit for surgery 
91 
76 
61 
40 
49
Administrative Cancellations* 
40 
32 
37 
33 
49
Reason not recorded 10 2 3 3 3
Total 348 301 289 212 237 Data Source: Hospital Patient Administration System (TrakCare Report OPT0016A)
*Administrative Cancellations are in-house movements within the electronic booking system – patients are unaffected and unaware of movement.
A Theatre Task and Finish Group is currently in progress. This work is primarily focusing on staffing, culture, efficiencies, quality & safety of patient care and clinical governance and risk management. Significant improvement has been seen within each of these areas, for example:
- the overall short-term sickness has not increased;
- targeted wellbeing support is in place for theatre staff;
- the pre-operative assessment team is ensuring patients are fully optimised and prepared for surgery; this team is also working more closely with the theatre bookings team to ensure that all specialist equipment and support staff are appropriately booked;
- the theatre bookings team is using surgeon-specific data to accurately book theatre lists to maximise the use of theatre time; and
- the introduction of the electronic staff roster more accurately matches the individual staff member's skills to those needed on a day to day basis.