HIGH levels of demand over the winter period left many non-surgical patients being cared for in surgical beds.

As a result, patients waiting for routine surgery such as gallbladder removals, breast surgery, prostate operations, and hip and knee replacements had their operations postponed.

Surgical director Duncan Murray said: “We do everything we possibly can to avoid cancelling operations but if faced on any given day with ten available post operative surgical beds and 15 patients are booked for non-emergency surgery, we have no option but to postpone some operations. In this situation, we try our very best to choose patients for whom postponement of their surgery will have the least impact.

“We are acutely aware of the impact this has on those patients - with the emotional and psychological energy that goes into preparing yourself for an operation on top of practical considerations that are taken into account, to be cancelled at short notice is highly undesirable.

“To avoid facing the same difficulties in future we needed to make a plan: the discussion went ‘can we afford to do this?’ and the answer was ‘we can’t afford not to’. The benefits for us as an organisation and for patients were such we just couldn’t carry on as we were.”

The way the wards were designed had led to beds for plastic surgery and orthopaedic patients being “slightly over-catered” for. With some re-jigging of the model on how those two groups of patients are looked after, the hospital has been able to free up surgical ward capacity to give to medical patients.

Dr Murray said: “While what we’ve given up is greater than the spare capacity we had, we have created a new short stay surgical unit which will be mainly for patients having planned surgery - those people expecting to come in for short admissions such as overnight stays, or maybe two or three nights at the most.”

He said the new unit and additional medical beds will mean less disruption and give greater certainty to patients having surgery.

“The main benefit for our surgical patients is the predictability of having their operations when planned,” he said.

“There will be benefits for patients having more urgent surgery, whose inpatient stays can sometimes be prolonged through pressure on availability of surgical beds. For example, instead of a patient requiring plastic surgery for a hand injury spending eight hours in hospital waiting around in a dayroom on a ward, they will be able to come in in a much more planned, predictable way to have their surgery, spend the night in hospital and then go home the next day.

"Minimising the length of their stay in hospital has clear benefits for patients as well as the organisation.”

Over the winter period close to a thousand patients were cared for in escalation areas with several ward moves involved being part of their stay in hospital.

Dr Murray said: “The reconfigurations will significantly diminish, if not completely eradicate, the number of patients being nursed in inappropriate environments, areas which are not specifically designed and set up for inpatient care that get used because we are trying to provide as much care as we can to people who need it.”

Between now and Christmas, Dr Murray says there may be times when operations are again postponed for patients.

“For part of the interim period we will be in a slightly worse position then we are in right now so we are having to make pragmatic plans to manage what will be a short-term decrease in capacity to reach the long-term goal of a much better position.”