Data-driven study provides evidence that day case sinus surgery is safe

New research led by the Getting It Right First Time (GIRFT) team has supported the safety of performing endoscopic sinus surgery (ESS) as a day case for most patients.

As the NHS works to recover from the peaks of the Covid-19 pandemic, it is widely recognised that increasing the range and number of operations which can safely be carried out without the need to admit patients to hospital is a key tool in reducing the waiting list backlog.

The new study – Safety of day-case endoscopic sinus surgery in England, published in Clinical Otolaryngology – aimed to demonstrate the safety of day case ESS, an operation on the sinuses which uses small telescopes (endoscopes) to improve drainage and ventilation and therefore prevent infections.

Data for more than 49,000 NHS patients who had ESS in a hospital in England between 2014 and 2019 was examined; in the same period, day case rates for ESS increased from 64% to 79%. The study found that patients operated on as a day case were slightly less likely to be readmitted to hospital as an emergency within 30 days of their surgery. There was also little difference in the 30-day readmission rate between trusts carrying out more than 80% of cases as day surgery, compared with those carrying out less than 50%.

The study contributes to the evidence base on the safety of ESS, supporting GIRFT’s elective recovery work to drive high-volume low complexity (HVLC) surgery as day case in the ENT specialty, to help reduce the backlog.

ENT is one of six high-volume specialties in focus as part of GIRFT’s HVLC work – the others are orthopaedics and spinal surgery, urology, general surgery, ophthalmology and gynaecology. The HVLC programme works with trusts and integrated care systems (ICS) to agree standardised pathways and adopt best practice, as well as pooling pool capacity and resources, to deliver excellent clinical outcomes and equity of access to care for their population.

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