Groundbreaking F1-inspired initiative which could help ailing NHS hospitals clear record waiting lists this winter

An NHS hospital is carrying out a week's worth of operations in one day by using an F1-inspired approach to blast through waiting lists.

Guy's and St Thomas' NHS Foundation Trust in London runs monthly High Intensity Theater (HIT) sessions at weekends.

It involves running two operating rooms in parallel, so that as soon as one procedure is completed, the next patient is already under anesthesia and being wheeled in.

The consultant behind the initiative said it essentially turns the operating room into a Formula 1 pit stop, with 'one person doing the right rear wheel, and one person doing the left front wheel'.

It is hoped the approach can be rolled out nationally to reduce England's record backlog of 7.8 million.

Guy's and St Thomas' NHS Foundation Trust in London runs monthly High Intensity Theater (HIT) sessions at weekends. In the photo: Sint-Thomas Hospital

Official figures also show that waiting lists for routine NHS procedures have also risen to a new record, with around 6.5 million patients in England waiting for 7.77 million appointments and procedures in England

Nurses are also on hand during the approach, and they can clear the operating room in less than two minutes.

During the latest HIT session, which took place on Saturday, medics cleared a third of the hospital's gynecological oncology waiting list.

Two teams of theater staff – six surgeons, four anesthetists and eighteen nurses – performed 21 operations on twenty patients by lunchtime, compared to the usual six that would be completed over the course of a full day.

Rather than rushing or taking shortcuts, physicians are simply “efficient.”

After one patient's surgery is completed, the second is brought in already sedated, said Kariem El-Boghdadly, the anesthesiologist who led the plan.

As a result, doctors have to go through two to three times more procedures than normal.

What do the latest NHS performance figures show?

The total waiting list grew by more than 20,000 to 7.77 million in September. This is an increase from the 7.75 million in August.

There were 227 people wait more than two years to start treatment in late September, compared to 265 in August.

The number of people waiting over a year 391,122 people requiring hospital treatment was slightly lower than the 396,643 in the previous month.

About 44,655 people had to wait more than 12 hours in emergency departments in England in October. This figure is up from 33,107 in September.

A total of 144,926 people waited at least four hours of admission decision in October, up from 125,829 in September.

Only 70.2 percent of patients were seen within four hours at A&Es last month. NHS standards require 95 percent to be admitted, transferred or discharged within four hours.

In October, the average Category one response time – calls from people with life-threatening illnesses or injuries – lasted 8 minutes and 40 seconds. The target time is seven minutes.

It took an average of 41 minutes and 40 seconds for ambulances to respond category two callssuch as burns, epilepsy and strokes. This is more than twice as long as the target of 18 minutes.

Response times for category three calls – such as late stages of labour, non-severe burns and diabetes – on average 2 hours, 31 minutes and 5 seconds. Nine out of ten ambulances should arrive to these calls within two hours.

The patients who have cancer are diagnosed earlier than they otherwise would have been, which could allow them to access treatment more quickly. Every four weeks of delay in the diagnosis and treatment of cancer increases the chance that a patient will die by 10 percent.

The HIT program has also allowed St. Thomas plastic surgeons to operate on three months of breast cancer patients in five days.

In addition, eight prostate cancer patients underwent robot-assisted prostatectomy – a procedure to remove the prostate gland – in just one day. Medics said this was equivalent to a week's worth of procedures.

Other successes include twelve knee replacements a day, compared to the three or four a day in a typical NHS theatre.

Surgical teams even finish early because the model is so efficient.

Dr. Kariem El-Boghdadly told it The times that it was related to motor racing.

'There's one person doing the right rear wheel, and one person doing the left front wheel. It is the same. The operating room is basically like that,” he said.

The lead surgeon “bounces from one theater to another and does the critical phase of the operation,” while more junior surgeons assist, Dr. El-Boghdadly said.

'We are eliminating any downtime. “We avoid having a patient undergoing surgery in the operating room,” he added.

Gautam Mehra, the gynecological oncologist, told the newspaper: “It is very satisfying. You can do a lot in a short time without wasting time.

'The productivity is really great. The patients are satisfied and a lot of planning is being done to remove the stress. It goes quite smoothly on the day, without endangering the safety of the patient.'

Imran Ahmad, an anesthetist who developed the approach with Dr El-Boghdadly, believes the model would dramatically reduce the NHS backlog if rolled out nationally.

“Every time we create one of these HIT lists, I'm amazed at how efficient it is,” he said.

The Times reports that Dr Ahmad has discussed the approach with both NHS England and the Department of Health.

The NHS waiting list reached a record 7.8 million in September, an increase of 630,000 compared to September 2022.

By comparison, around 4.4 million people were stuck in the system when the pandemic reached Britain.

Of those waiting, often painfully, nearly 400,000 have waited at least a year, while more than 200 have been queuing for more than two years.

The NHS has been ordered to eliminate all waiting times over a year by March 2025.

The NHS was told to scrap two-year waiting times by July 2022, except for patients who do chose to wait longer, did not want to travel to be seen more quickly, or for very complex cases requiring specialist treatment.

Rishi Sunak made reducing waiting lists one of his priorities for 2023, promising in January that 'waiting lists will fall and people will get the care they need more quickly'.

However, he claimed that healthcare strikes made the task “more challenging.”

More than a million appointments have been canceled since the strikes began last December.

But officials said the real impact of strikes is much greater because many hospitals avoid surgeries before strike dates.

And junior doctors will again participate in the picket lines for 72 hours starting December 20 at 7 a.m. They will go on strike for a record six days on January 3 at 7am.

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