Vetted access to day case hand surgery.

This prospective study was undertaken in the day surgery unit of Monklands Hospital, Airdrie. The consultant hand surgeon screened all general practitioner referrals between September 1998 and July 2002, and suitable patients referred for minor hand procedures were listed directly on to the day-case waiting list without an initial review in outpatient department. The main end points in this study were accuracy of diagnosis, the appropriateness of surgical treatment plan, patient acceptability and the impact of direct listing on waiting times and attendance. There was agreement in clinical diagnosis in 92%, and the choice of treatment plan was judged to be appropriate in 96% cases. The overall patient acceptability was 90%. This one-visit system not only cuts down on the patients waiting time from initial referral up to surgery but also reduces the number of hospital visits for the patients.