The effects of cuts in services on the work of a surgical unit in a district general hospital.

A reduction of the total scheduled operating time from 12 to 6.5 sessions/week available to a general surgical firm in a district general hospital resulted in 31% fewer admissions and 33% fewer operations on scheduled lists. Our data has confirmed that the brunt of these cuts were borne by patients awaiting routine surgery (the only category of admission which the surgical team can control). Routine operations performed were 54% fewer after the cuts compared with normal working. We estimate that this resulted in an increase of 89 patients awaiting routine surgery in 1 month. The number of emergency operations which we were able to perform on scheduled lists was reduced from 15/month before the cuts to 7/month after the cuts. Our results also illustrate the value of having a separate community hospital where routine surgery can be performed.