Analysis of a year's general surgical activity in a District General Hospital.

The activity of the surgical unit of a District General Hospital was analysed over a one-year period. The numbers of outpatients seen, admissions, operations performed, and operative workload were all higher, in terms of the available surgical personnel, than those expected of a unit of this size. Thirty-five per cent of admissions were emergencies but these occupied 58 per cent of bed days. Nonetheless, three-quarters of admitted patients were discharged within five days. Three-quarters of operations were Minor or Intermediate, one-quarter were Major or more complex. Consultants performed/supervised 48 per cent of operations. 42.5 per cent were performed by unsupervised trainees and 9.4 per cent by clinical assistants. Solo trainees performed the majority of emergency operations (73.7 per cent). With regard to operative activity, the Service Equivalent Value of consultants and trainees approximated to expectations, but clinical assistants contributed more than expected.