An emergency daytime theatre list: utilisation and impact on clinical practice.

A prospective study of all weekday emergency surgery performed in a district general hospital over an 18-month period was undertaken to assess the impact of a fully staffed, daytime operating theatre for emergency surgery on night-time operating and on consultant supervision of trainees. In the 12 months following the introduction of the emergency list there was a 46% reduction in the number of general surgical operations performed after midnight compared with the preceding 6 months. Despite the increase in daytime operating the degree of consultant participation was unchanged, with the majority of emergency procedures being performed by unsupervised junior surgeons and anaesthetists. Although the emergency theatre was available to all specialties and was used for 'scheduled' and occasional 'elective' cases when there were no emergencies, only 37% of total theatre time was used. Without a change in consultant workload and practice which permits their increased involvement in emergency surgery, a dedicated daytime emergency theatre may be a costly measure which fails to fulfil all CEPOD recommendations.