Guy’s and St Thomas’ FT launch new HIT lists to help tackle COVID-19 backlog

Guy’s and St Thomas’ NHS Foundation Trust has launched new high intensity theatre lists (HIT lists) designed to help reduce the backlog for non-emergency surgery caused by the pandemic. 

The new HIT lists – developed by staff at the trust – focus on one type of routine procedure at a time in order to maximise the number of patients treated in one day.  

The implementation of the HIT lists includes:  

  • Increasing the number of anaesthetic, surgical and theatre staff to “minimise the turnaround time between cases, making more time available for the surgeon to operate”.
  • Using two theatres and three teams so a surgeon can go between cases without having to wait for the patient – this enables “for many more cases to be done in the same time period”. 
  • Several multidisciplinary meetings are required for each HIT list to select suitable cases, patients and team members, and to plan the equipment and order of the lists – this includes managers, administration staff, therapists, nurses, pharmacists, anaesthetists and surgeons.

According to the trust, 11 HIT lists have been held so far, in which 240 patients across a range of specialities, including gastrointestinal, gynaecology, orthopaedics and ear nose and throat (ENT) were treated. 

The leader of the new effort at the organisation, Dr Imran Ahmad, Consultant Anaesthetist and Deputy Clinical Director for Anaesthesia and Theatres, commented: “For many surgical procedures, the time required to perform the actual surgery is significantly less than the time spent preparing and anaesthetising the patient, setting up the equipment and helping the patient to recover – in some cases the operating time can be as little as 30% of the duration of the whole operating list.  

“We have looked at every aspect of the patient’s pathway in detail to see where we can safely improve on efficiency, save time and parallel process in order to increase the surgeon’s operating time, by reducing non-operative time.”