Award-winning HSE programme improving access to surgical care extending nationally


Improved access to surgical care for patients will continue as the HSE’s Transforming Theatre Programme rolls out in more hospitals following a successful pilot in the South West.

Using a data-driven approach, the Programme identifies opportunities to improve how surgical theatres are used. This ensures theatres are operating as efficiently as possible and procedures are carried out in the most appropriate setting, freeing up theatre time so that more patients can be seen. 

The 18-month pilot at South / South West Hospital Group (SSWHG) focused on improving patient flow through the operating theatre. In the first six months of 2023, an additional 1,775 patients were treated, compared to the same period in 2022 and has proven to help generate more used theatre hours across the Hospital Group.

Professor Deborah McNamara, Clinical Lead, HSE National Clinical Programme for Surgery, explaining the objectives of the project, said, “One of our aims was to improve patient flow through the operating theatre, by providing a structured quality improvement methodology to achieve tangible improvements. The programme took a multidisciplinary approach, helping to engage nursing, anaesthesiology and surgical staff in operating theatre departments to identify and address the barriers to being more efficient.”

The pilot was recently awarded the European Innovation Award 2023 by the European Association of Hospital Managers and the HSE Service Excellence Award for Innovation in Service Delivery. South/South West Hospitals Group’s Professor Mark Corrigan, Clinical Lead and Grace Reidy, Transforming Theatre Programme Lead oversaw the pilot there.

Professor Corrigan said, “Working on this programme has been an immense privilege. It has personally allowed me to witness the remarkable transformation achieved by empowering our staff across 10 hospitals and 56 operating rooms. Their skill in identifying and driving improvements is exceptional.”

Grace Reidy added, “The true reward of everyone’s collective efforts at every level is reflected in the increased number of patients who have already benefited and will continue to benefit from the improvements driven by our staff every day. The commitment demonstrated by everyone involved – surgeons, anaesthetists, nursing staff and managers – in the programme has been extraordinary.”

Based on the success of the pilot, the programme has now been extended nationally as the National Perioperative Patient Pathway Enhancement Programme (NPPPEP). The programme will be rolled out across all hospital groups, coordinated by the HSE Strategic Programmes Office, and is currently being rolled out in Dublin Midlands Hospital Group and Saolta University Healthcare Group.

Welcoming the development, Deirdre McNamara, Director of Strategic Programmes, HSE, said, “The National Perioperative Patient Pathway Enhancement Programme will enable a more efficient and effective use of operating theatre resources. It supports our commitment to improving the patient experience and health outcomes by reducing waiting lists and ensuring more timely access to services.”

All 10 hospitals in the SSWHG actively deployed lean methodology across the 56 operating theatres and minor procedure rooms and introduced measures to examine theatre flow, capacity and daily activity. Standardised theatre effectiveness metrics were developed by RCSI/ NCPS to capture data. This supported the Hospital Group and each hospital to implement quality improvement initiatives. These included opening a minor operation (local anaesthetic) facility to increase theatre capacity for operations that require general anaesthesia, and supporting the right care in the right place. Essential to the success of the programme was its alignment with usual hospital governance systems to use the data generated to identify surgical theatre capacity across the Hospital Group and actively assist the Group to increase the flow of surgical patients.

National Perioperative Patient Pathway Enhancement Programme (NPPPEP)

The National Perioperative Patient Pathway Enhancement Programme (NPPPEP) is a collaborative initiative between the HSE Clinical, Strategy and Planning, and Operations functions; RCSI, the National Clinical Programme for Surgery (NCPS); the National Clinical Programme for Anaesthesia (NCPA); and participating hospital groups and hospitals to improve operating theatre access and flow.

The programme is led on behalf of the HSE by the Strategic Programmes Office and governed by a National Steering Group co-chaired by HSE Chief Clinical Officer Colm Henry and HSE Chief Operations Officer Damien McCallion, with representation from all key programme partners. RCSI is the technical partner for this programme, providing guidance on programme design, development, and delivery with specialised input to the measurement system used.