Description
Routine hospital data was used to investigate the appropriateness
of elective surgery in Barking and Havering. Rates of surgical
HRGs were measured against suitable comparators. Procedures
contributing to HRGs with higher rates locally were identified.
Possible reasons for the differences were explored with local
clinicians.
Numbers of tonsillectomies, varicose vein operations, grommet
insertions, cystoscopies, circumcisions, arthroscopies and
minor skin procedures were higher than expected locally, without
obvious explanation. Some of these procedures have limited
clinical value. Some elective surgery in Barking and Havering
appears inappropriate. This method has proved useful in targeting
initiatives for clinical change. We express concern that government
initiatives seek to reduce waiting times by increasing the
volume of surgery, but do not address its appropriateness.
