South West NHS Trust

November 2024 - February 2025

Converting strong utilisation into 740 additional elective cases

How a South-West NHS trust strengthened theatre planning and booking to increase elective activity by 11.3% and reduce dropped sessions by more than 40%.

The Challenge

Strong reported utilisation was not producing the expected number of elective cases.

The trust was reporting good theatre utilisation through Model Hospital, but activity remained lower than expected. High dropped sessions and on-the-day cancellations were known issues, while average cases per session did not reflect the apparent use of theatre time. The service needed stronger central coordination, more reliable list-cover processes and a clearer understanding of where time and activity were being lost.

Results at a glance

+740 cases

compared with the same period in previous year

11.3% increase

in total elective theatre activity

40.1% reduction

in dropped sessions

2.1% reduction

in combined on-the-day cancellation and DNA rate

What we changed

Productive Partners reviewed theatre data and operational processes, then implemented targeted changes across planning, scheduling, booking and day-of-surgery delivery.

Strengthen 6-4-2 list cover

Introduced a new tracker, standardised rota submissions and revised the format and membership of 6-4-2 meetings to improve visibility and accountability.

Standardise scheduling

Implemented consistent consultant list sign-off, scheduling meetings, booking rules and planned session times across the service.

Reduce avoidable disruption

Introduced a new on-the-day cancellation procedure and escalation route, alongside booking scripts, 48-hour calls and two-way SMS.

Improve list performance and flow

Used consultant challenge sessions and OPCS touch-time benchmarking to optimise list booking and focus pathway reviews on the largest opportunities.

The outcome

The trust delivered substantially more activity from its existing theatre estate.

Between November 2024 and February 2025, the trust delivered 7,283 elective theatre cases, 740 more than during the same period a year earlier. This represented an 11.3% increase in total activity.

Dropped sessions reduced by 40.1%, from 7.8% to 4.7%. The combined on-the-day cancellation and DNA rate fell from 16.6% to 14.5%, while capped theatre utilisation increased from 81.7% to 82.6%.

The service also gained clearer planning controls and practical tools that theatre coordinators could continue using after the programme.

Reflecting on the partnership

“It’s been lovely to work with a team who really understand how theatres work. It helped me to see some holes in our data which I hadn’t considered previously and helped get a better grasp of our specific data.”

Financial Improvement Lead

South West NHS Trust

More case studies

40% reduction

in late starts

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18.4% increase

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How an East of England NHS trust strengthened theatre planning, reduced dropped sessions and delivered 446 additional elective cases in three months.

East of England NHS trust

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