INTRODUCTION
As elective surgery services recover from the COVID-19 pandemic the rate
of return to normal activity levels has been slower for ear, nose and
throat (ENT) surgery than for other specialties in a number of
countries.1,2 Concerns regarding spread of COVID-19
during potentially aerosol generating procedures such as endoscopic
sinus surgery (ESS) may have influenced this.3,4 As
elective ENT services now look to reduce the patient backlog, efficient
working practice will be essential.
For certain groups of patients undergoing relatively low-risk
procedures, day-case surgery may be part of the solution. In ENT surgery
in England, prior to the COVID-19 pandemic, a number of hospital trusts,
had moved to a model of day-case surgery as the default for low risk
patients and low complexity procedures, including
ESS.5
In England, The Getting It Right First Time (GIRFT) programme has a
remit to reduce unwarranted variation in clinical practice where this
impacts negatively on patient outcomes or service efficiency. Variation
in rates of day-case surgery is an area of particular
interest.6,7 Key barriers to increasing day-case rates
identified by the GIRFT ENT national report were a cultural reluctance
to change practice, a lack of day-case infrastructure, a concern that
outcomes would be compromised and a sense that their day-case rates were
already ’optimal’ for their patient population.5
The aim of this study was to investigate the safety of day-case ESS
within the National health Service (NHS) in England using a national
administrative dataset.