WTP2.05 Overnight Surgeries - A Strategic Pathway to Ease Pressures off Emergency Theatres

Aims Increasing healthcare burden poses challenges to hospitals where capacity remains largely unchanged. Challenges include long waiting lists and delays to emergency theatres. Traditional practice is to minimise overnight operating. We hypothesised that with dedicated nightshifts for doctors/surgeons, overnight low risk surgeries are not associated with worse outcomes. Methods We analysed emergency general surgeries during night shift hours (20:00 to 08:00) between October 2024 and December 2024 in a single tertiary unit. Procedures (such as NELA eligible surgeries) expected to require the presence of a consultant surgeon were excluded. Outcomes included need for a consultant surgeon to attend, length of stay postoperatively, and complications over a 30-day period. Results Eighty three patients met the criteria. The mean patient age was 38 years. Procedures included incision and drainage of abscess (24), laparoscopic appendicectomy (51), open hernia repair (7) and debridement for necrotizing fasciitis (1). In 3 cases, a consultant was called to attend. There were no intraoperative complications. Only 10% had postoperative complication including collection (3), haematoma (1), ileus (1), AKI (1), chest infection (1) and laryngospasm not requiring ITU support (1). Majority (87%) of the patients were discharged home within the first 48 hours; 72% within 24 hours. Conclusions Performing low risk surgeries overnight does not worsen patient outcomes. In fact, it may help in decreasing the overall length of stay by decreasing time to surgery. This is in addition to relieving the burden off busy emergency theatres where patient harm may occur due to delay in accessing theatres.