An observational national study of anaesthetic workload and seniority across the working week and weekend in the UK in 2016: the 6th National Audit Project (NAP6) Activity Survey
UK national anaesthetic activity was studied in 2013 but weekend working was not examined. Understanding changes since 2013 in workload and manpower distribution, including weekends, would be of value in workforce planning. We performed an observational survey of NHS hospitals' anaesthetic prac...
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| Veröffentlicht in: | British journal of anaesthesia : BJA 2018-07, Vol.121 (1), p.134-145 |
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| creator | Kemp, H. Marinho, S. Cook, T.M. Farmer, L. Bellamy, M. Egner, W. Farooque, S. Ferguson, K. Floss, K. Garcez, T. Karanam, S. Hitchman, J. Kong, K.-L. McGuire, N. Nasser, S. Lucas, D.N. Thomas, M. Torevell, H. Warner, A. Harper, N.J.N. |
| description | UK national anaesthetic activity was studied in 2013 but weekend working was not examined. Understanding changes since 2013 in workload and manpower distribution, including weekends, would be of value in workforce planning.
We performed an observational survey of NHS hospitals' anaesthetic practice in October 2016 as part of the 6th National Audit Project of the Royal College of Anaesthetists (NAP6). All cases cared for by an anaesthetist during the study period were included. Patient characteristics and details of anaesthetic conduct were collected by local anaesthetists.
Responses were received from 342/356 (96%) hospitals. In total, 15 942 cases were reported, equating to an annual anaesthetic workload of ≈3.13 million cases. Approximately 95% (9888/10 452) of elective and 72% (3184/4392) of emergency work was performed on weekdays and 89% (14 145/15 942) of activity was led by senior (consultant or career grade) anaesthetists and 1.1% (180/15942) by those with |
| doi_str_mv | 10.1016/j.bja.2018.04.010 |
| format | Article |
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We performed an observational survey of NHS hospitals' anaesthetic practice in October 2016 as part of the 6th National Audit Project of the Royal College of Anaesthetists (NAP6). All cases cared for by an anaesthetist during the study period were included. Patient characteristics and details of anaesthetic conduct were collected by local anaesthetists.
Responses were received from 342/356 (96%) hospitals. In total, 15 942 cases were reported, equating to an annual anaesthetic workload of ≈3.13 million cases. Approximately 95% (9888/10 452) of elective and 72% (3184/4392) of emergency work was performed on weekdays and 89% (14 145/15 942) of activity was led by senior (consultant or career grade) anaesthetists and 1.1% (180/15942) by those with <2 yr anaesthetic experience. During weekends case urgency increased, the proportion of healthy patients reduced and case mix changed. Cases led by senior anaesthetists fell to 80% (947/1177) on Saturday and 66% (342/791) on Sunday. Senior involvement in obstetric anaesthetic activity was 69% (628/911) during the week and 45% (182/402) at weekends, compared with 93% (791/847) in emergency orthopaedic procedures during the week and 89% (285/321) at weekends. Since 2013, the proportion of obese patients, elective weekend working, and depth of anaesthesia monitoring has increased [12% (1464/12 213) vs 2.8%], but neuromuscular monitoring has not [37% (2032/5532) vs 38% of paralysed cases].
Senior clinicians deliver most UK anaesthesia care, including at weekends. Our findings are important for any planned workforce reorganisation to rationalise 7-day working.</description><identifier>ISSN: 0007-0912</identifier><identifier>EISSN: 1471-6771</identifier><identifier>DOI: 10.1016/j.bja.2018.04.010</identifier><identifier>PMID: 29935565</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; anaesthesia ; Anesthesia, Obstetrical - statistics & numerical data ; Anesthesiologists ; Anesthetics ; audit ; Consciousness Monitors ; Cross-Sectional Studies ; Emergency Medical Services ; Female ; Humans ; Male ; Medical Audit ; monitoring ; Monitoring, Intraoperative - statistics & numerical data ; Neuromuscular Monitoring ; Obesity - complications ; Pregnancy ; Surveys and Questionnaires ; technique ; United Kingdom ; workforce ; Workload - statistics & numerical data</subject><ispartof>British journal of anaesthesia : BJA, 2018-07, Vol.121 (1), p.134-145</ispartof><rights>2018 British Journal of Anaesthesia</rights><rights>Copyright © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-f28e95863fcfec697762b0f7c01ed319b0b946940f19d6368c5b62b5f4f9bdf23</citedby><cites>FETCH-LOGICAL-c396t-f28e95863fcfec697762b0f7c01ed319b0b946940f19d6368c5b62b5f4f9bdf23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29935565$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kemp, H.</creatorcontrib><creatorcontrib>Marinho, S.</creatorcontrib><creatorcontrib>Cook, T.M.</creatorcontrib><creatorcontrib>Farmer, L.</creatorcontrib><creatorcontrib>Bellamy, M.</creatorcontrib><creatorcontrib>Egner, W.</creatorcontrib><creatorcontrib>Farooque, S.</creatorcontrib><creatorcontrib>Ferguson, K.</creatorcontrib><creatorcontrib>Floss, K.</creatorcontrib><creatorcontrib>Garcez, T.</creatorcontrib><creatorcontrib>Karanam, S.</creatorcontrib><creatorcontrib>Hitchman, J.</creatorcontrib><creatorcontrib>Kong, K.-L.</creatorcontrib><creatorcontrib>McGuire, N.</creatorcontrib><creatorcontrib>Nasser, S.</creatorcontrib><creatorcontrib>Lucas, D.N.</creatorcontrib><creatorcontrib>Thomas, M.</creatorcontrib><creatorcontrib>Torevell, H.</creatorcontrib><creatorcontrib>Warner, A.</creatorcontrib><creatorcontrib>Harper, N.J.N.</creatorcontrib><title>An observational national study of anaesthetic workload and seniority across the working week and weekend in the UK in 2016: the 6th National Audit Project (NAP6) Activity Survey</title><title>British journal of anaesthesia : BJA</title><addtitle>Br J Anaesth</addtitle><description>UK national anaesthetic activity was studied in 2013 but weekend working was not examined. Understanding changes since 2013 in workload and manpower distribution, including weekends, would be of value in workforce planning.
We performed an observational survey of NHS hospitals' anaesthetic practice in October 2016 as part of the 6th National Audit Project of the Royal College of Anaesthetists (NAP6). All cases cared for by an anaesthetist during the study period were included. Patient characteristics and details of anaesthetic conduct were collected by local anaesthetists.
Responses were received from 342/356 (96%) hospitals. In total, 15 942 cases were reported, equating to an annual anaesthetic workload of ≈3.13 million cases. Approximately 95% (9888/10 452) of elective and 72% (3184/4392) of emergency work was performed on weekdays and 89% (14 145/15 942) of activity was led by senior (consultant or career grade) anaesthetists and 1.1% (180/15942) by those with <2 yr anaesthetic experience. During weekends case urgency increased, the proportion of healthy patients reduced and case mix changed. Cases led by senior anaesthetists fell to 80% (947/1177) on Saturday and 66% (342/791) on Sunday. Senior involvement in obstetric anaesthetic activity was 69% (628/911) during the week and 45% (182/402) at weekends, compared with 93% (791/847) in emergency orthopaedic procedures during the week and 89% (285/321) at weekends. Since 2013, the proportion of obese patients, elective weekend working, and depth of anaesthesia monitoring has increased [12% (1464/12 213) vs 2.8%], but neuromuscular monitoring has not [37% (2032/5532) vs 38% of paralysed cases].
Senior clinicians deliver most UK anaesthesia care, including at weekends. 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Understanding changes since 2013 in workload and manpower distribution, including weekends, would be of value in workforce planning.
We performed an observational survey of NHS hospitals' anaesthetic practice in October 2016 as part of the 6th National Audit Project of the Royal College of Anaesthetists (NAP6). All cases cared for by an anaesthetist during the study period were included. Patient characteristics and details of anaesthetic conduct were collected by local anaesthetists.
Responses were received from 342/356 (96%) hospitals. In total, 15 942 cases were reported, equating to an annual anaesthetic workload of ≈3.13 million cases. Approximately 95% (9888/10 452) of elective and 72% (3184/4392) of emergency work was performed on weekdays and 89% (14 145/15 942) of activity was led by senior (consultant or career grade) anaesthetists and 1.1% (180/15942) by those with <2 yr anaesthetic experience. During weekends case urgency increased, the proportion of healthy patients reduced and case mix changed. Cases led by senior anaesthetists fell to 80% (947/1177) on Saturday and 66% (342/791) on Sunday. Senior involvement in obstetric anaesthetic activity was 69% (628/911) during the week and 45% (182/402) at weekends, compared with 93% (791/847) in emergency orthopaedic procedures during the week and 89% (285/321) at weekends. Since 2013, the proportion of obese patients, elective weekend working, and depth of anaesthesia monitoring has increased [12% (1464/12 213) vs 2.8%], but neuromuscular monitoring has not [37% (2032/5532) vs 38% of paralysed cases].
Senior clinicians deliver most UK anaesthesia care, including at weekends. Our findings are important for any planned workforce reorganisation to rationalise 7-day working.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>29935565</pmid><doi>10.1016/j.bja.2018.04.010</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult anaesthesia Anesthesia, Obstetrical - statistics & numerical data Anesthesiologists Anesthetics audit Consciousness Monitors Cross-Sectional Studies Emergency Medical Services Female Humans Male Medical Audit monitoring Monitoring, Intraoperative - statistics & numerical data Neuromuscular Monitoring Obesity - complications Pregnancy Surveys and Questionnaires technique United Kingdom workforce Workload - statistics & numerical data |
| title | An observational national study of anaesthetic workload and seniority across the working week and weekend in the UK in 2016: the 6th National Audit Project (NAP6) Activity Survey |
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