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.