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Organisation

Clinical Lead

Each DSU should have a Clinical Lead or Director who has a specific interest in day case surgery and who will lead the development of local policies, guidelines and Clinical Governance in this area. A consultant anaesthetist or surgeon with management experience is ideally suited to such a post. This individual should have adequate time allocated in their contract for this responsibility. In the accompanying essays you will find a section exploring further the role of the Anaesthetist as the Clinical Lead but remember this can also apply to surgical colleagues with an interest in ambulatory surgery.

Nursing Lead

Each unit also requires adequate staffing led by a senior nurse who provides the day-to-day administration of the unit in liaison with the Director. The senior nurse in charge of the ambulatory surgery unit should be expected to spend the majority of his/her time within that unit. Hands on activity by senior staff members ensures a valid understanding of any problems that can emerge in day to day practice and will enable these to be more speedily rectified. The staffing levels will depend on the design of the facility and the work undertaken, as well as local preferences. The DSU should have reception staff of high quality as well as its own nursing personnel. We recommend that each DSU formulates its own staffing structure which takes into consideration their local needs.

Operational Group

Each unit should have an operational group which should oversee the day to day running operation of the unit. This may include representatives from anaesthesia, surgery, hospital nursing, community nursing, general practice, pharmacy, management, finance, audit, and ancillary care. This group should agree an operational policy, define a timetable, review any operational problems and organise audit strategies. They should meet on a regular basis and any concerns raised must be acted on by hospital management.