Published: 22/08/2002, Volume II2, No. 5819 Page 4 5

The government's announcement of extra funding to expand day case surgery and to open 10 more diagnosis and treatment centres has been welcomed by trust managers, who believe it will be key to reducing waiting times to six months by 2005.

Health minister John Hutton last week announced that£68m will be available over two years to expand day case surgery by 120,000 extra operations per year.

Mr Hutton also announced that£39m will be spent on the new diagnostic and treatment centres, treating over 25,000 extra cases a year, many of them as day surgery.

There was also an allocation of£22m to fund 100 schemes to improve primary care services, and 24 NHS LIFT schemes to build new primary care facilities.

The government expects around£400m of mainly private sector capital investment to be levered in by the LIFT (local improvement finance trust) schemes for improving primary care facilities.

Guidance for trusts on increasing the amount of day surgery has also been produced, with the ambition of having 75 per cent of all elective surgery eventually done as day cases.

The money available for day surgery is£31m in the current financial year and£37m in the next. Acute and primary care trusts can access the money, from the Treasury capital modernisation fund, through capacity plans being developed by each strategic health authority by 31 October.

The Modernisation Agency will hold a summit next month for trusts with low levels of day surgery activity to look at methods of improving their rates, with support from trusts achieving higher day surgery rates.

In the operational guide to day surgery published by the Department of Health, it suggests PCTs should provide incentives to trusts to undertake day surgery in preference to inpatient care where appropriate. It also suggests there could be mechanisms 'within the new hospital payment incentive structure' to encourage day surgery. 'For instance, new tariffs could be used to penalise excessive inpatient admissions and reward increased day case surgery, ' the document says.

One of the largest diagnostic and treatment centres will be at Frimley Park Hospitals trust, where£7m will be invested in an ophthalmology centre to treat around 3,400 patients a year as day patients.

Trust deputy chief executive David Crowe said: 'We are running at 99 plus per cent capacity, and we need to expand. By moving ophthalmology capacity, we created extra capacity elsewhere as well. It was seen as a great way to reorganise these facilities. We feel this will deliver the NHS plan targets for 2005 of six months.'

The South West London orthopaedic centre, to be built at Epsom Hospital, will cost£14.2m.

The centre will focus on hip and knee replacement work for Epsom and St Helier trust, Kingston Hospital trust, Mayday Healthcare trust and St George's Healthcare trust.

Epsom and St Helier chief executive John de Braux said: 'Orthopaedics is the specialty with largest waiting times.We are meeting the current targets but in order to drive these down to six months, we will need this extra capacity. Hips and knees from these four trusts will realise additional capacity.'

British Association of Day Surgery president David Ralphs welcomed the announcements on day surgery, but warned that facilities must be reserved for day surgery only.

He said: 'The potential of day surgery will only fully be realised if managers resist the temptation to encroach on day surgery facilities, and recognise that these have to be ring-fenced.'