The National Perioperative Patient Pathway Enhancement Programme (NPPPEP) is a collaborative between the HSE, RCSI National Clinical Programme for Surgery and the National Clinical Programme for Anaesthesia. The programme consists of four elements:  management structure, management systems, measurement system and improvement methodology. NPPPEP enables improved governance of operating theatre resources and capacity, locally and regionally. It identifies opportunities for improvement in each local operating theatre and at regional level. The objectives of the programme are to:

• increase theatre effectiveness,
• increase patient throughput,
• reduce waiting lists, and
• perform procedures in an effective location.          

HSE Strategic Programmes commissioned the RCSI NCPS as Technical Partners to roll out NPPPEP nationally. The team members are Charlie Dineen, Therese Callinan and Denise Kearney. The programme design is based on a pilot Transforming Theatre Programme (TTP) which was implemented in South/South West Hospitals Group (SSWHG) in 2021/22. The TTP was designed, developed, and delivered by RCSI National Clinical Programme in Surgery (NCPS). The programme recently won the Innovation in Service Delivery award at the HSE Service Excellence Awards and the European Innovation Award 2023 by the European Association of Hospital Managers at an event in Luxembourg.

Mr Charlie Dineen speaking at the Modernised Care Pathway Conference in November 2023.

NPPPEP commenced in September 2023 in 5 hospitals across 2 Hospital Groups, i.e. Saolta (Galway University Hospital, Sligo University Hospital and Roscommon University and Dublin Midlands Hospital Group (Midlands Regional Hospital Tullamore and The Reeves Day Surgery Centre Tallaght hospital).

To date, all sites have established their management structure (the formation of local multidisciplinary teams including a surgeon, anaesthetist, nursing and business operations), attend scheduled regular review meetings with the RCSI technical partners and HSE Programme Manager and are using the Theatre Measurement Model and Business Intelligence data to identify opportunities for improvement in line with programme objectives. The RCSI team also support local teams on-site, with data analysis, identifying goals and coaching to deliver QI initiatives. The next phase of the programme will involve modelling of capacity to meet demand and designing the future state. From April 2024, NPPPEP will expand into additional Hospital Group/sites.