Impact of the Federated Data Platform's digital surgery scheduling system on elective theatre utilisation at an NHS Trust: an interrupted time series analysis

ObjectivesTo evaluate the NHS Federated Data Platform (FDP) Inpatient Care Coordination Solution (CCS) digital scheduling tool on elective theatre utilisation. MethodsAn interrupted time series assessed changes in theatre utilisation and cancellations following tool adoption (January 2022). Weekly data spanned 90 weeks (April 2021 to December 2023). Outcomes included weekly median theatre utilisation (actual, booked, and bookings per session) and the percentage of cancelled bookings. Models incorporated a 5-week lag and estimated level (step-change) and trend (slope) effects. ResultsPost-intervention level and trend increases were observed for booked ({beta}=4.40, P=0.045; {beta}=0.26, P=0.002) and actual ({beta}=3.98, P=0.064; {beta}=0.23, P=0.006) utilisation. Bookings per session showed a significant level increase ({beta}=0.34, P=0.002) with no trend change ({beta}=0.00, P=0.790). Across the post-intervention period, compared with counterfactual estimates, booked and actual utilisation were 15.0% (95% CI: 13.4 to 16.5%, P<0.0001) and 12.2% (95% CI: 10.8 to 13.5%, P<0.0001) higher, while bookings per session were 10.9% (95% CI: 9.5 to 12.4%, P<0.0001) higher. Significant positive effects were observed for Urology, General Surgery, Gynaecology, Plastic Surgery and Ophthalmology. Cancellation rates remained stable pre- and post-intervention (5.2% vs. 5.2%, P=0.488), but a significant upward trend was associated with the tool ({beta}=2.1, P=0.001). DiscussionFindings suggest that a centralised digital scheduling tool can improve theatre capacity, while a small increase in cancellation trend likely reflects post-pandemic recovery or improved recording. Future research should explore speciality-level use and the sustainability of observed gains. ConclusionThe introduction of the CCS tool was associated with improved theatre utilisation. Summary boxO_ST_ABSWhat is already known on the topicC_ST_ABSO_LIInefficient surgical scheduling results in delays in care, suboptimal patient outcomes, and increased costs for healthcare providers. C_LIO_LIDigital theatre scheduling systems have been developed to enhance scheduling efficiency; however, evidence of their effectiveness from real-world implementations remains limited. C_LIO_LIMost previous studies focus on theoretical optimisation models rather than practical, system-wide impact in routine care settings. C_LI What this study addsO_LIProvides real-world evidence that integrated digital scheduling platforms can enhance elective theatre scheduling, indicating a more efficient use of existing capacity despite variation across specialities. C_LI How this study might affect research, practice or policyO_LIEnhanced scheduling efficiency benefits patients by minimising wait times and reducing the risks associated with delays, strengthening the argument for adopting such tools to address the current backlog in elective care. C_LIO_LIIdentifies priorities for future research, including long-term evaluation, factors influencing adoption, and the role of digital scheduling in elective recovery. C_LI