Professional Standards Advisory Committee

Professional Standards Advisory Committee

Lindsay Roberts, FRCS FRACS
Chairman, Australian Day Surgery Council, 1990 – 2000
President Elect, International Association For Ambulatory Surgery 1999

The first annual general meeting of the Day Surgery Facility Professional Standards Advisory Committee was held early in December 1986. It has been a year of considerable achievment for the committee and these are addressed in the first report of the Chairman, Mr. Lindsay Roberts.

The Day Surgery Facility Professional Standards Advisory Committee was formed on 10th December, 1985, and has held meetings at approximately four weekly intervals over the past eleven months. The first expanded meeting of the Committee to include co-opted representatives of all appropriate surgical and medical societies was held on 12th June, 1986, and this proved to be a most successful and informative meeting.

The most important activity of the Committee to date has been the preparation of standards for day surgery facility accreditation culminating in the publication of a “Manual for the Accreditation of Day Surgery Facilities” (June 1986). Panels of surgeons, anaesthetists and nurses have been nominated and working papers for surveys of day surgery facilities have been prepared.

The Committee has commenced the accreditation of day surgery facilities. The first survey for accreditation was carried out at the Sydney Day Surgery Centre on October 3, 1986, the survey panel consisting of a Surgeon, Anaesthetist and a registered Nurse. A Statement of Accreditation, prepared by the Committee and effective for three years, is to be presented to the Sydney Day Surgery Centre. Two further applications for accreditation have been received from the Hornsby Day Surgery Centre and the Fairfield Day Surgery Centre, and it is anticipated that these surveys will be carried out early in the New Year. There are a number of other smaller, longer standing day surgery facilities which it is hoped will to rise to the necessary standards.

There have been many enquiries on various aspects of day surgery facilities and their development, not only from New South Wales but also other States, and copies of the Manual for Accreditation of Day Surgery Facilities have been widely distributed. It is of interest that both St. Vincent’s Private and the Mater Private Hospitals are well advanced in planning for the construction of multi-service complexes which will include day surgery centres. The most significant recent Interstate development has been the opening of Perth Surgicentre, South Perth, which is also a multi-service complex, the day surgery centre in which has six operating theatres.

The original National Working Party on Day Surgery which published its Report and Recommendations on Day Surgery in 1981, was reconvened in April 1986, to revise the Report and at that meeting the New South Wales Committee was granted interim imprimatur status to institute accreditation of day surgery facilities pending discussion with the Australian Council on Hospital Standards on the final responsibility for accreditation of day surgery facilities. A further important decision was taken at that meeting to form the National Day Surgery Facility Standards Committee which replaces the original Working Party and has assumed responsibility for National Standards for Day Surgery, which will be conveyed to the Australian Council on Hospital Standards.

A decision by the National Day Surgery Facility Standards Committee (the original Working Party) as to the most appropriate organisation to be responsible for accreditation at the State level has not been resolved. A postal ballot, which was considered unsatisfactory in its format, supported the Australian Council on Hospital Standards rather than State Committees similar to the New South Wales Day Surgery Facility Professional Standards Advisory Committee. This decision stimulated considerable concern, and in many cases objection, by many Federal and New South Wales State Colleges and Associations of Surgeons and Anaesthetists. There has been concerted expression of opinion that the National Committee should be reconvened to resolve this important question which, apart from its significance of principle, is delaying publication of’ the revised Report and Recommendations on Day Surgery.

There has been a wide body of’ support for the New South Wales Committee, and extension of such truly professional standards committees to other States as the development of day surgery demands. Similarly, there is a large body of opinion that the A.C.H.S which was offered the responsibility for standards in day surgery five years ago and failed to deliver, is not the appropriate body for this responsibility.

Hopefully, this important matter can be appropriately resolved in the immediate future. At a meeting of the Committee on 13th October, 1986, based upon overwhelming support for the New South Wales Committee and the Committees own determination to continue with its activities, the following motion was passed unanimously:

“That the Day Surgery Facility Professional Standards Advisory Committee determines to continue its activities as set out in the interim charter (with addenda) “

At the request of the New South Wales Minister for Health, a meeting arranged by the Medical Services Committee, was held on Monday, 10th November, the Department of Health being represented by Mr R. Dash, who informed the meeting that any opinion or statement that he might make should not be taken as representing policy of the Health Department. It was therefore emphasised that this meeting should be in the form of an informal discussion with exchange of ideas and attitudes.

The meeting was informative and the Committee was able to express, and even recommend, certain of its basic objective and attitudes in respect of registration and accreditation and of day surgery facilities. Following the meeting, a Policy-Position Paper was prepared by our Committee and forwarded to the Medical Services Committee, with copies to the Secretary of the Department of Health and Mr. R. Dash, with a request that any proposed legislation or regulations for day surgery facilities be forwarded to our Committee for consideration.

I have pleasure in expressing my great respect for the members of our Committee, who have attended regular monthly meetings and have achieved so much in twelve months since the Committee was formed. The most notable achievement has been publication of the New South Wales Manual for the Accreditation of Day Surgery Facilities, the “Silver Book”, which is the basis for accreditation and which has been uniformly acclaimed for its standards.

On behalf of the Committee, I would like to express our gratitude to Mr. Richard Colbran, Executive Director of the Australian Association of Surgeons, and his staff, who have acted as Secretariat to the Committee. His efficiency, reliability and attention to detail are without peer and largely responsible for the faultless organisation of the Committee’s activities during the past year. Gratitude is also expressed to the Australian Association of Surgeons which agreed to bear the financial responsibility for general running expenses of the Committee. The accompanying Financial Statement indicates the extent of our indebtedness to the Association, the largest expense being the publication of the Manual. It is recognised that the Committee’s activities and achievements are dependent on this financial support and any donation by a Professional College, Association or Society, would be appreciated,

Much of the important ground work has been completed, and next year should see consolidation of the Committee, especially within the Profession but also, hopefully, to Government. In July 1986 a Seminar on Day Surgery was held by HOSPLAN, and notwithstanding several interesting contributions the seminar was conspicuous by the minimal involvement of the medical profession. Serious consideration will be given by our Committee to the organisation of a ‘Professional’ Seminar on Day Surgery next year and, based on the considerable broad spectrum of interest already shown, such a Seminar would, I believe, attract great support.

At a meeting on 3rd November, 1980, the Committee re-elected the Chairman for a further, final, period of twelve months commencing December 1986. 1 would like to express my gratitude and respect for the Committee’s confidence and assure them of my continued determined efforts to ensure its consolidation.

To my knowledge this has been an unique achievement whereby the profession in its own right, by its own initiative and with no outside influence, has drawn up standards and applied those standards, in the manner of peer review in its most constructive form, to this field of professional service – the field of day surgery, which is in its infancy in Australia, but nevertheless soundly established and destined to play a major role in the future provision of surgical and anaesthetic services.

The Day Surgery Facility Professional Standards Advisory Committee is determined to continue this vitally important professional endeavour.

Lindsay Roberts

Epilogue To Chairman’s Address – December 1986

At a meeting of the National Day Surgery Facilities, Standards Committee on the 11th December 1986 the problem involving the Australian Council of Hospital Standards was resolved by unanimous decision. In summary, terms of the resolution provide for each state to nominate its preferred organisation for the supervision, control and accreditation of day surgery facilities for that state. The organisation may be a professional standards advisory committee, such as that which has been established in New South Wales, or the Australian Council on Hospital Standards. Hopefully, in the near future, a reconciliation will be achieved so that these organisations will recognise the one manual for accreditation of day surgery facilities and mutually agree to co-operate in its application.

At that meeting a further decision was made to form a Subcommittee of the National Committee to produce a National Manual for the Accreditation of Day Surgery Facilities, based on the New South Wales Manual (the Silver Book). Such a National Manual would be available to any state which elected to form a day surgery committee, with the obvious advantage of’ uniformity of accreditation standards in each state.