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Ten More Dilemmas in Day Surgery Ten more frequently asked about problem areas in Day Surgery. Written by a multidisciplinary team o…

Our History

The History of the British Association of Day Surgery

At the end of the 1970s and in the early 1980s a small number of enthusiasts began to develop and expand day surgery in their own hospitals. Indeed, a few became evangelists for this approach to treatment, travelling widely and promoting its benefits at district, regional and national meetings. Two of these, Dr Tom Ogg and Professor Paul Jarrett, increasingly found themselves speaking at the same events. They were both concerned that despite good, published evidence on paediatric day surgery that the majority of the British medical and nursing establishment remained apathetic with regards to the expansion of day surgery. Consequently, they believed that a coordinated approach to the promotion of day surgery might be beneficial. One Saturday in August 1988, the pair met at the Garden House Hotel in Cambridge . During an excellent and well lubricated lunch they decided that the way forward was to form a day surgery association which, to maximise its impact, should be multidisciplinary. Now that was the easy part. However, funding was required to make their idea a reality. Fortunately, Paul Jarrett was then a director of a healthcare company and he convinced his fellow directors to sponsor a two-day meeting to discuss the formation of an association. The meeting was held on the 22nd and 23rd April 1989, at the Stafford Hotel in St James, London-a hotel better known for accommodating Elizabeth Taylor and the Trumps than as a birthplace for medical associations. Those attending, apart from Jarrett (consultant general surgeon, Kingston) and Ogg (consultant anaesthetist, Cambridge) were Dr Tony Davenport (retired anaesthetist, Northwick Park ), Dr Jean Millar (consultant anaesthetist, Oxford), Dr Peter Simpson (regional medical officer, Liverpool), Mrs Sarah Penn (nursing sister, Barnet Hospital ) and Dr Chris Ward (consultant plastic surgeon, Charing Cross Hospital ). Mr Brendan Devlin and Professor Sir Miles Irvin sent their support and apologies. All at this meeting agreed that the formation of a multidisciplinary association would be beneficial. Plans for funding, promotion, annual national meetings and the development of a journal were extensively discussed. Predictably, perhaps, the decision on the name of the new association took a disproportionate amount of time. Eventually it was whittled down to six alternatives of which two were favourites-the British Association of Surgery and Outpatient Investigation (SOPI) and the British Association of Day Surgery (BADS). SOPI seemed inappropriate and so the Association was named BADS. Paul Jarrett was elected chairman, Tom Ogg, chairman elect, Jean Millar secretary, Tony Davenport journal editor, and Peter Simpson , Chris Ward and Sarah Penn committee members. Basically the original aims of BADS were:

  1. To encourage the expansion of day surgery
  2. To promote education and high quality treatment
  3. To conduct research and publish the findings
  4. To organise meetings, seminars lectures and conferences
  5. To provide advice on the construction and management of day units
  6. To maintain high standards of surgical, anaesthetic and nursing care
  7. To organise a day surgery reference library

 

A further meeting in July 1989, at the Churchill Hospital , Oxford day unit confirmed funding from ICI Pharmaceuticals for a national meeting. However, no publisher had been found to produce a journal at no cost to the Association. The first annual meeting entitled "The Future of British Day Care Surgery-a multidisciplinary approach" was held at the Royal Society of Medicine, London on Friday, 1st June 1990.Although the lecture hall, with 200 seats, was fully booked before the meeting, a further 50 people turned up on the day and had to be housed in another room with piped sound. Here was the evidence that there was indeed a need for relevant education and guidance on all aspects of day surgery. Amongst the delegates was Baroness Julia Cumberledge (later Health Minister and spokesman in the Lords) a founding member and, over the years, a great supporter of the Association. One of the guest speakers was Professor Sir Liam Donaldson now Chief Medical Officer. At this meeting there was strong support for an association and BADS was inaugurated. The annual membership fee was set at the princely sum of £5.The Association soon became the voice of British Day Surgery and participated in the publication of many reports. From 1990 to 1997, various documents were published in conjunction with the Audit Commission (on several occasions), the NHS Management Executive (Value for Money Unit), Royal College of Surgeons of England, the Royal College of Anaesthetists, Welsh Health Planning, Caring for Children in the Health Services Research Unit(Aberdeen University), the NHS Estates Section and the Department of Health. Amongst the authors of these reports are many well-known names, including Jarrett, Ogg, Devlin, Penn, Ralphs and Wilkinson. Certainly many organisations were keenly interested in the development of safe day surgery and many members of the BADS committee travelled the length and breadth of lecturing, attending crucial formative meetings and discussing the relevance of their own research findings. All the essential references required to establish day surgery have recently been brought together in the 2004 index to volumes 1-13 of the Journal of One-day Surgery. The committee of the Association, with new secretary Sarah Penn , met quarterly either in the postgraduate medical centre at Barnet Hospital or a hotel next to the South Mimms service area on the M25. At this stage, the Association had no office nor paid secretarial assistance and it was administered from the officers' homes mainly at their personal expense. Nevertheless, such was the enthusiasm of the BAD committee that no scheduled meeting was ever cancelled because of the weather, lack of interest or more pressing clinical commitments. Membership fees and profits from annual meetings were put aside for several years, to build a fund for the future so that an office, a secretary and proper charity status could eventually be achieved. However, despite the Association working on a shoestring and goodwill, membership grew and the first constitution was published. Then BADS secured the services of Newton Mann Limited to publish the Journal of One-day Surgery free to members of the Association. The editor was the enthusiastic late Dr Tony Davenport and volume 1, number1 of this journal was available for the second annual meeting at the University of Birmingham Medical School on 21stJune 1991. There were then around 400 members and the membership fees were increased to £10 in 1991-92, although the early meetings were heavily subsidised by the pharmaceutical industry. For example, the cost of attending the Birmingham meeting, including lunch, was only £10! Similarly in May 1992 the annual meeting at the Royal College of Surgeons of cost £20 including a years membership. At the London meeting Tom Ogg took over as Chairman and the following year introduced the first two-day annual meeting. This allowed a social event to be held on the evening of the first day. The meeting was held at the Corn Exchange in Cambridge on the 2nd and 3rd July 1993.Delegates was treated to an organ recital at Kings College Chapel, dinner was then served on the college lawns and accommodation was available in Downing College . It could be said that BADS had come of age. After the 1994 annual meeting at Keele University , the late Brendan Devlin became Chairman. Over the next two year she and the new secretary, David Ralphs, consolidated the basis of the Association. A carefully worded and legally correct constitution was drawn up, full charity status achieved and a permanent office based at the Royal College of Surgeons of obtained. The post of Chairman was elevated to that of President. [David Ralphs was also instrumental in designing the BADS logo during this time,Ed].Annual conferences in Eastbourne (1995) and Glasgow (1996)followed. Much of the administrative hard work for these large conferences was performed by Mr Neil Strachan of Kite Communications. Then in April 1997 BADS, a founding member of the International Association for Ambulatory Surgery (IAAS), hosted the 2nd International Congress on Ambulatory Surgery at the Queen Elizabeth II centre in London in conjunction with its own annual meeting. Over1500 delegates attended and the great success of this event was due to the hard work put in by the Congress President, Tom Ogg and his energetic local organising committee of Paul Jarrett, Paul Baskerville , David Ralphs and Sarah Penn (President BADS, 1996-98). For the record Jarrett and Ogg eventually became Presidents of the IAAS, a multidisciplinary organisation involving over 35 countries. Subsequently, the Association has continued to develop and has gained a number of significant achievements. These include the election of Sarah Penn as the first female and nurse president-a first and still unique appointment amongst day surgery organisations worldwide. More recently, the Association has established a permanent office manager and has taken on the organisation of its own meetings. Notably, several other of the early members, including David Ralphs, Peter Simpson , Paul Baskerville and Jill Solly, have gone on to become President. Any organisation should, of course, always look to the future. However, it is sometimes of interest to learn how things evolved. We hope that this article fulfils that purpose for the first years of BADS. Despite the hours of hard grind we would undoubtedly do the same again if only for the many hours of enjoyment in the company of our multidisciplinary colleagues. It is indeed rewarding for us to see that BAD continues to spread the word of day surgery even in troubled times.

This information is largely taken from an article by

PROFESSOR PAUL EM JARRETT 
Professor of Day Surgery & Consultant Surgeon, Kingston Hospital NHS Trust. and 

Dr TOM OGG 
Retired Director Day Surgery & Consultant Anaesthetist. Addenbrookes NHS Trust, Cambridge