The verdict in three sentences
In an 8-theatre surgical clinic, theatre utilisation stuck at 65% means almost 6,400 hours of open but unused theatre time every year. Operating theatre scheduling software costs EUR 20,000 to 60,000 a year as an off-the-shelf module or EUR 50,000 to 120,000 excluding VAT as custom development, with EHR integration and certified health data hosting (HDS in France, NHS DSPT and UK GDPR compliance in London). Gaining 10 utilisation points is worth around EUR 1.5 million (about GBP 1.3 million) in annual revenue, which makes budget a secondary question compared with surgeon adoption.
Why theatres plateau at 65%
Whether in Montpellier or London, the causes are well known: sessions allocated out of habit and never released, scheduling on paper or spreadsheets, last-minute cancellations not reallocated, end-of-day overruns that discourage adding a patient. Health authorities such as France's HAS and the UK's GIRFT programme recommend steering by indicators (utilisation, overrun rate, session release lead time) that few clinics produce automatically.
| Theatre indicator (8 theatres, 2026 order of magnitude) | Current situation | Target with software |
|---|---|---|
| Open theatre hours per year (10 h x 230 days) | 18,400 h | 18,400 h |
| Utilisation rate | 65% | 75% |
| Hours actually used | 11,960 h | 13,800 h |
| Sessions not released at D-7 | 12 to 18% | under 5% |
| Overrun rate after 6 pm | 15% | 6 to 8% |
| Same-day cancellations not backfilled | 70% | 35% |
| Theatre manager time spent scheduling | 15 h per week | 5 h per week |
Off-the-shelf module or custom development
| Criterion | Off-the-shelf scheduling module | Custom development |
|---|---|---|
| Cost | EUR 20,000 to 60,000 a year (licence + support) | EUR 50,000 to 120,000 excl. VAT then EUR 10,000 to 20,000 a year |
| Time to go live | 3 to 6 months | 5 to 8 months |
| EHR and PAS integration (HL7, FHIR) | Standard connectors, sometimes billed extra | Built for your EHR |
| Session rules and surgeon preferences | Limited configuration | Clinic-specific rules |
| Certified health hosting | Included with the certified vendor | With a certified host (EUR 300 to 1,200 a month) |
| Cumulative 5-year cost | EUR 100,000 to 300,000 | EUR 90,000 to 220,000 |
| Ownership of code and data | Vendor | Clinic |
An off-the-shelf module suits a clinic that accepts standard processes. Custom development is justified when the clinic has specific organisational rules (theatres shared between specialties, integrated day surgery, several sites) or a closed EHR.
Revenue recovered by utilisation gain
Assuming average revenue of EUR 800 per used theatre hour (tariffs and fees, order of magnitude for a clinic focused on orthopaedics and general surgery), each utilisation point on 18,400 hours equals 184 hours, or about EUR 147,000 a year.
| Utilisation gain | Extra hours | Revenue recovered per year |
|---|---|---|
| + 2 points | 368 h | EUR 294,400 |
| + 4 points | 736 h | EUR 588,800 |
| + 6 points | 1,104 h | EUR 883,200 |
| + 8 points | 1,472 h | EUR 1,177,600 |
| + 10 points | 1,840 h | EUR 1,472,000 |
These amounts assume surgical demand exists (waiting lists, surgeons ready to operate more) and that nursing staff can follow. Software frees capacity; it does not create patients.
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Dr Hélène Martin, director of an 8-theatre clinic in Montpellier, opts for custom development at EUR 95,000 excluding VAT, plus EUR 15,000 a year for maintenance and certified hosting. After 12 months, utilisation rises from 65% to 71%, or 1,104 extra hours. On that volume, the contribution margin after staff and consumables is estimated at 25%, so 883,200 x 0.25 = EUR 220,800 a year. The project pays back in about 6 months of operation at that pace, and theatre managers recover 10 hours a week.
FAQ
Is certified health data hosting really mandatory?
Yes, in France any software storing identifiable health data for a facility must use an HDS-certified host, and in the UK suppliers must meet the NHS DSPT and UK GDPR. Allow EUR 300 to 1,200 a month depending on volume and the required availability level.
How does EHR integration work?
Through HL7 v2 or FHIR feeds for patients, procedures and operative notes. A connector costs EUR 8,000 to 20,000 excluding VAT, and the EHR vendor sometimes charges to open the interface.
Will surgeons actually use the tool?
Adoption depends on simple mobile access and session release rules approved by the medical committee. Plan 2 to 3 months of change management and indicators shared every month.
Is the software a medical device?
A purely organisational scheduling tool is generally not a medical device. If clinical decision support features are added, a regulatory analysis is needed before go-live.
How long before a gain is measurable?
The first effects on released sessions appear within 6 to 8 weeks. A stable gain of 5 to 10 utilisation points is usually seen between 6 and 12 months.
Let's scope your project. Share your number of theatres, your EHR and current indicators and we will compare off-the-shelf and custom options, with a budget between EUR 50,000 and 120,000 excluding VAT and a 5 to 8 month timeline. Detailed quote within 48 h. WhatsApp +221 77 596 93 33.
Mohamed Bah
Fondateur, Kolonell
Passionate about digital and entrepreneurship in Africa, Mohamed has been helping Sénégalese businesses with their digital transformation since 2020. Founder of Kolonell, he believes every SME deserves a professional and accessible online présence.
