Shoulder arthroplasty is effectively performed as a day-case surgery, however in our UK tertiary shoulder unit, patients were typically admitted the night before for pre-operative blood testing. The National Health Service’s (NHS) Getting It Right First Time (GIRFT) initiative strongly advocates for day-case surgery where clinically appropriate. We introduced day-of-surgery admissions (DOSA) to reduce length of stay (LOS), improve patient comfort, and cut NHS costs. Baseline data collected over 10 months at our site showed 27 shoulder arthroplasties were performed with 0% DOSA and an average LOS of two nights. Using Kotter’s Change Model, and Plan-Do-Study-Act (PDSA) cycles, DOSA was implemented via a departmental presentation (PDSA1) and reinforced through booking department communications (PDSA2). DOSA rates increased to 51% (PDSA1) and 79% (PDSA2), with a significant reduction in LOS from 2.07 to 1.29 nights. This service improvement project suggests that DOSA can be implemented for shoulder arthroplasty patients at a single UK site, potentially reducing LOS without compromising patient safety. However, given the limited sample size and single-site design, further research across multiple NHS sites is necessary to validate these findings and assess broader applicability. While initial results align with GIRFT recommendations, ongoing evaluation is required to determine long-term sustainability and impact on health care efficacy. This project also highlights the potential for scaling similar interventions across other NHS health boards to deliver cost-effective, patient centred care.