About one in 10 operations in England are cancelled with less than 24 hours’ notice or postponed, according to research..
A study of elective surgery at 91 English NHS trusts found that 10% of operations were cancelled the day before the planned surgery date; while 9% were postponed when patients had their pre-op appointment.
If the study’s findings were replicated nationally, that would equate to approximately 300,000 cancellations or postponements. Yet nearly 40% of cancellations could be avoided, the authors concluded.
The latest figures show that as of the end of February, just over 6 million patients were waiting for treatment.
Researchers for the National Institute for Health and Care Research Central London patient safety research collaboration, NHS England, University College London and the Royal College of Anaesthetists examined planned surgery data over seven days in November 2024. They found that the most common causes of cancellations were for medical reasons, patients not attending, operating lists overrunning and emergency admissions. But in 37.3% of cases, had these issues been identified as little as three to five days earlier, the operation could either have gone ahead, or another patient could have been offered the surgery slot, the study calculated.
The study, published in the British Journal of Anaesthesia, also found that nearly two-thirds of operations postponed at the pre-op appointment were because patients needed further tests or specialist clinical review.
The authors concluded that clinical pathways need overhauling, with more early screening, nimbler surgery scheduling and better communication.
The lead author, Dr James Bedford of University College London, said: “We need to ensure we identify health problems, which put patients at risk of post-operative complications, as early as possible, so that these can be improved while they are waiting for their operation.”
Early screening also helps to identify low-risk patients who could be offered surgery at short notice, when slots become free at the last minute, he added.
Writing in a linked editorial, Prof Scarlett McNally, a consultant orthopaedic surgeon, said the findings “underscore the scale of systemic inefficiencies, unacceptable waste of public money and emotional toll experienced by patients”.
She said: “Without a different approach that focuses on supporting and preparing these patients, waiting lists will remain unacceptably high, as procedures are too frequently postponed or cancelled.”
Prof Frank Smith, the vice-president of the Royal College of Surgeons of England, said the study underlined just how damaging cancelling or postponing operations could be for patients and the NHS.
He said: “High-quality care before and after surgery is just as important as the operation itself. The findings underline the need for earlier, better coordinated care so patients are in the best possible condition when they reach the operating theatre.
“Supporting patients to ‘wait well’ reduces last-minute cancellations, improves recovery and helps the NHS make better use of precious surgical capacity.”
An NHS spokesperson said: “We are seeing great examples of NHS teams across the country offering more personalised support to ensure patients are fit for surgery, and we need to continue and extend this progress to improve preoperative care for patients, eliminate avoidable postponements and keep bringing waiting lists down.”
