One in 10 operations either cancelled last-minute or postponed, analysis finds
Around one in 10 operations in England were either cancelled within 24 hours or postponed because patients were not adequately prepared, new analysis has found.
Almost four in 10 last-minute cancellations were potentially avoidable, the study also suggests.
Experts said bolstering perioperative care “must be a priority” for the NHS or the health service risks waiting lists remaining “unacceptably high”.
The study, published in the British Journal of Anaesthesia, examined data from November 11 to November 18, 2024.
The time period included 22,573 preoperative assessment appointments and 19,905 planned procedures across 78 NHS trusts.
Across 91 participating trusts, including those which did not report pre-operative data, there were 2,190 postponements.
Analysis found the national rate of planned surgery being cancelled within 24 hours was 10%.
The top three reasons for cancellations were acute medical conditions, list overruns, and patients not attending.
However, some 37.3% of the cancellations were “potentially avoidable”, according to the study.
If problems were recognised three to five days earlier, the cancellation could have either been prevented, or another patient could have been booked on to operating lists, researchers said.
Elsewhere, 9% of pre-operative assessment appointments resulted in surgeries being postponed.
Most were down to patients not being adequately prepared, with 61% pushed back because patients needed further tests, specialist anaesthetic or a medical review, usually because of other medical conditions.
Lead author Dr James Bedford, of University College London, worked on the project alongside the National Institute of Health Research Central London Patient Safety Research Collaboration, NHS England, and the Royal College of Anaesthetists.
He said the findings underline “the need for better implementation of patient care ahead of surgery, across the NHS”.
He added: “In particular – and in keeping with standards issued by NHS England – we need to ensure we identify health problems, which put patients at risk of postoperative complications, as early as possible, so that these can be improved while they are waiting for their operation.
“The process of early screening also helps to identify patients who are low risk, who can potentially be called to have surgery at short notice, therefore reducing their waiting time, and improving service efficiency.”
In a linked editorial, Professor Scarlett McNally, a consultant orthopaedic surgeon, wrote: “NHS England has spent billions building new surgical hubs, but such stand-alone units do not operate on patients at greater risk of complications, those who are older, or living with underlying health conditions and in need of the additional back-up of an NHS hospital.
“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.”
Figures published earlier this month showed the waiting time for hospital treatment in England fell for the fourth month in a row.
An estimated 7.22 million treatments were waiting to be carried out at the end of February, relating to 6.11 million patients, down from 7.25 million treatments and 6.13 million patients at the end of January.
Commenting on the analysis, Dr Claire Shannon, president of the Royal College of Anaesthetists, said: “This study shows why strengthening perioperative care must be a priority.
“Delivering joined-up, patient-centred care before, during and after surgery leads to better outcomes for patients and is more efficient and cost effective for the NHS.”
Prof Frank Smith, vice-president of the Royal College of Surgeons of England said “high-quality care before and after surgery is just as important as the operation itself”.
He added: “Surgeons play a central role in leading teams to ensure patients are genuinely ready for surgery, not simply waiting for a date.
“The findings underline the need for earlier, better co-ordinated care so patients are in the best possible condition when they reach the operating theatre.”
Dr Denny Levett, director of the Centre for Perioperative Care, said: “So many last-minute cancellations in elective surgery could be avoided by earlier screening and better preparation before surgery.”
Published: by Radio NewsHub