Cancellations and postponements in NHS hospitals in England: using new data to fix NHS waiting lists for surgery.

Abstract

A recent report in the British Journal of Anaesthesia analysed planned operations in National Health Service (NHS) hospitals in England found 10% of operations are cancelled within 24 hours of planned surgery and 9% of scheduled patients are postponed at the preoperative assessment clinic.¹ Moreover, 25% of operating lists run inefficiently. Bedford and colleagues report the findings of the Postponement and Cancellations in Elective Care (PACE2024) study conducted over one week across 64.5% of NHS Trusts undertaking elective surgery in England.¹ One quarter of cancellations were for medical reasons, one quarter were due to the patient not attending or the operation not being needed, necessary or convenient, and one fifth due to operating lists overrunning or emergency admissions. Two-thirds of postponements from preoperative assessment clinics were because the patient needed further tests or a specialist or medical review. This large study provides evidence to support and inform major pathway redesign with early screening, standardisation of processes, agile scheduling, senior clinical involvement, better shared decision making, encouragement of patient optimisation, good communication, true team-working and culture change.