Cancelled elective operations are an indicator of hospital capacity, as operations may be cancelled because of a lack of ward beds, equipment or theatre staff.
The cancelled elective operations standard is a pledge in the Handbook to the NHS Constitution which states, “all patients who have operations cancelled, on or after the day of admission (including the day of surgery), for non-clinical reasons to be offered another binding date within 28 days, or the patient’s treatment to be funded at the time and hospital of the patient’s choice”.
When resources are constrained, people who are admitted to hospital in an emergency are prioritised, so more elective operations are cancelled. In March 2020, after the outbreak of coronavirus (Covid-19), trusts were asked to postpone all non-urgent elective operations to free up capacity. In May, hospitals began to restart planned procedures, prioritising those with the most urgent clinical need. However in winter 2020/21, some planned surgeries were postponed due to another Covid-19 outbreak corresponding to an increase in the number of Covid-19 hospitalisations.
The collection and publication of cancelled elective operations statistics was paused at the start of the Covid-19 pandemic, to free up capacity in the NHS. NHS England resumed publishing cancelled elective operations data from Q3 2021/22. No data is available between Q4 2019/20 and Q2 2021/22.
The cancelled elective operations dataset records the number of last-minute cancelled operations. A cancellation is considered last-minute if the patient is told about the cancellation on the day of surgery. The NHS standard is that, in the event of a last-minute cancellation, a patient should receive their treatment within 28 days of cancellation.
The number of cancelled operations fluctuates a lot within a given year. They are usually higher in Q3 and Q4, covering the winter months. The chart above shows a moving average of the number of cancelled operations across four quarters. So, the value for Q4 2016/17 is an average number of cancelled operations for Q1 2016/17, Q2 2016/17, Q3 2016/17 and Q4 2016/17.
The number of cancelled operations reached a peak in Q3 2001/02 at 21,687, decreasing to 13,914 in Q3 2011/12. Since then, there has been an increase in the number of cancelled operations, reaching 21,591 in Q3 2019/20. It is worth noting that 731,893 more elective operations took place in Q3 2019/20 than in the previous peak in Q3 2001/02, a 35% increase.
The number of patients who did not receive their operation within 28 days of cancellation follows a similar trend. In 2001/02, an average of 4,772 patients each quarter did not receive their operation within 28 days of cancellation, which then declined to below 1,000 patients between 2006/07 and 2013/14. Since then, there has been a gradual rise in the number of patients who waited longer than 28 days for their rescheduled operation. In Q3 2021/22, the number of patients who did not receive their operation within 28 days of cancellation increased to 4,603, 24% of all cancelled operations.
About this data
Data for this chart is taken from NHS England’s publicly available statistics on cancelled elective operations.
The chart above shows a moving average of the number of cancelled operations across four quarters. So, the value for Q4 2016/17 is an average number of cancelled operations for Q1 2016/17, Q2 2016/17, Q3 2016/17 and Q4 2016/17.
For more information about this data, pleases see the guidance on the NHS England website.