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 as the number of patients in hospital with Covid-19 increased.
NHS England has paused collection and publication of some of its official statistics until further notice, including the cancelled operations dataset. Here we use Hospital Episode Statistics (HES) data to look at the number of operation appointments and the percentage that are cancelled.
The total number of operation appointments includes operations that were carried out, operations where the patient did not attend, and cancelled operations. The number of operation appointments fluctuates from month to month, but generally decreases in December. Between May 2017 and February 2020, the percentage of operations that were cancelled either by the provider or by, or on behalf of, the patient remained constant at 3%.
In March 2020, trusts were asked to postpone non-urgent elective activity to increase capacity for the response to the Covid-19 pandemic. The percentage of operations that were cancelled increased sharply, reaching a peak of 13.8% in April 2020. The number of operation appointments fell to 869,580 – 61% lower than in April 2019. This may reflect the increase in cancelled operations, as well as a decrease in operations being booked in order to free up hospital capacity for the pandemic response.
The number of operation appointments increased to 1,885,713 in November 2020, but fell to 1,570,119 in January 2021 (36% lower than in January 2020). The percentage of operations cancelled has decreased since April 2020, but remains higher than before the pandemic. In January 2021, 5.5% of operations were cancelled by the provider or by, or on behalf of, the patient.
About this data
This indicator uses data from Hospital Episode Statistics (HES). An operation appointment is defined as an appointment in which one or more operative procedures was carried out. The total number of operation appointments includes operations that were carried out, operation appointments where the patient did not attend, operations cancelled by the healthcare provider or cancelled by, or on behalf of, the patient, and a small number of appointments where it is not known if the operation was carried out.