• On the day cancelled operations hits highest proportion of admissions since 2004-05
  • The number of cancellations is highest figure since records began in 1990s
  • Surgeon leaders warn patients facing “unacceptable” delays can deteriorate further

The proportion of last minute cancelled operations in the NHS hit the highest rate in over a decade in the last quarter of 2017-18 – and rocketed 20 per cent on the same period in the previous year.

There were 25,475 operations cancelled at the last minute for non-clinical reasons by NHS providers between January and March 2018, up from 21,219 in the same quarter the previous year, according to NHS England data published today.

This is the highest number of last minute cancellations since records began in 1994-95, and the highest proportion of total activity, 1.3 per cent of admissions, since 2004-05 (see grpah below).

The Royal College of Surgeons raised concerns about the “unacceptable [and] exceptionally high number” of last minute cancellations. These patients were facing distress and pain and delays “could mean that their condition deteriorates,” the college warned.

The unplanned cancellations come despite NHS bosses ordering an extended suspension on non-urgent hospital operations in January. This resulted in a significant number of “planned cancellations” before the day of the procedure, which were not included in today’s data.

The unplanned cancellations in the last quarter made up just 1.3 per cent of all elective activity, but the RCS warned the rise, up from 1.1 per cent in the previous fourth quarter, was further evidence of the stress on the system and an indication of deeper capacity and demand problems.

The last time there was higher proportion of cancellations than last quarter was in 2004-05 when 1.6 per cent of admissions were cancelled which equated to 21,566 individual operations being postponed. The highest ever proportion was the 1.8 per cent reported in 2000-01. This represented 24,976 cancelled procedures.

Cancelled ops graph Q4 17 18

For the last quarter, United Lincolnshire Hospitals Trust recorded the highest number of cancellations of any trust (864), with Manchester University Foundation Trust and Plymouth Hospitals Trust also recording more than 600 last minute cancelled procedures (see table below).

The top of the list was dominated by the larger trusts, but also by trusts like United Lincolnshire that have long struggled on other key performance measures.

RCS vice president Ian Eardley said: “An exceptionally high number of operations were cancelled at the last minute between January and March.

“This will be because of increasing numbers of patients attending emergency care and requiring admission into planned surgery wards, as well as problems discharging patients who are ready to leave hospital, as there is inadequate social care support in the community.

“This is concerning given that hospitals had already cancelled a large number of operations in advance and these ‘advance’ cancellations will not be included in the statistics.

“Patients are being forced to wait too long for planned surgery and an unacceptable number have suffered the stress of having their operation cancelled at the last minute. It is very distressing for patients who are often in pain, or immobile, and the delay could mean that their condition deteriorates.”

NHS England said that 2,948, or 11.6 per cent, of the cancelled patients were not treated within 28 days of a cancellation, up from the 1,663, or 7.8 per cent, of patients who were not treated within 28 days in the last quarter of 2016-17.

The Department of Health and Social Care spokesman said it “recognised” the distress to patients and highlighted its plans for a long term funding settlement for the service.

A DHSC spokesman said: “We recognise it can be distressing for patients who have their operations cancelled, and this winter the NHS has to cancel more than usual due to a severe flu outbreak, but the number of cancelled operations remains low in the context of the millions of operations performed in the NHS each year.

“The prime minister and health and social care secretary have committed to a long term plan with a sustainable multi-year settlement for the NHS to help it manage growing patient demand, which will be agreed with NHS leaders, clinicians, and health experts.”

Last minute cancelled operations at all trusts in quarter four 2017-18

TrustLast minute elective operations cancelled for non-clinical reasonsPatients not treated within 28 days of last minute elective cancellation
UNITED LINCOLNSHIRE HOSPITALS TRUST 864 68
MANCHESTER UNIVERSITY FT 668 30
UNIVERSITY HOSPITALS PLYMOUTH TRUST 620 120
LEEDS TEACHING HOSPITALS TRUST 584 130
NORFOLK AND NORWICH UNIVERSITY HOSPITALS FT 572 101
UNIVERSITY HOSPITALS BIRMINGHAM FT 478 44
BARTS HEALTH TRUST 471 47
UNIVERSITY HOSPITALS OF NORTH MIDLANDS TRUST 449 57
UNIVERSITY HOSPITALS OF LEICESTER TRUST 429 144
UNIVERSITY COLLEGE LONDON HOSPITALS FT 407 53
IMPERIAL COLLEGE HEALTHCARE TRUST 405 79
SHEFFIELD TEACHING HOSPITALS FT 382 16
HEART OF ENGLAND FT 372 1
BLACKPOOL TEACHING HOSPITALS FT 367 74
LUTON AND DUNSTABLE UNIVERSITY HOSPITAL FT 361 24
EAST LANCASHIRE HOSPITALS TRUST 346 16
YORK TEACHING HOSPITAL FT 342 21
CAMBRIDGE UNIVERSITY HOSPITALS FT 340 31
ROYAL CORNWALL HOSPITALS TRUST 335 136
FRIMLEY HEALTH FT 328 32
PENNINE ACUTE HOSPITALS TRUST 327 60
UNIVERSITY HOSPITALS BRISTOL FT 321 21
NORTH BRISTOL TRUST 306 27
UNIVERSITY HOSPITAL SOUTHAMPTON FT 300 33
GUY’S AND ST THOMAS’ FT 287 42
HULL AND EAST YORKSHIRE HOSPITALS TRUST 279 20
OXFORD UNIVERSITY HOSPITALS FT 273 59
NORTH WEST ANGLIA FT 268 60
LANCASHIRE TEACHING HOSPITALS FT 266 16
BRADFORD TEACHING HOSPITALS FT 264 9
LONDON NORTH WEST UNIVERSITY HEALTHCARE TRUST 264 0
UNIVERSITY HOSPITALS COVENTRY AND WARWICKSHIRE TRUST 261 55
NORTHAMPTON GENERAL HOSPITAL TRUST 261 60
EPSOM AND ST HELIER UNIVERSITY HOSPITALS TRUST 259 6
BUCKINGHAMSHIRE HEALTHCARE TRUST 258 2
SALFORD ROYAL FT 250 9
IPSWICH HOSPITAL TRUST 243 21
ST GEORGE’S UNIVERSITY HOSPITALS FT 235 35
KING’S COLLEGE HOSPITAL FT 224 42
WRIGHTINGTON, WIGAN AND LEIGH FT 217 13
WORCESTERSHIRE ACUTE HOSPITALS TRUST 217 72
PORTSMOUTH HOSPITALS TRUST 211 14
SOUTH TEES HOSPITALS FT 202 34
KETTERING GENERAL HOSPITAL FT 197 0
COUNTY DURHAM AND DARLINGTON FT 195 13
ROYAL DEVON AND EXETER FT 194 26
CITY HOSPITALS SUNDERLAND FT 193 30
TORBAY AND SOUTH DEVON FT 189 39
BARKING, HAVERING AND REDBRIDGE UNIVERSITY HOSPITALS TRUST 187 28
ROYAL BROMPTON AND HAREFIELD FT 187 2
COUNTESS OF CHESTER HOSPITAL FT 185 53
MID ESSEX HOSPITAL SERVICES TRUST 185 16
DONCASTER AND BASSETLAW TEACHING HOSPITALS FT 180 9
THE QUEEN ELIZABETH HOSPITAL, KING’S LYNN, FT 174 40
MILTON KEYNES UNIVERSITY HOSPITAL FT 163 60
STOCKPORT FT 162 11
NORTHERN LINCOLNSHIRE AND GOOLE FT 161 35
THE ROYAL WOLVERHAMPTON TRUST 159 0
WEST HERTFORDSHIRE HOSPITALS TRUST 154 54
ROYAL FREE LONDON FT 151 10
SURREY AND SUSSEX HEALTHCARE TRUST 151 57
EAST KENT HOSPITALS UNIVERSITY FT 151 8
THE DUDLEY GROUP FT 150 9
ROYAL LIVERPOOL AND BROADGREEN UNIVERSITY HOSPITALS TRUST 147 13
NOTTINGHAM UNIVERSITY HOSPITALS TRUST 146 8
EAST AND NORTH HERTFORDSHIRE TRUST 136 34
SANDWELL AND WEST BIRMINGHAM HOSPITALS TRUST 136 3
SHREWSBURY AND TELFORD HOSPITAL TRUST 136 3
ROYAL PAPWORTH HOSPITAL FT 134 3
UNIVERSITY HOSPITALS OF MORECAMBE BAY FT 133 4
DERBY TEACHING HOSPITALS FT 133 30
DORSET COUNTY HOSPITAL FT 130 4
NORTH CUMBRIA UNIVERSITY HOSPITALS FT 128 19
THE NEWCASTLE UPON TYNE HOSPITALS FT 126 12
COLCHESTER HOSPITAL UNIVERSITY FT 126 2
CALDERDALE AND HUDDERSFIELD FT 124 6
CHELSEA AND WESTMINSTER HOSPITAL FT 120 10
SOUTHEND UNIVERSITY HOSPITAL FT 119 14
CHESTERFIELD ROYAL HOSPITAL FT 114 14
THE HILLINGDON HOSPITALS FT 113 4
ST HELENS AND KNOWSLEY HOSPITAL SERVICES TRUST 111 0
MID CHESHIRE HOSPITALS FT 108 16
MID YORKSHIRE HOSPITALS TRUST 108 0
MAIDSTONE AND TUNBRIDGE WELLS TRUST 107 13
ROYAL BERKSHIRE FT 106 16
BASILDON AND THURROCK UNIVERSITY HOSPITALS FT 105 2
GREAT ORMOND STREET HOSPITAL FOR CHILDREN FT 105 24
BIRMINGHAM WOMEN’S AND CHILDREN’S FT 104 0
POOLE HOSPITAL FT 104 3
HAMPSHIRE HOSPITALS FT 103 3
ASHFORD AND ST PETER’S HOSPITALS FT 101 15
MEDWAY FT 98 19
QUEEN VICTORIA HOSPITAL FT 97 12
THE ROTHERHAM FT 96 0
THE ROYAL BOURNEMOUTH AND CHRISTCHURCH HOSPITALS FT 96 1
BOLTON NHS FOUNDATION TRUST 95 10
ROYAL SURREY COUNTY HOSPITAL FT 94 2
NORTH TEES AND HARTLEPOOL FT 93 6
BEDFORD HOSPITAL TRUST 93 0
EAST SUSSEX HEALTHCARE TRUST 93 2
WYE VALLEY TRUST 90 32
GATESHEAD HEALTH FT 87 3
SALISBURY FT 87 0
ALDER HEY CHILDREN’S FT 86 11
ROYAL UNITED HOSPITALS BATH FT 85 13
WESTERN SUSSEX HOSPITALS FT 85 8
WARRINGTON AND HALTON HOSPITALS FT 83 10
BURTON HOSPITALS FT 79 0
MOORFIELDS EYE HOSPITAL FT 77 0
HARROGATE AND DISTRICT FT 76 0
TAUNTON AND SOMERSET FT 75 9
ISLE OF WIGHT TRUST 74 0
JAMES PAGET UNIVERSITY HOSPITALS FT 73 0
LIVERPOOL HEART AND CHEST HOSPITAL FT 72 0
AIREDALE FT 72 0
WEST SUFFOLK FT 72 9
GREAT WESTERN HOSPITALS FT 71 2
TAMESIDE AND GLOSSOP INTEGRATED CARE FT 67 0
YEOVIL DISTRICT HOSPITAL FT 67 0
THE PRINCESS ALEXANDRA HOSPITAL TRUST 64 6
GEORGE ELIOT HOSPITAL TRUST 61 3
WIRRAL UNIVERSITY TEACHING HOSPITAL FT 59 37
SHEFFIELD CHILDREN’S FT 57 4
SOUTH WARWICKSHIRE FT 57 1
AINTREE UNIVERSITY HOSPITAL FT 56 0
NORTHUMBRIA HEALTHCARE FT 55 3
LEWISHAM AND GREENWICH TRUST 54 0
DARTFORD AND GRAVESHAM TRUST 53 0
THE ROYAL ORTHOPAEDIC HOSPITAL FT 50 0
BRIGHTON AND SUSSEX UNIVERSITY HOSPITALS TRUST 50 2
BARNSLEY HOSPITAL FT 49 0
THE WALTON CENTRE FT 48 0
SHERWOOD FOREST HOSPITALS FT 48 13
CROYDON HEALTH SERVICES TRUST 42 1
ROYAL NATIONAL ORTHOPAEDIC HOSPITAL TRUST 41 5
EAST CHESHIRE TRUST 40 0
NORTH MIDDLESEX UNIVERSITY HOSPITAL TRUST 39 3
NORTHERN DEVON HEALTHCARE TRUST 34 7
SOUTHPORT AND ORMSKIRK HOSPITAL TRUST 28 0
THE ROBERT JONES AND AGNES HUNT ORTHOPAEDIC HOSPITAL FT 27 0
SOUTH TYNESIDE FT 26 0
KINGSTON HOSPITAL FT 25 4
HOMERTON UNIVERSITY HOSPITAL FT 24 0
WESTON AREA HEALTH TRUST 24 0
WALSALL HEALTHCARE TRUST 22 0
WILL ADAMS TREATMENT CENTRE 20 5
WHITTINGTON HEALTH TRUST 18 1
LIVERPOOL WOMEN’S FT 17 0
DERBYSHIRE COMMUNITY HEALTH SERVICES FT 15 0
KIM’S HOSPITAL (NEWNHAM COURT) 10 0
THE ROYAL MARSDEN FT 9 0
SHROPSHIRE COMMUNITY HEALTH TRUST 4 0
SOUTHERN HEALTH FT 2 0
ISIGHT 1 0
THE CROFT SHIFA HEALTH CENTRE 0 0
THE CHRISTIE FT 0 0
NUFFIELD HEALTH, CAMBRIDGE HOSPITAL 0 0
BIRMINGHAM COMMUNITY HEALTHCARE FT 0 0
SOMERSET PARTNERSHIP FT 0 0