21,273 operations cancelled before the start of ‘winter pressures’

New NHS figures show 21,273 operations were cancelled at the last minute in the three months to the end of December 2022, with hospitals feeling ‘winter pressures’ well before the winter had officially started. The data also shows 4,593 patients were not treated within 28 days of their cancellation, in a breach of the standard.

The data highlights the scale of operations that were cancelled at the last minute for non-clinical reasons. A last-minute cancellation is one that occurs on the day the patient was due to arrive, after they have arrived in hospital or on the day of their operation. 

NHS England’s monthly Referral to Treatment (RTT) statistics also report the total number of people waiting for consultant-led NHS hospital treatment has seen a small increase on November 2022, with 7.20 million on the list in December 2022.  

Despite the huge efforts of NHS staff, the number of patients waiting more than 18 months has started to increase again. In November 2022 it was 48,961 and has now increased to 54,882 patients waiting 18 months (78 weeks) or more in December 2022 for consultant-led hospital treatment. The government’s Elective Recovery Plan has a target to eliminate NHS waits of over 18 months (78 weeks), by April 2023.

The most common long waits seen were for Trauma and Orthopaedic treatment – such as hip and knee replacements (797,630), Ear Nose and Throat treatment (549,656), or General Surgery – such as gallbladder removals and hernia operations (442,948).

Mr Tim Mitchell, Vice President of the Royal College of Surgeons of England, said: “NHS staff have worked incredibly hard to make sure the longest waits for surgery have been dramatically reduced over the last year.  
  
“However, the data show that too many patients are still suffering the distress of having their operations cancelled at the last minute. Their lives, and sometimes livelihoods, remain on hold while they wait for a new date and the relief from pain that surgery will bring. In some areas, surgeons are telling us that they are dealing with more complex cases, more frequently, as patients’ conditions deteriorate while on long waiting lists.  

“No surgeon wants to be in the position of telling a patient their surgery has to be cancelled but the very high demand we have seen in emergency departments since the summer, and problems discharging patients who are ready to leave hospital when there is a lack of social care, mean this is too often what has to happen. Gaps in the workforce also play a huge part. Often there will be a surgeon available to operate, but no theatre nurses or anaesthetists.”

NHS England has announced 37 new surgical hubs, ten expanded existing hubs and 81 new theatres dedicated to planned care, in an effort to speed up the recovery of waiting lists. 

Commenting on the new hubs and extra theatre capacity, Mr Mitchell added: “These new surgical hubs will go a good way to helping bring down waiting lists. It is excellent news for patients and positive news for surgeons who have shared with us their frustration at not being able to get patients in for their operations due to a lack of theatre capacity. But there is more to be done.

“We would like to see surgical hubs established in every area of the country with a particular focus on those areas that are underserved and struggling to bring down waiting times. All of this will also mean nothing in the long term unless we have a resilient workforce to staff hubs. The Government’s much anticipated workforce plan couldn’t come soon enough.” 

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