Around one in 10 planned operations in England are being cancelled with less than 24 hours’ notice, highlighting mounting pressure on the NHS and growing inefficiencies in surgical care.
A major study examining elective procedures across 91 NHS trusts found that 10% of operations were cancelled the day before surgery, while a further 9% were postponed at the pre-operative stage. If reflected nationwide, this could amount to roughly 300,000 cancellations or delays.
Researchers say nearly 40% of these disruptions could be avoided with earlier intervention and improved planning.
The analysis, conducted by teams including University College London and the Royal College of Anaesthetists, reviewed surgical data over a one-week period in November 2024. The findings were published in the British Journal of Anaesthesia.
The most common causes of last-minute cancellations included medical complications, patients failing to attend, operating lists overrunning, and emergency hospital admissions. However, in 37.3% of cases, issues could have been identified several days earlier, allowing operations to proceed or slots to be reassigned.
The study also found that nearly two-thirds of procedures postponed during pre-op appointments were delayed because patients required additional tests or specialist reviews.
Lead researcher Dr James Bedford said earlier screening is essential to ensure patients are fit for surgery and to reduce avoidable cancellations. He added that identifying low-risk patients in advance could help fill last-minute gaps in operating schedules.
Experts warn the current system is placing unnecessary strain on both patients and healthcare resources. Professor Scarlett McNally said the findings highlight systemic inefficiencies, wasted public funding and the emotional toll on patients whose procedures are delayed.
Meanwhile, Professor Frank Smith stressed that better pre- and post-operative care is key to improving outcomes and reducing cancellations. He noted that supporting patients while they wait can improve recovery and make better use of limited surgical capacity.
As of February, more than 6 million people in England were waiting for treatment, underlining the scale of the challenge.
An NHS spokesperson said progress is being made in improving pre-operative care, with more personalised support helping patients prepare for surgery. However, further efforts are needed to cut avoidable delays and reduce waiting lists.
The findings add to growing concerns over NHS capacity, as demand continues to outpace resources across England’s healthcare system.