Patient safety

Record number of operations cancelled last minute

NHS hospitals cancelled a record number of operations at the last minute, official figures have revealed.

In January to March 2018, there were 25,475 cancelled operations - the highest figure since quarterly records began in 1994.

These cancelled operations equate to a 1.3% of total admissions, which is the highest proportion since 2005.

Previously, the highest figure was 24,976 cancellations back in January-March 2001.

Worryingly, 11.6% of patients whose operations had been cancelled did not have their treatment rearranged within 28 days - the highest percentage since 2005.

As well as these last minute cancellations, 2,755 patients have faced waits of over a year for NHS treatment.

Just 87.2% of patients were seen within the 18 week ‘referral to treatment’ time frame, meaning that the government’s target of 92% has not been met in over two years.

In March 2018, the number of patients waiting more than 18 weeks to start planned treatment was 491,102 - an increase of almost 130,000 from the previous year.

In November, the Royal College of Surgeons (RCS) found that 40% more patients were waiting more than six months for treatment and that 59% more were waiting at least nine.

The RCS has warned that the “extreme pressures” in A&E departments during March have had a knock-on effect of “spiralling waiting times” for planned surgery, with just 76.4% of patients seen within four hours in major A&E departments - the worst performance in hospital A&E departments since modern records began. The RCS has said this is likely to have resulted in hospitals cancelling planned surgery.

However, last month the number of patients treated at major A&E departments within four hours rose to 82.3% - an improvement on March 2018, but still well below the government target of 95%.

Saffron Cordery, deputy chief executive of NHS Providers, said that it was encouraging to see some recovery in performance against the four hour A&E target, but that the figures highlight the scale of challenges faced by trusts, calling the pressures on trusts and frontline staff “severe.”

“The increase in emergency admissions – up nearly 7% compared to the same time last year – shows how they have risen to the challenge.

"But services are clearly overstretched,” she added.

She explained that the number of patients facing so called “trolley waits”, patients who experience delays after being told they should be admitted, has risen by over 40% compared to the same time last year.

Commenting on delays for planned treatment, she said: “And performance against the 18-week target for routine operations such as knee and hip replacements has slipped back again. The number of people on the waiting list has grown by 5% in the last year, and the number waiting more than 18 weeks has risen by 35% in 12 months.

“Many of these patients have to live with continued pain, restricted mobility, and the risk that their condition could deteriorate further.”

Cordery warned that without urgent steps to address staff and bed shortages in hospitals, community mental health, ambulance services and in social care, that many of the “hard won gains of the last decade” could be lost.

Ian Eardly, vice president of the RCS and consultant urologist, 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.”

Eardly added that the number of patients who have had their operations cancelled at the last minute is “unacceptable”, warning that not only is it very distressing for a patient who is often in pain or immobile, but that it could also mean that their condition deteriorates.

Top image: Zdenko Zivkovic

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