The stark warning came in the Royal College of Surgeons of England (RCS England) Advancing the Surgical Workforce: 2025 UK Surgical Workforce Census report.

Tim Mitchell, president of RCS England, said: ‘Surgeons recognise the need for NHS reform and are committed to delivering the changes required. However, ambitious targets cannot be met without operating theatres, staff and equipment. Immediate action is needed to expand surgical capacity, invest in estates and tackle the £15.9bn maintenance backlog. Otherwise reducing waiting times and ensuring patients receive timely care will remain out of reach.'

Key findings from the report include:

• 53% of surgical consultants identified theatre access as a major challenge, driven by limited theatre space (73%), theatre staff shortages (59%) and bed availability (47%).  
• 61% of surgical consultants and 65% of dental consultants, along with 66% of core surgical trainees and 62% of higher surgical trainees, identified burnout as a major challenge.  
• 61% of surgical consultants and 69% of dental consultants regularly work beyond contracted hours.  
• 59% of surgical consultants aged 55-59 years plan to retire within four years.  

In addition, almost half (44%) of surgical trainees reported not having dedicated time for training, with access to opportunities in the independent sector - where NHS care is increasingly delivered - remaining inadequate.

In the past year, only 10% of core surgical trainees and 7% of higher surgical trainees gained operating experience outside the NHS. 

Alongside this, RCS England made specific recommendations on workforce and training for the 10-Year Workforce Plan and Medical Training Review, including: publishing transparent workforce numbers; increasing surgical training posts; guaranteeing theatre time for training; embedding protected training time in job plans; and mandating flexible working options.

A Department of Health and Social Care spokesperson said: ‘This Government has provided the NHS with record funding, and thanks to our reforms, the health service is delivering record activity and increased productivity.

‘Patients deserve to get the surgery they need without lengthy waits, and that's exactly why this Government invested in 17 surgical hubs this year, delivering tens of thousands of extra operations a year.

‘Surgical hubs are a key part of the Government's plan to increase capacity for planned surgery and reduce waiting times. The hubs focus entirely on planned procedures so operations can continue without being disrupted by emergency admissions.'

The DHSC said funding allocations for surgical hubs, including site details, will be confirmed in due course, with priority given to trusts without existing or planned hubs and those with the highest waiting lists.