The study by the National Institute of Health Research (NIHR), Central London Patient Safety Research Collaboration, NHS England, University College London and the Royal College of Anaesthetists was published today in the British Journal of Anaesthesia.
Professor Scarlett McNally, consultant orthopaedic surgeon said ‘the findings underscore the scale of systemic inefficiencies, unacceptable waste of public money and emotional toll experienced by patients'.
The seven-day snapshot of 91 NHS trusts, conducted from 11-18 November 2024, found 40% of last moment cancellations were deemed to be potentially avoidable.
Most postponements occurred because patients had not been adequately prepared and were not in the best medical condition for an anaesthetic or surgery by the time of their pre-operative assessment.
Over half of postponements (61%) were due to patients needing further tests or specialist anaesthetic or medical review, often as a result of the patient's other medical conditions.
In addition, 25% of operating lists were reported as running inefficiently with reasons including scheduling, organisational issues, delays in patients arriving and staffing issues.
The authors highlight the need for earlier, robust processes to ensure underlying health issues are identified at the time patients are added to the waiting list.
Dr Claire Shannon, president of the Royal College of Anaesthetists, said: ‘This study shows why strengthening perioperative care must be a priority. Delivering joined-up, patient-centred care before, during and after surgery leads to better outcomes for patients and is more efficient and cost effective for the NHS.'
An NHS spokesperson said: ‘As this study shows, NHS surgery is becoming more efficient, with staff delivering a record number of elective operations and tests in 2025, reducing waiting lists to their lowest level in over three years and year-long waits to their lowest in nearly six.
‘We are seeing great examples of NHS teams across the country offering more personalised support to ensure patients are fit for surgery, and we need to continue and extend this progress to improve pre-operative care for patients, eliminate avoidable postponements and keep bringing waiting lists down.'
