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RCS: Last minute cancelled operations hits highest number since 1994

10 May 2018

•   There were 25,475 operations cancelled at the last minute in January-March 2018. This is the highest number since quarterly records began in 1994. This represents 1.3% of total admissions and the highest proportion of admissions since 2005. 

•   The number of patients having to wait more than a year for NHS treatment has now reached 2,755 patients.

•   82.3 % of patients at major A&E departments were treated within four-hour target in April 2018, which is an improvement on previous month but lower than April 2017.
The extreme pressures in accident and emergency departments during March have had a knock-on effect on spiralling waiting times for planned surgery, the Royal College of Surgeons (RCS) has warned. The RCS is also concerned that over 25,000 operations were cancelled at the last minute, despite NHS England guiding hospitals to cancel operations in advance during January.

There were 25,475 operations cancelled at the last minute during January-March 2018. This equates to 1.3% of total admissions. This is the highest figure since records began in 1994 (the previous record number was 24,976 cancellations in Jan-Mar 2001) and is the highest proportion of admissions since 2005.  In addition, 11.6% of patients who had their operation cancelled did not have their treatment rearranged within 28 days. This is also the highest percentage since 2005.

NHS England ‘referral to treatment’ statistics for March 2018 show that the number of patients waiting more than 18 weeks to start planned treatment in March 2018 was 491,102.  Only 87.2% were seen within 18 weeks, meaning the government’s 92% target has now not been met in more than two years – since February 2016.  The number of patients waiting longer than 18 weeks for planned treatment in March 2017 was 362,527.

The increase in cancelled operations in January-March is likely to have been caused by the extreme pressures on accident and emergency departments in the same period. In March only 76.4% of patients were seen within 4 hours in major A&E departments. This was the worst performance in hospital A&E departments since modern records began, and is likely to have resulted in hospitals cancelling planned surgery to focus their efforts on patients needing emergency treatment.
NHS England has previously said that the referral to treatment figures published today should be used as a benchmark for the rest of the financial year – and NHS hospitals should not allow their overall waiting list size to exceed these.2
The data also shows that 2,755, patients waited more than 52 weeks for NHS treatment compared to 1,528 in March 2017.  
The data published today shows that in April 2018, 82.3% of patients at major A&E departments (‘type 1 units’) were treated within the four-hour government target. Although this was well below the 95% standard, it was an improvement on March 2018.  The total number of A&E attendances at major units was 1,253,832 in April 2018, compared to 1,253,743 in April 2017. 
Mr Ian Eardley, Vice President of the Royal College of Surgeons 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.

“Patients are being forced to wait too long for planned surgery and an unacceptable number have suffered the stress of having their operation cancelled at the last minute.  It is very distressing for patients who are often in pain, or immobile, and the delay could mean that their condition deteriorates.
“At the end of March the Government announced that it intends to provide substantial additional funding for the NHS. This is very welcome. It must be used to improve access to existing hospital services, increase bed capacity and also to transform the way we provide care for older patients, so they can be treated closer to their homes.”

Notes to editors

1. Full data is available here: 

2. NHS England and NHS Improvement’s document Refreshing NHS Plans for 2018/19 states: “…Commissioners and providers should plan on the basis that their RTT waiting list, measured as the number of patients on an incomplete pathway, will be no higher in March 2019 than in March 2018 and, where possible, they should aim for it to be reduced.  Numbers nationally of patients waiting more than 52 weeks for treatment should be halved by March 2019, and locally eliminated wherever possible.”

3. The Royal College of Surgeons of England is a professional membership organisation and registered charity, which exists to advance surgical standards and improve patient care.

4. For more information, please contact the Press Office: Telephone: 020 7869 6047/6052; Email:; Out of hours media enquiries: 07966 486832. 

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