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New Royal College of Surgeons of England survey reveals a lack of beds halted operations in November 2019

09 Jan 2020

As NHS England publishes performance statistics for November 2019, the Royal College of Surgeons of England (RCS) can reveal that nearly eight in ten surgeons said they were unable to operate due to a lack of beds in November 2019.

NHS England’s ‘referral to treatment’ statistics for November 2019, published today, show that the number of patients waiting more than 18 weeks to start planned treatment was 690,096. Only 84.4% of patients were seen within 18 weeks, missing the government’s statutory target of 92% yet again.

RCS surveyed 421 surgeons who were due to perform an operation in a NHS hospital in November 2019. The survey results, published today, find that:

  • Nearly four in ten (37%) surgeons said they had to undertake more complex surgery, due to a patient being on a waiting list for an extended period - including for more advanced cancers.
  • Nearly eight in ten (77%) surgeons said there were staff in their trust unable to operate because there were not enough beds to admit patients.
  • Almost half (46%) said they did not start their most recent operating list on time. Delays to start times can lead to operations later in the day being cancelled.
  • Nearly 60% had to cancel operations at the last minute (i.e. on the day of the patient’s operation).
  • Four in ten (40%) said there were ‘mothballed’ wards in their trust that could be used, if more staff were recruited.

Professor Derek Alderson, President of the Royal College of Surgeons of England, said:

“I am frustrated that we continue to see no improvement in waiting times. Surgeons have told us loud and clear, we need more hospital beds and nursing staff to bring waiting times down – these were the top reasons cited in the survey when asked about delayed operations and last minute cancellations in their Trust. 

“We call on the new government to make good on their election promise to invest in the NHS, and bring down waiting times. Not only will this improve the quality of life of thousands of people across the country, but also it makes sense for public finances. Our research finds that surgeons are having to perform more complex and costly surgery because patients’ conditions have deteriorated during the wait for an operation. Meanwhile patients are left unable to return to work or look after their families. The government must sort this out.

“We are calling for a five year plan to fix waiting lists. We need more beds and more nursing staff to bring waiting times back down. We are currently in discussions with NHS England about how to do this, and this evidence from surgeons will inform those discussions.”

The top five reasons respondents cited for last minute cancellations (in order) are:

  1. Lack of ward beds
  2. Lack of critical care/high dependency beds
  3. Lack of operating theatre capacity/access
  4. Lack of staff (e.g. surgeon, anaesthetist, theatre staff, nurses, physios)
  5. Lack of infrastructure (e.g. diagnostics, equipment failure)

Notes to editors

  1. The RCS survey fieldwork ran from 29 November 2019-17 December 2019. The survey was completed by 421 surgeons.
  2. Full NHS England data is available here:
  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 RCS press office: telephone: 020 7869 6047; email:; out-of-hours media enquiries: 07966 486832.

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