Cancelled elective operations are an indicator of hospital capacity, as operations may be cancelled because of a lack of ward beds, equipment or theatre staff.
The cancelled elective operations standard is a pledge in the Handbook to the NHS Constitution which states "all patients who have operations cancelled, on or after the day of admission (including the day of surgery), for non-clinical reasons to be offered another binding date within 28 days, or the patient's treatment to be funded at the time and hospital of the patient's choice".
When looking at the data it is important to remember the NHS National Emergency Pressures Panel's recommendation for hospitals to defer all non-urgent inpatient elective care for the month of January 2018. This decision was made to help increase capacity and minimise disruptive last-minute cancellations over the winter period.
Elective operations are operations that are organised in advance.
Cancelled elective operations are defined as those which have been cancelled by the trust for non-clinical reasons on the day of admission or later (including the day of surgery).
Some common non-clinical reasons for cancelled operations include:
- ward beds being unavailable;
- surgeon being unavailable;
- emergency cases needing the theatre;
- theatre list over-running;
- equipment failure;
- administrative errors;
- anaesthetists unavailable;
- theatre staff unavailable;
- critical care bed not available.
A breach is counted at the point it occurs i.e. if after 28 days of a last-minute cancellation the patient has not been treated then the breach should be recorded. The 28 day period does not stop at the end of a quarter but is continuous.
Further guidance can be found on the NHS England, Cancelled Elective Operations website.