Cancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 UK National Health Service hospitals

Western Sussex Hospitals NHS Foundation Trust, West Herts Hospitals NHS Trust, Weston Area Health NHS Trust, West Suffolk NHS Foundation Trust, The Whittington Hospital NHS Trust, Wirral University Teaching Hospital NHS Foundation Trust, Worcestershire Acute Hospitals NHS Trust, Wrightington, Wigan and Leigh NHS Foundation Trust, Wye Valley NHS Trust, Yeovil District Hospital NHS Foundation Trust, York Teaching Hospital NHS Foundation Trust, the SNAP-2: EPICCS collaborators, Health Services Research Centre, National Institute of Academic Anaesthesia, Study Steering Group, Net Solving Limited, Trainee Research Networks, Abertawe Bro Morgannwg University Health Board, Aintree University Hospitals NHS Foundation Trust, Airedale NHS Foundation Trust, Aneurin Bevan Health BoardAshford & St Peters NHS Foundation Trust, Barking, Havering and Redbridge University Hospitals NHS Trust, Barnsley Hospital NHS Foundation Trust, Barts Health NHS Trust, Basildon and Thurrock University Hospitals NHS Foundation Trust, Bedford Hospital NHS Trust, Belfast Health and Social Care Trust, Betsi Cadwaladr University Health Board, Birmingham Women's NHS Foundation Trust, Blackpool Teaching Hospitals NHS Foundation Trust, Bolton Hospital NHS Foundation Trust, Bradford Teaching Hospitals NHS Foundation Trust, Brighton and Sussex University Hospitals NHS Trust, Buckinghamshire Healthcare NHS Trust, Burton Hospitals NHS Foundation Trust, Calderdale and Huddersfield NHS Foundation Trust, Cambridge University Hospitals NHS Foundation Trust, Cardiff and Vale University Health Board, Central Manchester University Hospitals NHS Foundation Trust, Chelsea and Westminster Hospital NHS Foundation Trust, Chesterfield Royal Hospital NHS Foundation Trust, The Christie Hospital NHS Foundation Trust, City Hospitals Sunderland NHS Foundation Trust, Colchester Hospital University NHS Foundation Trust, Countess of Chester NHS Foundation Trust, County Durham and Darlington NHS Foundation Trust, Croydon Health Services NHS Trust, Cwm Taf University Health Board, Dartford and Gravesham NHS Trust, Derby Hospitals NHS Foundation Trust, Doncaster and Bassetlaw Hospitals NHS Foundation Trust, Dorset County Hospital NHS Foundation Trust, The Dudley Group NHS Foundation Trust, East and North Hertfordshire NHS Trust, East Kent Hospitals University NHS Foundation Trust, East Lancashire Hospitals NHS Trust, East Sussex Healthcare NHS Trust, Epsom and St Helier University Hospitals NHS Trust, Frimley Health NHS Foundation Trust, Gateshead Health NHS Foundation Trust, Gloucestershire Hospitals NHS Foundation Trust, Great Western Hospitals NHS Foundation Trust, Guy's and St Thomas’ NHS Foundation Trust, Hampshire Hospitals NHS Foundation Trust, Harrogate and District NHS Foundation Trust, Heart Of England NHS Foundation Trust, The Hillingdon Hospitals NHS Foundation Trust, Homerton University Hospital NHS Foundation Trust, Hull and East Yorkshire Hospitals NHS Trust, Hywel Dda Health Board, Imperial College Healthcare NHS Trust, Ipswich Hospital NHS Trust, Isle of Wight NHS Trust, James Paget University Hospitals NHS Foundation Trust, Kettering General Hospital NHS Foundation Trust, King's College Hospital NHS Foundation Trust, Kingston Hospital NHS Foundation Trust, Lancashire Teaching Hospitals NHS Foundation Trust, Leeds Teaching Hospitals NHS Trust, Lewisham and Greenwich NHS Trust, Liverpool Women's NHS Foundation Trust, Luton and Dunstable University Hospital NHS Foundation Trust, Medway NHS Foundation Trust, Mid Cheshire Hospitals NHS Foundation Trust, Mid Essex Hospital Services NHS Trust, Mid Yorkshire Hospitals NHS Trust, Milton Keynes University Hospital NHS Foundation Trust, Newcastle upon Tyne Hospitals NHS Foundation Trust, NHS Ayrshire & Arran, NHS Dumfries & Galloway, NHS Fife, NHS Greater Glasgow & Clyde, NHS Highland, NHS Lanarkshire, NHS Lothian, NHS Scotland Special Board, NHS Shetland, NHS Tayside, Norfolk and Norwich University Hospitals NHS Foundation Trust, Northampton General Hospital NHS Trust, North Bristol NHS Trust, North Cumbria University Hospitals NHS Trust, Northern Devon Healthcare NHS Trust, Northern Health and Social Care Trust, Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, North Middlesex University Hospital NHS Trust, North Tees and Hartlepool NHS Trust, Northumbria Healthcare NHS Foundation Trust, North West Anglia NHS Foundation Trust, Nottingham University Hospitals NHS Trust, Oxford University Hospitals NHS Foundation Trust, Papworth Hospital NHS Foundation Trust, Pennine Acute NHS Trust, Plymouth Hospitals NHS Trust, Poole Hospital NHS Foundation Trust, Portsmouth Hospitals NHS Trust, The Princess Alexandra Hospital NHS Trust, Queen Elizabeth Hospital NHS Foundation Trust, Queen Victoria Hospital NHS Foundation Trust, Robert Jones and Agnes Hunt Orthopaedic Hospital Foundation Trust, Rotherham NHS Foundation Trust, Royal Berkshire NHS Foundation Trust, Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust, Royal Cornwall Hospitals NHS Trust, Royal Devon and Exeter NHS Foundation Trust, Royal Free London NHS Foundation Trust, The Royal Liverpool and Broadgreen University Hospitals NHS Trust, The Royal Marsden NHS Foundation Trust, Royal National Orthopaedic Hospital NHS Trust, The Royal Orthopaedic Hospital NHS Foundation Trust, Royal Surrey County Hospital NHS Foundation Trust, Royal United Hospitals Bath NHS Trust, The Royal Wolverhampton Hospitals NHS Trust, Salford Royal NHS Foundation Trust, Salisbury NHS Foundation Trust, Sandwell and West Birmingham Hospitals NHS Trust, Sheffield Teaching Hospitals NHS Foundation Trust, Shrewsbury and Telford Hospital NHS Trust, South Eastern Health and Social Care Trust, Southport and Ormskirk Hospital NHS Trust, South Tees Hospitals NHS Foundation Trust, South Tyneside NHS Foundation Trust, South Warwickshire NHS Foundation Trust, St George's Healthcare NHS Trust, St Helens and Knowsley Teaching Hospitals NHS Trust, Stockport NHS Foundation Trust, Surrey and Sussex Healthcare NHS Trust, Tameside Hospital NHS Foundation Trust, Taunton and Somerset NHS Foundation Trust, Torbay and South Devon NHS Foundation Trust, United Lincolnshire Hospitals NHS Trust, University College London Hospitals NHS Foundation Trust, University Hospital of North Midlands NHS Trust, University Hospital of South Manchester NHS Foundation Trust, University Hospitals Birmingham NHS Foundation Trust, University Hospitals Bristol NHS Foundation Trust, University Hospitals Coventry and Warwickshire NHS Trust, University Hospitals of Leicester NHS Trust, University Hospitals of Morecambe Bay NHS Foundation Trust, University Hospital Southampton NHS Foundation Trust, Walsall Healthcare NHS Trust, Warrington & Halton Hospitals NHS Foundation Trust, Western Health and Social Care Trust

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Cancellation of planned surgery impacts substantially on patients and health systems. This study describes the incidence and reasons for cancellation of inpatient surgery in the UK NHS. Methods: We conducted a prospective observational cohort study over 7 consecutive days in March 2017 in 245 NHS hospitals. Occurrences and reasons for previous surgical cancellations were recorded. Using multilevel logistic regression, we identified patient- and hospital-level factors associated with cancellation due to inadequate bed capacity. Results: We analysed data from 14 936 patients undergoing planned surgery. A total of 1499 patients (10.0%) reported previous cancellation for the same procedure; contemporaneous hospital census data indicated that 13.9% patients attending inpatient operations were cancelled on the day of surgery. Non-clinical reasons, predominantly inadequate bed capacity, accounted for a large proportion of previous cancellations. Independent risk factors for cancellation due to inadequate bed capacity included requirement for postoperative critical care [odds ratio (OR)=2.92; 95% confidence interval (CI), 2.12–4.02; P<0.001] and the presence of an emergency department in the treating hospital (OR=4.18; 95% CI, 2.22–7.89; P<0.001). Patients undergoing cancer surgery (OR=0.32; 95% CI, 0.22–0.46; P<0.001), obstetric procedures (OR=0.17; 95% CI, 0.08–0.32; P<0.001), and expedited surgery (OR=0.39; 95% CI, 0.27–0.56; P<0.001) were less likely to be cancelled. Conclusions: A significant proportion of patients presenting for surgery have experienced a previous cancellation for the same procedure. Cancer surgery is relatively protected, but bed capacity, including postoperative critical care requirements, are significant risk factors for previous cancellations.

Original languageEnglish (US)
Pages (from-to)730-738
Number of pages9
JournalBritish Journal of Anaesthesia
Volume121
Issue number4
DOIs
StatePublished - Oct 1 2018

Fingerprint

National Health Programs
Inpatients
Cohort Studies
Odds Ratio
Confidence Intervals
Postoperative Care
Critical Care
Censuses
Ambulatory Surgical Procedures
Obstetrics
Observational Studies
Hospital Emergency Service
Neoplasms
Logistic Models
Health

Keywords

  • Health Services Research
  • medical resource utilisation
  • operating room management
  • surgery

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Western Sussex Hospitals NHS Foundation Trust, West Herts Hospitals NHS Trust, Weston Area Health NHS Trust, West Suffolk NHS Foundation Trust, The Whittington Hospital NHS Trust, Wirral University Teaching Hospital NHS Foundation Trust, ... Western Health and Social Care Trust (2018). Cancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 UK National Health Service hospitals. British Journal of Anaesthesia, 121(4), 730-738. https://doi.org/10.1016/j.bja.2018.07.002

Cancelled operations : a 7-day cohort study of planned adult inpatient surgery in 245 UK National Health Service hospitals. / Western Sussex Hospitals NHS Foundation Trust; West Herts Hospitals NHS Trust; Weston Area Health NHS Trust; West Suffolk NHS Foundation Trust; The Whittington Hospital NHS Trust; Wirral University Teaching Hospital NHS Foundation Trust; Worcestershire Acute Hospitals NHS Trust; Wrightington, Wigan and Leigh NHS Foundation Trust; Wye Valley NHS Trust; Yeovil District Hospital NHS Foundation Trust; York Teaching Hospital NHS Foundation Trust; the SNAP-2: EPICCS collaborators; Health Services Research Centre, National Institute of Academic Anaesthesia; Study Steering Group; Net Solving Limited; Trainee Research Networks; Abertawe Bro Morgannwg University Health Board; Aintree University Hospitals NHS Foundation Trust; Airedale NHS Foundation Trust; Aneurin Bevan Health Board; Ashford & St Peters NHS Foundation Trust; Barking, Havering and Redbridge University Hospitals NHS Trust; Barnsley Hospital NHS Foundation Trust; Barts Health NHS Trust; Basildon and Thurrock University Hospitals NHS Foundation Trust; Bedford Hospital NHS Trust; Belfast Health and Social Care Trust; Betsi Cadwaladr University Health Board; Birmingham Women's NHS Foundation Trust; Blackpool Teaching Hospitals NHS Foundation Trust; Bolton Hospital NHS Foundation Trust; Bradford Teaching Hospitals NHS Foundation Trust; Brighton and Sussex University Hospitals NHS Trust; Buckinghamshire Healthcare NHS Trust; Burton Hospitals NHS Foundation Trust; Calderdale and Huddersfield NHS Foundation Trust; Cambridge University Hospitals NHS Foundation Trust; Cardiff and Vale University Health Board; Central Manchester University Hospitals NHS Foundation Trust; Chelsea and Westminster Hospital NHS Foundation Trust; Chesterfield Royal Hospital NHS Foundation Trust; The Christie Hospital NHS Foundation Trust; City Hospitals Sunderland NHS Foundation Trust; Colchester Hospital University NHS Foundation Trust; Countess of Chester NHS Foundation Trust; County Durham and Darlington NHS Foundation Trust; Croydon Health Services NHS Trust; Cwm Taf University Health Board; Dartford and Gravesham NHS Trust; Derby Hospitals NHS Foundation Trust; Doncaster and Bassetlaw Hospitals NHS Foundation Trust; Dorset County Hospital NHS Foundation Trust; The Dudley Group NHS Foundation Trust; East and North Hertfordshire NHS Trust; East Kent Hospitals University NHS Foundation Trust; East Lancashire Hospitals NHS Trust; East Sussex Healthcare NHS Trust; Epsom and St Helier University Hospitals NHS Trust; Frimley Health NHS Foundation Trust; Gateshead Health NHS Foundation Trust; Gloucestershire Hospitals NHS Foundation Trust; Great Western Hospitals NHS Foundation Trust; Guy's and St Thomas’ NHS Foundation Trust; Hampshire Hospitals NHS Foundation Trust; Harrogate and District NHS Foundation Trust; Heart Of England NHS Foundation Trust; The Hillingdon Hospitals NHS Foundation Trust; Homerton University Hospital NHS Foundation Trust; Hull and East Yorkshire Hospitals NHS Trust; Hywel Dda Health Board; Imperial College Healthcare NHS Trust; Ipswich Hospital NHS Trust; Isle of Wight NHS Trust; James Paget University Hospitals NHS Foundation Trust; Kettering General Hospital NHS Foundation Trust; King's College Hospital NHS Foundation Trust; Kingston Hospital NHS Foundation Trust; Lancashire Teaching Hospitals NHS Foundation Trust; Leeds Teaching Hospitals NHS Trust; Lewisham and Greenwich NHS Trust; Liverpool Women's NHS Foundation Trust; Luton and Dunstable University Hospital NHS Foundation Trust; Medway NHS Foundation Trust; Mid Cheshire Hospitals NHS Foundation Trust; Mid Essex Hospital Services NHS Trust; Mid Yorkshire Hospitals NHS Trust; Milton Keynes University Hospital NHS Foundation Trust; Newcastle upon Tyne Hospitals NHS Foundation Trust; NHS Ayrshire & Arran; NHS Dumfries & Galloway; NHS Fife; NHS Greater Glasgow & Clyde; NHS Highland; NHS Lanarkshire; NHS Lothian; NHS Scotland Special Board; NHS Shetland; NHS Tayside; Norfolk and Norwich University Hospitals NHS Foundation Trust; Northampton General Hospital NHS Trust; North Bristol NHS Trust; North Cumbria University Hospitals NHS Trust; Northern Devon Healthcare NHS Trust; Northern Health and Social Care Trust; Northern Lincolnshire and Goole Hospitals NHS Foundation Trust; North Middlesex University Hospital NHS Trust; North Tees and Hartlepool NHS Trust; Northumbria Healthcare NHS Foundation Trust; North West Anglia NHS Foundation Trust; Nottingham University Hospitals NHS Trust; Oxford University Hospitals NHS Foundation Trust; Papworth Hospital NHS Foundation Trust; Pennine Acute NHS Trust; Plymouth Hospitals NHS Trust; Poole Hospital NHS Foundation Trust; Portsmouth Hospitals NHS Trust; The Princess Alexandra Hospital NHS Trust; Queen Elizabeth Hospital NHS Foundation Trust; Queen Victoria Hospital NHS Foundation Trust; Robert Jones and Agnes Hunt Orthopaedic Hospital Foundation Trust; Rotherham NHS Foundation Trust; Royal Berkshire NHS Foundation Trust; Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust; Royal Cornwall Hospitals NHS Trust; Royal Devon and Exeter NHS Foundation Trust; Royal Free London NHS Foundation Trust; The Royal Liverpool and Broadgreen University Hospitals NHS Trust; The Royal Marsden NHS Foundation Trust; Royal National Orthopaedic Hospital NHS Trust; The Royal Orthopaedic Hospital NHS Foundation Trust; Royal Surrey County Hospital NHS Foundation Trust; Royal United Hospitals Bath NHS Trust; The Royal Wolverhampton Hospitals NHS Trust; Salford Royal NHS Foundation Trust; Salisbury NHS Foundation Trust; Sandwell and West Birmingham Hospitals NHS Trust; Sheffield Teaching Hospitals NHS Foundation Trust; Shrewsbury and Telford Hospital NHS Trust; South Eastern Health and Social Care Trust; Southport and Ormskirk Hospital NHS Trust; South Tees Hospitals NHS Foundation Trust; South Tyneside NHS Foundation Trust; South Warwickshire NHS Foundation Trust; St George's Healthcare NHS Trust; St Helens and Knowsley Teaching Hospitals NHS Trust; Stockport NHS Foundation Trust; Surrey and Sussex Healthcare NHS Trust; Tameside Hospital NHS Foundation Trust; Taunton and Somerset NHS Foundation Trust; Torbay and South Devon NHS Foundation Trust; United Lincolnshire Hospitals NHS Trust; University College London Hospitals NHS Foundation Trust; University Hospital of North Midlands NHS Trust; University Hospital of South Manchester NHS Foundation Trust; University Hospitals Birmingham NHS Foundation Trust; University Hospitals Bristol NHS Foundation Trust; University Hospitals Coventry and Warwickshire NHS Trust; University Hospitals of Leicester NHS Trust; University Hospitals of Morecambe Bay NHS Foundation Trust; University Hospital Southampton NHS Foundation Trust; Walsall Healthcare NHS Trust; Warrington & Halton Hospitals NHS Foundation Trust; Western Health and Social Care Trust.

In: British Journal of Anaesthesia, Vol. 121, No. 4, 01.10.2018, p. 730-738.

Research output: Contribution to journalArticle

Western Sussex Hospitals NHS Foundation Trust, West Herts Hospitals NHS Trust, Weston Area Health NHS Trust, West Suffolk NHS Foundation Trust, The Whittington Hospital NHS Trust, Wirral University Teaching Hospital NHS Foundation Trust, Worcestershire Acute Hospitals NHS Trust, Wrightington, Wigan and Leigh NHS Foundation Trust, Wye Valley NHS Trust, Yeovil District Hospital NHS Foundation Trust, York Teaching Hospital NHS Foundation Trust, the SNAP-2: EPICCS collaborators, Health Services Research Centre, National Institute of Academic Anaesthesia, Study Steering Group, Net Solving Limited, Trainee Research Networks, Abertawe Bro Morgannwg University Health Board, Aintree University Hospitals NHS Foundation Trust, Airedale NHS Foundation Trust, Aneurin Bevan Health Board, Ashford & St Peters NHS Foundation Trust, Barking, Havering and Redbridge University Hospitals NHS Trust, Barnsley Hospital NHS Foundation Trust, Barts Health NHS Trust, Basildon and Thurrock University Hospitals NHS Foundation Trust, Bedford Hospital NHS Trust, Belfast Health and Social Care Trust, Betsi Cadwaladr University Health Board, Birmingham Women's NHS Foundation Trust, Blackpool Teaching Hospitals NHS Foundation Trust, Bolton Hospital NHS Foundation Trust, Bradford Teaching Hospitals NHS Foundation Trust, Brighton and Sussex University Hospitals NHS Trust, Buckinghamshire Healthcare NHS Trust, Burton Hospitals NHS Foundation Trust, Calderdale and Huddersfield NHS Foundation Trust, Cambridge University Hospitals NHS Foundation Trust, Cardiff and Vale University Health Board, Central Manchester University Hospitals NHS Foundation Trust, Chelsea and Westminster Hospital NHS Foundation Trust, Chesterfield Royal Hospital NHS Foundation Trust, The Christie Hospital NHS Foundation Trust, City Hospitals Sunderland NHS Foundation Trust, Colchester Hospital University NHS Foundation Trust, Countess of Chester NHS Foundation Trust, County Durham and Darlington NHS Foundation Trust, Croydon Health Services NHS Trust, Cwm Taf University Health Board, Dartford and Gravesham NHS Trust, Derby Hospitals NHS Foundation Trust, Doncaster and Bassetlaw Hospitals NHS Foundation Trust, Dorset County Hospital NHS Foundation Trust, The Dudley Group NHS Foundation Trust, East and North Hertfordshire NHS Trust, East Kent Hospitals University NHS Foundation Trust, East Lancashire Hospitals NHS Trust, East Sussex Healthcare NHS Trust, Epsom and St Helier University Hospitals NHS Trust, Frimley Health NHS Foundation Trust, Gateshead Health NHS Foundation Trust, Gloucestershire Hospitals NHS Foundation Trust, Great Western Hospitals NHS Foundation Trust, Guy's and St Thomas’ NHS Foundation Trust, Hampshire Hospitals NHS Foundation Trust, Harrogate and District NHS Foundation Trust, Heart Of England NHS Foundation Trust, The Hillingdon Hospitals NHS Foundation Trust, Homerton University Hospital NHS Foundation Trust, Hull and East Yorkshire Hospitals NHS Trust, Hywel Dda Health Board, Imperial College Healthcare NHS Trust, Ipswich Hospital NHS Trust, Isle of Wight NHS Trust, James Paget University Hospitals NHS Foundation Trust, Kettering General Hospital NHS Foundation Trust, King's College Hospital NHS Foundation Trust, Kingston Hospital NHS Foundation Trust, Lancashire Teaching Hospitals NHS Foundation Trust, Leeds Teaching Hospitals NHS Trust, Lewisham and Greenwich NHS Trust, Liverpool Women's NHS Foundation Trust, Luton and Dunstable University Hospital NHS Foundation Trust, Medway NHS Foundation Trust, Mid Cheshire Hospitals NHS Foundation Trust, Mid Essex Hospital Services NHS Trust, Mid Yorkshire Hospitals NHS Trust, Milton Keynes University Hospital NHS Foundation Trust, Newcastle upon Tyne Hospitals NHS Foundation Trust, NHS Ayrshire & Arran, NHS Dumfries & Galloway, NHS Fife, NHS Greater Glasgow & Clyde, NHS Highland, NHS Lanarkshire, NHS Lothian, NHS Scotland Special Board, NHS Shetland, NHS Tayside, Norfolk and Norwich University Hospitals NHS Foundation Trust, Northampton General Hospital NHS Trust, North Bristol NHS Trust, North Cumbria University Hospitals NHS Trust, Northern Devon Healthcare NHS Trust, Northern Health and Social Care Trust, Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, North Middlesex University Hospital NHS Trust, North Tees and Hartlepool NHS Trust, Northumbria Healthcare NHS Foundation Trust, North West Anglia NHS Foundation Trust, Nottingham University Hospitals NHS Trust, Oxford University Hospitals NHS Foundation Trust, Papworth Hospital NHS Foundation Trust, Pennine Acute NHS Trust, Plymouth Hospitals NHS Trust, Poole Hospital NHS Foundation Trust, Portsmouth Hospitals NHS Trust, The Princess Alexandra Hospital NHS Trust, Queen Elizabeth Hospital NHS Foundation Trust, Queen Victoria Hospital NHS Foundation Trust, Robert Jones and Agnes Hunt Orthopaedic Hospital Foundation Trust, Rotherham NHS Foundation Trust, Royal Berkshire NHS Foundation Trust, Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust, Royal Cornwall Hospitals NHS Trust, Royal Devon and Exeter NHS Foundation Trust, Royal Free London NHS Foundation Trust, The Royal Liverpool and Broadgreen University Hospitals NHS Trust, The Royal Marsden NHS Foundation Trust, Royal National Orthopaedic Hospital NHS Trust, The Royal Orthopaedic Hospital NHS Foundation Trust, Royal Surrey County Hospital NHS Foundation Trust, Royal United Hospitals Bath NHS Trust, The Royal Wolverhampton Hospitals NHS Trust, Salford Royal NHS Foundation Trust, Salisbury NHS Foundation Trust, Sandwell and West Birmingham Hospitals NHS Trust, Sheffield Teaching Hospitals NHS Foundation Trust, Shrewsbury and Telford Hospital NHS Trust, South Eastern Health and Social Care Trust, Southport and Ormskirk Hospital NHS Trust, South Tees Hospitals NHS Foundation Trust, South Tyneside NHS Foundation Trust, South Warwickshire NHS Foundation Trust, St George's Healthcare NHS Trust, St Helens and Knowsley Teaching Hospitals NHS Trust, Stockport NHS Foundation Trust, Surrey and Sussex Healthcare NHS Trust, Tameside Hospital NHS Foundation Trust, Taunton and Somerset NHS Foundation Trust, Torbay and South Devon NHS Foundation Trust, United Lincolnshire Hospitals NHS Trust, University College London Hospitals NHS Foundation Trust, University Hospital of North Midlands NHS Trust, University Hospital of South Manchester NHS Foundation Trust, University Hospitals Birmingham NHS Foundation Trust, University Hospitals Bristol NHS Foundation Trust, University Hospitals Coventry and Warwickshire NHS Trust, University Hospitals of Leicester NHS Trust, University Hospitals of Morecambe Bay NHS Foundation Trust, University Hospital Southampton NHS Foundation Trust, Walsall Healthcare NHS Trust, Warrington & Halton Hospitals NHS Foundation Trust & Western Health and Social Care Trust 2018, 'Cancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 UK National Health Service hospitals', British Journal of Anaesthesia, vol. 121, no. 4, pp. 730-738. https://doi.org/10.1016/j.bja.2018.07.002
Western Sussex Hospitals NHS Foundation Trust, West Herts Hospitals NHS Trust, Weston Area Health NHS Trust, West Suffolk NHS Foundation Trust, The Whittington Hospital NHS Trust, Wirral University Teaching Hospital NHS Foundation Trust et al. Cancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 UK National Health Service hospitals. British Journal of Anaesthesia. 2018 Oct 1;121(4):730-738. https://doi.org/10.1016/j.bja.2018.07.002
Western Sussex Hospitals NHS Foundation Trust ; West Herts Hospitals NHS Trust ; Weston Area Health NHS Trust ; West Suffolk NHS Foundation Trust ; The Whittington Hospital NHS Trust ; Wirral University Teaching Hospital NHS Foundation Trust ; Worcestershire Acute Hospitals NHS Trust ; Wrightington, Wigan and Leigh NHS Foundation Trust ; Wye Valley NHS Trust ; Yeovil District Hospital NHS Foundation Trust ; York Teaching Hospital NHS Foundation Trust ; the SNAP-2: EPICCS collaborators ; Health Services Research Centre, National Institute of Academic Anaesthesia ; Study Steering Group ; Net Solving Limited ; Trainee Research Networks ; Abertawe Bro Morgannwg University Health Board ; Aintree University Hospitals NHS Foundation Trust ; Airedale NHS Foundation Trust ; Aneurin Bevan Health Board ; Ashford & St Peters NHS Foundation Trust ; Barking, Havering and Redbridge University Hospitals NHS Trust ; Barnsley Hospital NHS Foundation Trust ; Barts Health NHS Trust ; Basildon and Thurrock University Hospitals NHS Foundation Trust ; Bedford Hospital NHS Trust ; Belfast Health and Social Care Trust ; Betsi Cadwaladr University Health Board ; Birmingham Women's NHS Foundation Trust ; Blackpool Teaching Hospitals NHS Foundation Trust ; Bolton Hospital NHS Foundation Trust ; Bradford Teaching Hospitals NHS Foundation Trust ; Brighton and Sussex University Hospitals NHS Trust ; Buckinghamshire Healthcare NHS Trust ; Burton Hospitals NHS Foundation Trust ; Calderdale and Huddersfield NHS Foundation Trust ; Cambridge University Hospitals NHS Foundation Trust ; Cardiff and Vale University Health Board ; Central Manchester University Hospitals NHS Foundation Trust ; Chelsea and Westminster Hospital NHS Foundation Trust ; Chesterfield Royal Hospital NHS Foundation Trust ; The Christie Hospital NHS Foundation Trust ; City Hospitals Sunderland NHS Foundation Trust ; Colchester Hospital University NHS Foundation Trust ; Countess of Chester NHS Foundation Trust ; County Durham and Darlington NHS Foundation Trust ; Croydon Health Services NHS Trust ; Cwm Taf University Health Board ; Dartford and Gravesham NHS Trust ; Derby Hospitals NHS Foundation Trust ; Doncaster and Bassetlaw Hospitals NHS Foundation Trust ; Dorset County Hospital NHS Foundation Trust ; The Dudley Group NHS Foundation Trust ; East and North Hertfordshire NHS Trust ; East Kent Hospitals University NHS Foundation Trust ; East Lancashire Hospitals NHS Trust ; East Sussex Healthcare NHS Trust ; Epsom and St Helier University Hospitals NHS Trust ; Frimley Health NHS Foundation Trust ; Gateshead Health NHS Foundation Trust ; Gloucestershire Hospitals NHS Foundation Trust ; Great Western Hospitals NHS Foundation Trust ; Guy's and St Thomas’ NHS Foundation Trust ; Hampshire Hospitals NHS Foundation Trust ; Harrogate and District NHS Foundation Trust ; Heart Of England NHS Foundation Trust ; The Hillingdon Hospitals NHS Foundation Trust ; Homerton University Hospital NHS Foundation Trust ; Hull and East Yorkshire Hospitals NHS Trust ; Hywel Dda Health Board ; Imperial College Healthcare NHS Trust ; Ipswich Hospital NHS Trust ; Isle of Wight NHS Trust ; James Paget University Hospitals NHS Foundation Trust ; Kettering General Hospital NHS Foundation Trust ; King's College Hospital NHS Foundation Trust ; Kingston Hospital NHS Foundation Trust ; Lancashire Teaching Hospitals NHS Foundation Trust ; Leeds Teaching Hospitals NHS Trust ; Lewisham and Greenwich NHS Trust ; Liverpool Women's NHS Foundation Trust ; Luton and Dunstable University Hospital NHS Foundation Trust ; Medway NHS Foundation Trust ; Mid Cheshire Hospitals NHS Foundation Trust ; Mid Essex Hospital Services NHS Trust ; Mid Yorkshire Hospitals NHS Trust ; Milton Keynes University Hospital NHS Foundation Trust ; Newcastle upon Tyne Hospitals NHS Foundation Trust ; NHS Ayrshire & Arran ; NHS Dumfries & Galloway ; NHS Fife ; NHS Greater Glasgow & Clyde ; NHS Highland ; NHS Lanarkshire ; NHS Lothian ; NHS Scotland Special Board ; NHS Shetland ; NHS Tayside ; Norfolk and Norwich University Hospitals NHS Foundation Trust ; Northampton General Hospital NHS Trust ; North Bristol NHS Trust ; North Cumbria University Hospitals NHS Trust ; Northern Devon Healthcare NHS Trust ; Northern Health and Social Care Trust ; Northern Lincolnshire and Goole Hospitals NHS Foundation Trust ; North Middlesex University Hospital NHS Trust ; North Tees and Hartlepool NHS Trust ; Northumbria Healthcare NHS Foundation Trust ; North West Anglia NHS Foundation Trust ; Nottingham University Hospitals NHS Trust ; Oxford University Hospitals NHS Foundation Trust ; Papworth Hospital NHS Foundation Trust ; Pennine Acute NHS Trust ; Plymouth Hospitals NHS Trust ; Poole Hospital NHS Foundation Trust ; Portsmouth Hospitals NHS Trust ; The Princess Alexandra Hospital NHS Trust ; Queen Elizabeth Hospital NHS Foundation Trust ; Queen Victoria Hospital NHS Foundation Trust ; Robert Jones and Agnes Hunt Orthopaedic Hospital Foundation Trust ; Rotherham NHS Foundation Trust ; Royal Berkshire NHS Foundation Trust ; Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust ; Royal Cornwall Hospitals NHS Trust ; Royal Devon and Exeter NHS Foundation Trust ; Royal Free London NHS Foundation Trust ; The Royal Liverpool and Broadgreen University Hospitals NHS Trust ; The Royal Marsden NHS Foundation Trust ; Royal National Orthopaedic Hospital NHS Trust ; The Royal Orthopaedic Hospital NHS Foundation Trust ; Royal Surrey County Hospital NHS Foundation Trust ; Royal United Hospitals Bath NHS Trust ; The Royal Wolverhampton Hospitals NHS Trust ; Salford Royal NHS Foundation Trust ; Salisbury NHS Foundation Trust ; Sandwell and West Birmingham Hospitals NHS Trust ; Sheffield Teaching Hospitals NHS Foundation Trust ; Shrewsbury and Telford Hospital NHS Trust ; South Eastern Health and Social Care Trust ; Southport and Ormskirk Hospital NHS Trust ; South Tees Hospitals NHS Foundation Trust ; South Tyneside NHS Foundation Trust ; South Warwickshire NHS Foundation Trust ; St George's Healthcare NHS Trust ; St Helens and Knowsley Teaching Hospitals NHS Trust ; Stockport NHS Foundation Trust ; Surrey and Sussex Healthcare NHS Trust ; Tameside Hospital NHS Foundation Trust ; Taunton and Somerset NHS Foundation Trust ; Torbay and South Devon NHS Foundation Trust ; United Lincolnshire Hospitals NHS Trust ; University College London Hospitals NHS Foundation Trust ; University Hospital of North Midlands NHS Trust ; University Hospital of South Manchester NHS Foundation Trust ; University Hospitals Birmingham NHS Foundation Trust ; University Hospitals Bristol NHS Foundation Trust ; University Hospitals Coventry and Warwickshire NHS Trust ; University Hospitals of Leicester NHS Trust ; University Hospitals of Morecambe Bay NHS Foundation Trust ; University Hospital Southampton NHS Foundation Trust ; Walsall Healthcare NHS Trust ; Warrington & Halton Hospitals NHS Foundation Trust ; Western Health and Social Care Trust. / Cancelled operations : a 7-day cohort study of planned adult inpatient surgery in 245 UK National Health Service hospitals. In: British Journal of Anaesthesia. 2018 ; Vol. 121, No. 4. pp. 730-738.
@article{29a720f5f11049e7a052e56a1326eb4e,
title = "Cancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 UK National Health Service hospitals",
abstract = "Background: Cancellation of planned surgery impacts substantially on patients and health systems. This study describes the incidence and reasons for cancellation of inpatient surgery in the UK NHS. Methods: We conducted a prospective observational cohort study over 7 consecutive days in March 2017 in 245 NHS hospitals. Occurrences and reasons for previous surgical cancellations were recorded. Using multilevel logistic regression, we identified patient- and hospital-level factors associated with cancellation due to inadequate bed capacity. Results: We analysed data from 14 936 patients undergoing planned surgery. A total of 1499 patients (10.0{\%}) reported previous cancellation for the same procedure; contemporaneous hospital census data indicated that 13.9{\%} patients attending inpatient operations were cancelled on the day of surgery. Non-clinical reasons, predominantly inadequate bed capacity, accounted for a large proportion of previous cancellations. Independent risk factors for cancellation due to inadequate bed capacity included requirement for postoperative critical care [odds ratio (OR)=2.92; 95{\%} confidence interval (CI), 2.12–4.02; P<0.001] and the presence of an emergency department in the treating hospital (OR=4.18; 95{\%} CI, 2.22–7.89; P<0.001). Patients undergoing cancer surgery (OR=0.32; 95{\%} CI, 0.22–0.46; P<0.001), obstetric procedures (OR=0.17; 95{\%} CI, 0.08–0.32; P<0.001), and expedited surgery (OR=0.39; 95{\%} CI, 0.27–0.56; P<0.001) were less likely to be cancelled. Conclusions: A significant proportion of patients presenting for surgery have experienced a previous cancellation for the same procedure. Cancer surgery is relatively protected, but bed capacity, including postoperative critical care requirements, are significant risk factors for previous cancellations.",
keywords = "Health Services Research, medical resource utilisation, operating room management, surgery",
author = "{Western Sussex Hospitals NHS Foundation Trust} and {West Herts Hospitals NHS Trust} and {Weston Area Health NHS Trust} and {West Suffolk NHS Foundation Trust} and {The Whittington Hospital NHS Trust} and {Wirral University Teaching Hospital NHS Foundation Trust} and {Worcestershire Acute Hospitals NHS Trust} and {Wrightington, Wigan and Leigh NHS Foundation Trust} and {Wye Valley NHS Trust} and {Yeovil District Hospital NHS Foundation Trust} and {York Teaching Hospital NHS Foundation Trust} and {the SNAP-2: EPICCS collaborators} and {Health Services Research Centre, National Institute of Academic Anaesthesia} and {Study Steering Group} and {Net Solving Limited} and {Trainee Research Networks} and {Abertawe Bro Morgannwg University Health Board} and {Aintree University Hospitals NHS Foundation Trust} and {Airedale NHS Foundation Trust} and {Aneurin Bevan Health Board} and {Ashford & St Peters NHS Foundation Trust} and {Barking, Havering and Redbridge University Hospitals NHS Trust} and {Barnsley Hospital NHS Foundation Trust} and {Barts Health NHS Trust} and {Basildon and Thurrock University Hospitals NHS Foundation Trust} and {Bedford Hospital NHS Trust} and {Belfast Health and Social Care Trust} and {Betsi Cadwaladr University Health Board} and {Birmingham Women's NHS Foundation Trust} and {Blackpool Teaching Hospitals NHS Foundation Trust} and {Bolton Hospital NHS Foundation Trust} and {Bradford Teaching Hospitals NHS Foundation Trust} and {Brighton and Sussex University Hospitals NHS Trust} and {Buckinghamshire Healthcare NHS Trust} and {Burton Hospitals NHS Foundation Trust} and {Calderdale and Huddersfield NHS Foundation Trust} and {Cambridge University Hospitals NHS Foundation Trust} and {Cardiff and Vale University Health Board} and {Central Manchester University Hospitals NHS Foundation Trust} and {Chelsea and Westminster Hospital NHS Foundation Trust} and {Chesterfield Royal Hospital NHS Foundation Trust} and {The Christie Hospital NHS Foundation Trust} and {City Hospitals Sunderland NHS Foundation Trust} and {Colchester Hospital University NHS Foundation Trust} and {Countess of Chester NHS Foundation Trust} and {County Durham and Darlington NHS Foundation Trust} and {Croydon Health Services NHS Trust} and {Cwm Taf University Health Board} and {Dartford and Gravesham NHS Trust} and {Derby Hospitals NHS Foundation Trust} and {Doncaster and Bassetlaw Hospitals NHS Foundation Trust} and {Dorset County Hospital NHS Foundation Trust} and {The Dudley Group NHS Foundation Trust} and {East and North Hertfordshire NHS Trust} and {East Kent Hospitals University NHS Foundation Trust} and {East Lancashire Hospitals NHS Trust} and {East Sussex Healthcare NHS Trust} and {Epsom and St Helier University Hospitals NHS Trust} and {Frimley Health NHS Foundation Trust} and {Gateshead Health NHS Foundation Trust} and {Gloucestershire Hospitals NHS Foundation Trust} and {Great Western Hospitals NHS Foundation Trust} and {Guy's and St Thomas’ NHS Foundation Trust} and {Hampshire Hospitals NHS Foundation Trust} and {Harrogate and District NHS Foundation Trust} and {Heart Of England NHS Foundation Trust} and {The Hillingdon Hospitals NHS Foundation Trust} and {Homerton University Hospital NHS Foundation Trust} and {Hull and East Yorkshire Hospitals NHS Trust} and {Hywel Dda Health Board} and {Imperial College Healthcare NHS Trust} and {Ipswich Hospital NHS Trust} and {Isle of Wight NHS Trust} and {James Paget University Hospitals NHS Foundation Trust} and {Kettering General Hospital NHS Foundation Trust} and {King's College Hospital NHS Foundation Trust} and {Kingston Hospital NHS Foundation Trust} and {Lancashire Teaching Hospitals NHS Foundation Trust} and {Leeds Teaching Hospitals NHS Trust} and {Lewisham and Greenwich NHS Trust} and {Liverpool Women's NHS Foundation Trust} and {Luton and Dunstable University Hospital NHS Foundation Trust} and {Medway NHS Foundation Trust} and {Mid Cheshire Hospitals NHS Foundation Trust} and {Mid Essex Hospital Services NHS Trust} and {Mid Yorkshire Hospitals NHS Trust} and {Milton Keynes University Hospital NHS Foundation Trust} and {Newcastle upon Tyne Hospitals NHS Foundation Trust} and {NHS Ayrshire & Arran} and {NHS Dumfries & Galloway} and {NHS Fife} and {NHS Greater Glasgow & Clyde} and {NHS Highland} and {NHS Lanarkshire} and {NHS Lothian} and {NHS Scotland Special Board} and {NHS Shetland} and {NHS Tayside} and {Norfolk and Norwich University Hospitals NHS Foundation Trust} and {Northampton General Hospital NHS Trust} and {North Bristol NHS Trust} and {North Cumbria University Hospitals NHS Trust} and {Northern Devon Healthcare NHS Trust} and {Northern Health and Social Care Trust} and {Northern Lincolnshire and Goole Hospitals NHS Foundation Trust} and {North Middlesex University Hospital NHS Trust} and {North Tees and Hartlepool NHS Trust} and {Northumbria Healthcare NHS Foundation Trust} and {North West Anglia NHS Foundation Trust} and {Nottingham University Hospitals NHS Trust} and {Oxford University Hospitals NHS Foundation Trust} and {Papworth Hospital NHS Foundation Trust} and {Pennine Acute NHS Trust} and {Plymouth Hospitals NHS Trust} and {Poole Hospital NHS Foundation Trust} and {Portsmouth Hospitals NHS Trust} and {The Princess Alexandra Hospital NHS Trust} and {Queen Elizabeth Hospital NHS Foundation Trust} and {Queen Victoria Hospital NHS Foundation Trust} and {Robert Jones and Agnes Hunt Orthopaedic Hospital Foundation Trust} and {Rotherham NHS Foundation Trust} and {Royal Berkshire NHS Foundation Trust} and {Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust} and {Royal Cornwall Hospitals NHS Trust} and {Royal Devon and Exeter NHS Foundation Trust} and {Royal Free London NHS Foundation Trust} and {The Royal Liverpool and Broadgreen University Hospitals NHS Trust} and {The Royal Marsden NHS Foundation Trust} and {Royal National Orthopaedic Hospital NHS Trust} and {The Royal Orthopaedic Hospital NHS Foundation Trust} and {Royal Surrey County Hospital NHS Foundation Trust} and {Royal United Hospitals Bath NHS Trust} and {The Royal Wolverhampton Hospitals NHS Trust} and {Salford Royal NHS Foundation Trust} and {Salisbury NHS Foundation Trust} and {Sandwell and West Birmingham Hospitals NHS Trust} and {Sheffield Teaching Hospitals NHS Foundation Trust} and {Shrewsbury and Telford Hospital NHS Trust} and {South Eastern Health and Social Care Trust} and {Southport and Ormskirk Hospital NHS Trust} and {South Tees Hospitals NHS Foundation Trust} and {South Tyneside NHS Foundation Trust} and {South Warwickshire NHS Foundation Trust} and {St George's Healthcare NHS Trust} and {St Helens and Knowsley Teaching Hospitals NHS Trust} and {Stockport NHS Foundation Trust} and {Surrey and Sussex Healthcare NHS Trust} and {Tameside Hospital NHS Foundation Trust} and {Taunton and Somerset NHS Foundation Trust} and {Torbay and South Devon NHS Foundation Trust} and {United Lincolnshire Hospitals NHS Trust} and {University College London Hospitals NHS Foundation Trust} and {University Hospital of North Midlands NHS Trust} and {University Hospital of South Manchester NHS Foundation Trust} and {University Hospitals Birmingham NHS Foundation Trust} and {University Hospitals Bristol NHS Foundation Trust} and {University Hospitals Coventry and Warwickshire NHS Trust} and {University Hospitals of Leicester NHS Trust} and {University Hospitals of Morecambe Bay NHS Foundation Trust} and {University Hospital Southampton NHS Foundation Trust} and {Walsall Healthcare NHS Trust} and {Warrington & Halton Hospitals NHS Foundation Trust} and {Western Health and Social Care Trust} and Wong, {D. J.N.} and Harris, {S. K.} and Moonesinghe, {S. R.} and Moonesinghe, {S. Ramani} and Wong, {Danny J.N.} and Harris, {Steve K.} and James Bedford and Oliver Boney and Maria Chazapis and Sharon Drake and Laura Farmer and David Gilhooly and James Goodwin and Jose Lourtie and Duncan Wagstaff and Mike Grocott and Robert Sneyd and Anna Batchelor and Stephen Brett and Catherine Plowright and Suman Shrestha and Richard Shawyer and Shafi Ahmed and Mizan Khondoker and Mike Nathanson and Paul Cripps and {Research & Audit Federation of Trainees (RAFT)}, {& Audit Federation of Trainees (RAFT)} and {Anaesthetic Audit}, Audit and {Intensive Care & Anaesthesia Research Network of North East Trainees (INCARNNET)}, {Care & Anaesthesia Research Network of North East Trainees (INCARNNET)} and {Merseyside Anaesthetic Group for Improving Quality (MAGIQ)}, {Anaesthetic Group for Improving Quality (MAGIQ)} and {Midlands East Research by Critical Care}, {East Research by Critical Care} and {North West Research}, {West Research} and {Oxford Critical Care Anaesthetic Research Enterprise (OxCCARE)}, {Critical Care Anaesthetic Research Enterprise (OxCCARE)} and {Pan-London Peri-operative Audit & Research Network (PLAN)}, {Peri-operative Audit & Research Network (PLAN)} and {Scottish East Quality Improvement & Research Academy (SEQuoIA)}, {East Quality Improvement & Research Academy (SEQuoIA)} and {SESSA Quality Improvement}, {Quality Improvement} and {Severn Trainees Anaesthetic Research (STAR)}, {Trainees Anaesthetic Research (STAR)} and {South West Anaesthetic Research Matrix (SWARM)}, {West Anaesthetic Research Matrix (SWARM)} and {South Yorkshire Hospitals Audit}, {Yorkshire Hospitals Audit} and {Southcoast Peri-operative Audit}, {Peri-operative Audit} and {Welsh Anaesthetic Audit Research & Engagement Network (WAAREN)}, {Anaesthetic Audit Research & Engagement Network (WAAREN)} and {West Midlands Trainee Research Anaesthesia & Intensive Care Network (WMTRAIN)}, {Midlands Trainee Research Anaesthesia & Intensive Care Network (WMTRAIN)} and Shilpa Rawat and Sonia Sathe and Alison Campbell and Janakan Anandarajah and Nicola Ball and Lalindra Bandara and Dennis Barnes and Maclean, {Sarah Ann}",
year = "2018",
month = "10",
day = "1",
doi = "10.1016/j.bja.2018.07.002",
language = "English (US)",
volume = "121",
pages = "730--738",
journal = "British Journal of Anaesthesia",
issn = "0007-0912",
publisher = "Oxford University Press",
number = "4",

}

TY - JOUR

T1 - Cancelled operations

T2 - a 7-day cohort study of planned adult inpatient surgery in 245 UK National Health Service hospitals

AU - Western Sussex Hospitals NHS Foundation Trust

AU - West Herts Hospitals NHS Trust

AU - Weston Area Health NHS Trust

AU - West Suffolk NHS Foundation Trust

AU - The Whittington Hospital NHS Trust

AU - Wirral University Teaching Hospital NHS Foundation Trust

AU - Worcestershire Acute Hospitals NHS Trust

AU - Wrightington, Wigan and Leigh NHS Foundation Trust

AU - Wye Valley NHS Trust

AU - Yeovil District Hospital NHS Foundation Trust

AU - York Teaching Hospital NHS Foundation Trust

AU - the SNAP-2: EPICCS collaborators

AU - Health Services Research Centre, National Institute of Academic Anaesthesia

AU - Study Steering Group

AU - Net Solving Limited

AU - Trainee Research Networks

AU - Abertawe Bro Morgannwg University Health Board

AU - Aintree University Hospitals NHS Foundation Trust

AU - Airedale NHS Foundation Trust

AU - Aneurin Bevan Health Board

AU - Ashford & St Peters NHS Foundation Trust

AU - Barking, Havering and Redbridge University Hospitals NHS Trust

AU - Barnsley Hospital NHS Foundation Trust

AU - Barts Health NHS Trust

AU - Basildon and Thurrock University Hospitals NHS Foundation Trust

AU - Bedford Hospital NHS Trust

AU - Belfast Health and Social Care Trust

AU - Betsi Cadwaladr University Health Board

AU - Birmingham Women's NHS Foundation Trust

AU - Blackpool Teaching Hospitals NHS Foundation Trust

AU - Bolton Hospital NHS Foundation Trust

AU - Bradford Teaching Hospitals NHS Foundation Trust

AU - Brighton and Sussex University Hospitals NHS Trust

AU - Buckinghamshire Healthcare NHS Trust

AU - Burton Hospitals NHS Foundation Trust

AU - Calderdale and Huddersfield NHS Foundation Trust

AU - Cambridge University Hospitals NHS Foundation Trust

AU - Cardiff and Vale University Health Board

AU - Central Manchester University Hospitals NHS Foundation Trust

AU - Chelsea and Westminster Hospital NHS Foundation Trust

AU - Chesterfield Royal Hospital NHS Foundation Trust

AU - The Christie Hospital NHS Foundation Trust

AU - City Hospitals Sunderland NHS Foundation Trust

AU - Colchester Hospital University NHS Foundation Trust

AU - Countess of Chester NHS Foundation Trust

AU - County Durham and Darlington NHS Foundation Trust

AU - Croydon Health Services NHS Trust

AU - Cwm Taf University Health Board

AU - Dartford and Gravesham NHS Trust

AU - Derby Hospitals NHS Foundation Trust

AU - Doncaster and Bassetlaw Hospitals NHS Foundation Trust

AU - Dorset County Hospital NHS Foundation Trust

AU - The Dudley Group NHS Foundation Trust

AU - East and North Hertfordshire NHS Trust

AU - East Kent Hospitals University NHS Foundation Trust

AU - East Lancashire Hospitals NHS Trust

AU - East Sussex Healthcare NHS Trust

AU - Epsom and St Helier University Hospitals NHS Trust

AU - Frimley Health NHS Foundation Trust

AU - Gateshead Health NHS Foundation Trust

AU - Gloucestershire Hospitals NHS Foundation Trust

AU - Great Western Hospitals NHS Foundation Trust

AU - Guy's and St Thomas’ NHS Foundation Trust

AU - Hampshire Hospitals NHS Foundation Trust

AU - Harrogate and District NHS Foundation Trust

AU - Heart Of England NHS Foundation Trust

AU - The Hillingdon Hospitals NHS Foundation Trust

AU - Homerton University Hospital NHS Foundation Trust

AU - Hull and East Yorkshire Hospitals NHS Trust

AU - Hywel Dda Health Board

AU - Imperial College Healthcare NHS Trust

AU - Ipswich Hospital NHS Trust

AU - Isle of Wight NHS Trust

AU - James Paget University Hospitals NHS Foundation Trust

AU - Kettering General Hospital NHS Foundation Trust

AU - King's College Hospital NHS Foundation Trust

AU - Kingston Hospital NHS Foundation Trust

AU - Lancashire Teaching Hospitals NHS Foundation Trust

AU - Leeds Teaching Hospitals NHS Trust

AU - Lewisham and Greenwich NHS Trust

AU - Liverpool Women's NHS Foundation Trust

AU - Luton and Dunstable University Hospital NHS Foundation Trust

AU - Medway NHS Foundation Trust

AU - Mid Cheshire Hospitals NHS Foundation Trust

AU - Mid Essex Hospital Services NHS Trust

AU - Mid Yorkshire Hospitals NHS Trust

AU - Milton Keynes University Hospital NHS Foundation Trust

AU - Newcastle upon Tyne Hospitals NHS Foundation Trust

AU - NHS Ayrshire & Arran

AU - NHS Dumfries & Galloway

AU - NHS Fife

AU - NHS Greater Glasgow & Clyde

AU - NHS Highland

AU - NHS Lanarkshire

AU - NHS Lothian

AU - NHS Scotland Special Board

AU - NHS Shetland

AU - NHS Tayside

AU - Norfolk and Norwich University Hospitals NHS Foundation Trust

AU - Northampton General Hospital NHS Trust

AU - North Bristol NHS Trust

AU - North Cumbria University Hospitals NHS Trust

AU - Northern Devon Healthcare NHS Trust

AU - Northern Health and Social Care Trust

AU - Northern Lincolnshire and Goole Hospitals NHS Foundation Trust

AU - North Middlesex University Hospital NHS Trust

AU - North Tees and Hartlepool NHS Trust

AU - Northumbria Healthcare NHS Foundation Trust

AU - North West Anglia NHS Foundation Trust

AU - Nottingham University Hospitals NHS Trust

AU - Oxford University Hospitals NHS Foundation Trust

AU - Papworth Hospital NHS Foundation Trust

AU - Pennine Acute NHS Trust

AU - Plymouth Hospitals NHS Trust

AU - Poole Hospital NHS Foundation Trust

AU - Portsmouth Hospitals NHS Trust

AU - The Princess Alexandra Hospital NHS Trust

AU - Queen Elizabeth Hospital NHS Foundation Trust

AU - Queen Victoria Hospital NHS Foundation Trust

AU - Robert Jones and Agnes Hunt Orthopaedic Hospital Foundation Trust

AU - Rotherham NHS Foundation Trust

AU - Royal Berkshire NHS Foundation Trust

AU - Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust

AU - Royal Cornwall Hospitals NHS Trust

AU - Royal Devon and Exeter NHS Foundation Trust

AU - Royal Free London NHS Foundation Trust

AU - The Royal Liverpool and Broadgreen University Hospitals NHS Trust

AU - The Royal Marsden NHS Foundation Trust

AU - Royal National Orthopaedic Hospital NHS Trust

AU - The Royal Orthopaedic Hospital NHS Foundation Trust

AU - Royal Surrey County Hospital NHS Foundation Trust

AU - Royal United Hospitals Bath NHS Trust

AU - The Royal Wolverhampton Hospitals NHS Trust

AU - Salford Royal NHS Foundation Trust

AU - Salisbury NHS Foundation Trust

AU - Sandwell and West Birmingham Hospitals NHS Trust

AU - Sheffield Teaching Hospitals NHS Foundation Trust

AU - Shrewsbury and Telford Hospital NHS Trust

AU - South Eastern Health and Social Care Trust

AU - Southport and Ormskirk Hospital NHS Trust

AU - South Tees Hospitals NHS Foundation Trust

AU - South Tyneside NHS Foundation Trust

AU - South Warwickshire NHS Foundation Trust

AU - St George's Healthcare NHS Trust

AU - St Helens and Knowsley Teaching Hospitals NHS Trust

AU - Stockport NHS Foundation Trust

AU - Surrey and Sussex Healthcare NHS Trust

AU - Tameside Hospital NHS Foundation Trust

AU - Taunton and Somerset NHS Foundation Trust

AU - Torbay and South Devon NHS Foundation Trust

AU - United Lincolnshire Hospitals NHS Trust

AU - University College London Hospitals NHS Foundation Trust

AU - University Hospital of North Midlands NHS Trust

AU - University Hospital of South Manchester NHS Foundation Trust

AU - University Hospitals Birmingham NHS Foundation Trust

AU - University Hospitals Bristol NHS Foundation Trust

AU - University Hospitals Coventry and Warwickshire NHS Trust

AU - University Hospitals of Leicester NHS Trust

AU - University Hospitals of Morecambe Bay NHS Foundation Trust

AU - University Hospital Southampton NHS Foundation Trust

AU - Walsall Healthcare NHS Trust

AU - Warrington & Halton Hospitals NHS Foundation Trust

AU - Western Health and Social Care Trust

AU - Wong, D. J.N.

AU - Harris, S. K.

AU - Moonesinghe, S. R.

AU - Moonesinghe, S. Ramani

AU - Wong, Danny J.N.

AU - Harris, Steve K.

AU - Bedford, James

AU - Boney, Oliver

AU - Chazapis, Maria

AU - Drake, Sharon

AU - Farmer, Laura

AU - Gilhooly, David

AU - Goodwin, James

AU - Lourtie, Jose

AU - Wagstaff, Duncan

AU - Grocott, Mike

AU - Sneyd, Robert

AU - Batchelor, Anna

AU - Brett, Stephen

AU - Plowright, Catherine

AU - Shrestha, Suman

AU - Shawyer, Richard

AU - Ahmed, Shafi

AU - Khondoker, Mizan

AU - Nathanson, Mike

AU - Cripps, Paul

AU - Research & Audit Federation of Trainees (RAFT), & Audit Federation of Trainees (RAFT)

AU - Anaesthetic Audit, Audit

AU - Intensive Care & Anaesthesia Research Network of North East Trainees (INCARNNET), Care & Anaesthesia Research Network of North East Trainees (INCARNNET)

AU - Merseyside Anaesthetic Group for Improving Quality (MAGIQ), Anaesthetic Group for Improving Quality (MAGIQ)

AU - Midlands East Research by Critical Care, East Research by Critical Care

AU - North West Research, West Research

AU - Oxford Critical Care Anaesthetic Research Enterprise (OxCCARE), Critical Care Anaesthetic Research Enterprise (OxCCARE)

AU - Pan-London Peri-operative Audit & Research Network (PLAN), Peri-operative Audit & Research Network (PLAN)

AU - Scottish East Quality Improvement & Research Academy (SEQuoIA), East Quality Improvement & Research Academy (SEQuoIA)

AU - SESSA Quality Improvement, Quality Improvement

AU - Severn Trainees Anaesthetic Research (STAR), Trainees Anaesthetic Research (STAR)

AU - South West Anaesthetic Research Matrix (SWARM), West Anaesthetic Research Matrix (SWARM)

AU - South Yorkshire Hospitals Audit, Yorkshire Hospitals Audit

AU - Southcoast Peri-operative Audit, Peri-operative Audit

AU - Welsh Anaesthetic Audit Research & Engagement Network (WAAREN), Anaesthetic Audit Research & Engagement Network (WAAREN)

AU - West Midlands Trainee Research Anaesthesia & Intensive Care Network (WMTRAIN), Midlands Trainee Research Anaesthesia & Intensive Care Network (WMTRAIN)

AU - Rawat, Shilpa

AU - Sathe, Sonia

AU - Campbell, Alison

AU - Anandarajah, Janakan

AU - Ball, Nicola

AU - Bandara, Lalindra

AU - Barnes, Dennis

AU - Maclean, Sarah Ann

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Background: Cancellation of planned surgery impacts substantially on patients and health systems. This study describes the incidence and reasons for cancellation of inpatient surgery in the UK NHS. Methods: We conducted a prospective observational cohort study over 7 consecutive days in March 2017 in 245 NHS hospitals. Occurrences and reasons for previous surgical cancellations were recorded. Using multilevel logistic regression, we identified patient- and hospital-level factors associated with cancellation due to inadequate bed capacity. Results: We analysed data from 14 936 patients undergoing planned surgery. A total of 1499 patients (10.0%) reported previous cancellation for the same procedure; contemporaneous hospital census data indicated that 13.9% patients attending inpatient operations were cancelled on the day of surgery. Non-clinical reasons, predominantly inadequate bed capacity, accounted for a large proportion of previous cancellations. Independent risk factors for cancellation due to inadequate bed capacity included requirement for postoperative critical care [odds ratio (OR)=2.92; 95% confidence interval (CI), 2.12–4.02; P<0.001] and the presence of an emergency department in the treating hospital (OR=4.18; 95% CI, 2.22–7.89; P<0.001). Patients undergoing cancer surgery (OR=0.32; 95% CI, 0.22–0.46; P<0.001), obstetric procedures (OR=0.17; 95% CI, 0.08–0.32; P<0.001), and expedited surgery (OR=0.39; 95% CI, 0.27–0.56; P<0.001) were less likely to be cancelled. Conclusions: A significant proportion of patients presenting for surgery have experienced a previous cancellation for the same procedure. Cancer surgery is relatively protected, but bed capacity, including postoperative critical care requirements, are significant risk factors for previous cancellations.

AB - Background: Cancellation of planned surgery impacts substantially on patients and health systems. This study describes the incidence and reasons for cancellation of inpatient surgery in the UK NHS. Methods: We conducted a prospective observational cohort study over 7 consecutive days in March 2017 in 245 NHS hospitals. Occurrences and reasons for previous surgical cancellations were recorded. Using multilevel logistic regression, we identified patient- and hospital-level factors associated with cancellation due to inadequate bed capacity. Results: We analysed data from 14 936 patients undergoing planned surgery. A total of 1499 patients (10.0%) reported previous cancellation for the same procedure; contemporaneous hospital census data indicated that 13.9% patients attending inpatient operations were cancelled on the day of surgery. Non-clinical reasons, predominantly inadequate bed capacity, accounted for a large proportion of previous cancellations. Independent risk factors for cancellation due to inadequate bed capacity included requirement for postoperative critical care [odds ratio (OR)=2.92; 95% confidence interval (CI), 2.12–4.02; P<0.001] and the presence of an emergency department in the treating hospital (OR=4.18; 95% CI, 2.22–7.89; P<0.001). Patients undergoing cancer surgery (OR=0.32; 95% CI, 0.22–0.46; P<0.001), obstetric procedures (OR=0.17; 95% CI, 0.08–0.32; P<0.001), and expedited surgery (OR=0.39; 95% CI, 0.27–0.56; P<0.001) were less likely to be cancelled. Conclusions: A significant proportion of patients presenting for surgery have experienced a previous cancellation for the same procedure. Cancer surgery is relatively protected, but bed capacity, including postoperative critical care requirements, are significant risk factors for previous cancellations.

KW - Health Services Research

KW - medical resource utilisation

KW - operating room management

KW - surgery

UR - http://www.scopus.com/inward/record.url?scp=85054450371&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85054450371&partnerID=8YFLogxK

U2 - 10.1016/j.bja.2018.07.002

DO - 10.1016/j.bja.2018.07.002

M3 - Article

C2 - 30236235

AN - SCOPUS:85054450371

VL - 121

SP - 730

EP - 738

JO - British Journal of Anaesthesia

JF - British Journal of Anaesthesia

SN - 0007-0912

IS - 4

ER -