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Variation in surgery postponement rates in the NHS in England
Emma McCone1,2, Chris Snowden1,2, Michael Swart1,3
1Getting It Right First Time Programme, NHS England, London, UK.
The British Journal of Surgery
|November 12, 2024
Summary
Elective surgery postponements occurred at a rate of 7.3% across England, with significant variation between hospitals. Most postponements for routine patients were medically related, highlighting issues in preoperative assessment efficiency.
Area of Science:
- Healthcare Management
- Surgical Pathways
- Patient Flow Optimization
Background:
- Preoperative assessment postponements significantly impact patient care and resource allocation.
- Current data on the frequency and reasons for these postponements are poorly documented.
Purpose of the Study:
- To investigate elective surgical postponement rates post-preoperative assessment in England.
- To identify the primary reasons for these postponements in patients on elective surgical pathways.
Main Methods:
- Retrospective analysis of clinical audit data from 16 National Health Service (NHS) trusts.
- Data collection focused on a two-week period in March 2024, reviewing approximately 8000 case notes.
Main Results:
- A 7.3% postponement rate was observed (583 out of ~8000 cases), with significant inter-trust variation (1.0% to 31.9%).
- Medical reasons accounted for 85.7% of postponements among routine patients.
- Routine patients faced long waits, with half waiting over 94 days from referral to preoperative assessment.
Conclusions:
- Minimizing surgical postponements is crucial for improving perioperative pathway efficiency.
- Enhancing preoperative assessment processes is essential for streamlining patient care and resource utilization.
