Evidence map›Paper›PMID 42031630›Full record

ArticleBritish journal of anaesthesia2026

The Postponement and Cancellations in Elective Care study: a national evaluation of case postponements and cancellations in elective surgical pathways.

James Bedford, Emma McCone, Adam Hunt, Eleanor Warwick, Iain Moppett, Martha Belete, Laura Cortes, Sarah Hayden, Andrew Kane, Justin Kua and 8 more

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In one paragraph

Article in British journal of anaesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

James BedfordNational Institute for Health Research-Central London Patient Safety Research Collaboration, London, UK; Department of Anaesthesia & Perioperative Medicine, University College London Hospitals NHS Foundation Trust, London, UK; Centre of Perioperative Medicine, Research Department for Targeted Intervention, Division of Surgery and Interventional Science, University College London, London, UK.
Emma McConeGetting It Right First Time Programme, NHS England, London, UK; Directorate of Perioperative and Critical Care Medicine, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, UK.
Adam HuntNational Institute for Health Research-Central London Patient Safety Research Collaboration, London, UK; Department of Anaesthesia & Perioperative Medicine, University College London Hospitals NHS Foundation Trust, London, UK; Centre of Perioperative Medicine, Research Department for Targeted Intervention, Division of Surgery and Interventional Science, University College London, London, UK.
Eleanor WarwickDepartment of Anaesthesia, Lewisham & Greenwich NHS Trust, London, UK; Centre for Research & Improvement, Royal College of Anaesthetists, London, UK.
Iain MoppettCentre for Research & Improvement, Royal College of Anaesthetists, London, UK; Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK.
Martha BeleteCentre for Research & Improvement, Royal College of Anaesthetists, London, UK.
Laura CortesCentre for Research & Improvement, Royal College of Anaesthetists, London, UK.
Sarah HaydenCentre of Perioperative Medicine, Research Department for Targeted Intervention, Division of Surgery and Interventional Science, University College London, London, UK.
Andrew KaneNational Institute for Health Research-Central London Patient Safety Research Collaboration, London, UK; Centre for Research & Improvement, Royal College of Anaesthetists, London, UK; Department of Anaesthesia, South Tees Hospital NHS Foundation Trust, Middlesbrough, UK.
Justin KuaCentre of Perioperative Medicine, Research Department for Targeted Intervention, Division of Surgery and Interventional Science, University College London, London, UK; Department of Anaesthesiology, St Paul's Hospital, Vancouver, BC, Canada.
Emira KursumovicCentre for Research & Improvement, Royal College of Anaesthetists, London, UK.
Georgina SingletonCentre for Research & Improvement, Royal College of Anaesthetists, London, UK; Department of Anaesthesia, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK.
James YoungElective Recovery Programme, NHS England, London, UK.
Adam FosterElective Recovery Programme, NHS England, London, UK.
Judith HendleyElective Recovery Programme, NHS England, London, UK.
Laura Saucedo-CuevasNational Institute for Health Research-Central London Patient Safety Research Collaboration, London, UK; Centre of Perioperative Medicine, Research Department for Targeted Intervention, Division of Surgery and Interventional Science, University College London, London, UK.
S Ramani MoonesingheNational Institute for Health Research-Central London Patient Safety Research Collaboration, London, UK; Department of Anaesthesia & Perioperative Medicine, University College London Hospitals NHS Foundation Trust, London, UK; Centre of Perioperative Medicine, Research Department for Targeted Intervention, Division of Surgery and Interventional Science, University College London, London, UK. Electronic address: ramani.moonesinghe@nhs.net.
Joanna SimpsonDepartment of Anaesthesia, East Suffolk and North Essex NHS Foundation Trust, Colchester, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundElective surgical postponements and cancellations adversely affect patient experience, clinical outcomes, and theatre efficiency within the UK NHS. The Postponement and Cancellations in Elective Care study aimed to establish the national incidence and underlying causes of elective surgical postponements at preoperative assessment and cancellations occurring within 24 h of planned surgery.

methodsThis 7-day prospective service evaluation (November 11-18, 2024) collected data from participating NHS England trusts via an online platform. Preoperative assessment postponements were defined as any factor preventing a patient with a 'to come in' date from undergoing surgery as planned, or preventing preoperative assessment completion as 'good to go' within 2 weeks for those without a 'to come in' date. Cancellations were defined as a decision not to proceed within 24 h of planned surgery.

resultsSeventy-eight trusts provided complete incidence data covering 22 573 preoperative assessment appointments and 19 905 planned procedures. The national preoperative assessment postponement incidence was 8.7% (95% confidence interval, 6.9-10.8%), most commonly attributable to further investigation or tests (n=595, 27.2%). The national cancellation incidence was 9.9% (95% confidence interval, 8.7-11.3%), most frequently associated with acute medical conditions (n=515, 23.8%) and list overruns (n=315, 14.5%).

conclusionsThe Postponement and Cancellations in Elective Care study provides the first national overview of elective surgical pathway disruption in the UK. Nearly half of postponements were attributable to requirements for additional investigation or specialty review, indicating the importance of earlier optimisation and robust preoperative assessment fit to proceed criteria. Acute medical conditions continue to impact short-notice cancellations. Standardised pathways, improved scheduling, and strengthened perioperative coordination could reduce disruption and improve theatre utilisation.

Indexed as

Appointments and SchedulesElective Surgical ProceduresHealth Services ResearchAttitude to HealthHumansNational Health ProgramsPreoperative CareProspective StudiesUnited Kingdomelective surgeryNHSpreoperative assessmentsurgery cancellationsurgery postponement

Identifiers

PMID42031630
PMCPMC13197895

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