Around one in ten operations across England are either cancelled within 24 hours or postponed due to inadequate patient preparation, according to new analysis.
The study also indicates that almost four in ten last-minute cancellations could potentially be avoided.
Experts are urging the NHS to make bolstering perioperative care “a priority”, warning that without it, waiting lists risk remaining “unacceptably high”.
The findings, published in the British Journal of Anaesthesia, examined data from 11 November to 18 November, 2024.
This period covered 22,573 preoperative assessment appointments and 19,905 planned procedures across 78 NHS trusts. Overall, 2,190 postponements were recorded across 91 participating trusts.
The analysis revealed a national rate of 10 per cent for planned surgeries cancelled within 24 hours. The top three reasons for these cancellations were identified as acute medical conditions, list overruns, and patients failing to attend.
However, some 37.3 per cent of the cancellations were “potentially avoidable”, according to the study.
If problems were recognised three to five days earlier, the cancellation could have either been prevented, or another patient could have been booked on to operating lists, researchers said.
Elsewhere, 9 per cent of pre-operative assessment appointments resulted in surgeries being postponed.
Most were down to patients not being adequately prepared, with 61 per cent pushed back because patients needed further tests, specialist anaesthetic or a medical review, usually because of other medical conditions.
Lead author Dr James Bedford, of University College London, worked on the project alongside the National Institute of Health Research Central London Patient Safety Research Collaboration, NHS England, and the Royal College of Anaesthetists.
He said the findings underline “the need for better implementation of patient care ahead of surgery, across the NHS”.
He added: “In particular – and in keeping with standards issued by NHS England – we need to ensure we identify health problems, which put patients at risk of postoperative complications, as early as possible, so that these can be improved while they are waiting for their operation.
“The process of early screening also helps to identify patients who are low risk, who can potentially be called to have surgery at short notice, therefore reducing their waiting time, and improving service efficiency.”
In a linked editorial, Professor Scarlett McNally, a consultant orthopaedic surgeon, wrote: “NHS England has spent billions building new surgical hubs, but such stand-alone units do not operate on patients at greater risk of complications, those who are older, or living with underlying health conditions and in need of the additional back-up of an NHS hospital.
“Without a different approach that focuses on supporting and preparing these patients, waiting lists will remain unacceptably high as procedures are too frequently postponed or cancelled.”
Figures published earlier this month showed the waiting time for hospital treatment in England fell for the fourth month in a row.
An estimated 7.22 million treatments were waiting to be carried out at the end of February, relating to 6.11 million patients, down from 7.25 million treatments and 6.13 million patients at the end of January.
Commenting on the analysis, Dr Claire Shannon, president of the Royal College of Anaesthetists, said: “This study shows why strengthening perioperative care must be a priority.
“Delivering joined-up, patient-centred care before, during and after surgery leads to better outcomes for patients and is more efficient and cost effective for the NHS.”
Prof Frank Smith, vice-president of the Royal College of Surgeons of England said “high-quality care before and after surgery is just as important as the operation itself”.
He added: “Surgeons play a central role in leading teams to ensure patients are genuinely ready for surgery, not simply waiting for a date.
“The findings underline the need for earlier, better co-ordinated care so patients are in the best possible condition when they reach the operating theatre.”
Dr Denny Levett, director of the Centre for Perioperative Care, said: “So many last-minute cancellations in elective surgery could be avoided by earlier screening and better preparation before surgery.”