The Postponement and Cancellations in Elective Care study: a national evaluation of case postponements and cancellations in elective surgical pathways (23 April 2026)

Summary

Postponing or cancelling elective surgical procedures can adversely affect the patient experience, clinical outcomes, and operational efficiency. The Postponement and Cancellations in Elective Care (PACE2024) study assessed the incidence and causes of postponement at preoperative assessment and cancellation within 24 h of planned surgery across the NHS in UK.

Content

Data from 78 NHS trusts from a 7-day survey in 2024 show reduced cancellation rates (now 9.9%) and postponements (8.7%) with improved theatre efficiency (74.7% of lists reported as running efficiently) since the Super-SNAP1 study in 2022. Postponements were most commonly attributable to a need for further investigation, and cancellations were most frequently associated with acute medical conditions and list overruns.

Because nearly half of postponements involved additional testing or consultations, and acute medical conditions were the main driver of short-notice cancellations, earlier optimisation and robust preoperative assessment to meet fit to proceed criteria are needed. Proactive management of acute medical conditions and patient-initiated reasons for cancellation, optimised theatre scheduling to reduce list overruns, and enhanced preassessment pathways to ensure preparation for surgery could reduce disruption and improve theatre utilisation, with positive impacts on patient experience, workforce, and resource utilisation.