Title : Same-day gynaecology theatre cancellations: A six-month retrospective audit at a district NHS hospital in the North West of England
Abstract:
Introduction:
Same-day theatre cancellations (SDTCs) remain a major challenge within the NHS, negatively affecting patient experience, workforce efficiency, theatre utilisation, and healthcare costs. Recent UK data from the PACE2024 study demonstrated cancellation rates of approximately 9.9% across NHS trusts, with many cancellations considered potentially avoidable (Bedford et al., 2026). National estimates suggest that on-the-day cancellations cost the NHS up to £400 million annually through lost theatre time and operational inefficiency (Centre for Perioperative Care, 2023).
Methods:
A retrospective audit reviewed all same-day gynaecology theatre cancellations at Royal Bolton Hospital between July and December 2024. During this six-month period, 60 out of 632 planned procedures were cancelled on the day of surgery, giving a cancellation rate of 9.6%, closely reflecting national data. The most common reason for cancellation was lack of theatre capacity or operating time for already scheduled cases (40%). Other causes included the need for further investigations or optimisation (18.3%), patient non-attendance (11.6%), acute illness (8.3%), patient-requested cancellations (8.3%), and surgeon-related factors (8.3%).
The audit highlighted the significant impact cancellations have on patients, including emotional distress, delayed treatment, disruption to employment and childcare arrangements, and reduced confidence in healthcare services. Recurrent cancellations also contributed to workforce pressure, inefficient theatre utilisation, financial loss, and prolonged waiting lists.
Conclusion :
Reducing avoidable cancellations through increased clinician involvement in theatre scheduling, realistic allocation of anaesthetic and operative time, proactive preoperative communication with patients, and improved multidisciplinary coordination may improve theatre efficiency, reduce NHS costs, and enhance patient outcomes.
