Cynulliad Cenedlaethol Cymru

Planned procedures may be postponed at short notice for a range of reasons – for clinical reasons; non-clinical reasons or by or because of an issue involving the individual themselves.

The table below shows the number of procedures postponed at short notice (either on the day or the day before) over the last five years.

Short notice postponed procedures for last five years

Note: 2023-24 data is up to February 2024

Note: 2020-21 data covers the start of the pandemic where all non-urgent surgery was postponed.

Note: the current cancellation figures are approximately 10%-12% of planned procedures

It is difficult to calculate costs associated with this data as costs vary by speciality and the nature of the operations. Based on Welsh Audit findings in its theatre review, it estimates a minute of theatre time costs £14.00.

If we average out each postponement as an hour, that would be a cost of £840 per procedure postponed.

Based on the figures quoted in table above, the annual costs are estimated at:

I was very clear when we launched the waiting well policy Promote, Prevent and Prepare in August 2023 about the importance we place in supporting people to ensure they are as fit as they can be prior to their operation. Evidence has shown that maximising fitness reduces risk of cancellation on the day due to fitness for surgery.

In addition to this policy, is the development of a more effective pre-operative assessment and process, building on the Getting it Right First-Time theatre optimisation guidance to improve theatre productivity. A new anaesthetic clinical implementation network has been established in the NHS Executive to take this work forward in 2024.

This work will look at assessing risk and fitness for an operation earlier in the patient pathway. This will give time for patients to be more proactively and effectively prepared for their treatment by optimising their health, such as losing weight, increasing their mobility, and stopping smoking. Patients will be supported to access relevant resources based on their individual needs, from online tools and information, local services in their community area, to dedicated pre-habilitation services depending on assessed individual needs.

This is an area where I expect significant improvement this year. Data from Hywel Dda on its short notice postponements indicate that its waiting well service introduced after the pandemic has made an impact. The number of short notice postponements have reduced by approximately 33%, resulting in a saving of approximately £1.2m in 2022-23 compared to 2019-20.