Knee surgery cancellations 'costing NHS millions'

A total of 9,403 knee replacement surgeries were cancelled between 2018 and 2023, according to the study

Cancelling knee replacement surgeries is "unforgivable", academics have said, as new research highlights how postponing operations is costing the NHS millions.

A quarter of scheduled operations across six NHS hospitals were cancelled with less than 24 hours' notice between 2018 and 2023, according to a University of Bristol study.

The research found that the loss of a minimum £6,500 per case during the five-year period had cost the NHS more than £15.5m and increased hospital waiting lists.

An NHS spokesperson said the number of knee replacements being carried out had risen since the period of the study by nearly a third but added that "there is further to go to prevent cancellations".

The study examined cancellations across six NHS hospitals in England, Scotland, Wales and Northern Ireland, between April 2018 and March 2023.

During this period, 17,223 total knee replacement operations were completed and 9,403 were cancelled.

The research team, led by academics at the National Institute for Health and Care Research at Bristol Biomedical Research Centre, said 25% of the cancellations were less than 24 hours before surgery, and 60% were within two to 14 days.

Peter Aitken, 77, was a patient and public contributor for the research

Former Bristol Rovers captain Peter Aitken, 71, said his operation had been cancelled while he sat waiting in his hospital gown.

"My knee replacement operation was originally booked for November 2023, but was cancelled after my pre-op appointment because of blood-thinning medication I was taking at the time," he said.

"It was rescheduled for March 2025, and I attended hospital on the day.

"But after a wait of seven-and-a-half hours, I was told at the 11th hour that the operation would have to be cancelled because they ran out of time."

Study author Dr Mark Eveleigh, consultant anaesthetist at Gloucestershire Hospitals NHS Foundation Trust, said: "Cancelled operations aren't just about wasted resources.

"Each cancellation statistic represents a patient who has often uprooted their entire life to get into hospital, [...] frequently at great cost to themselves.

"So for us then not to do the operation after they have gone through all that is, in my mind, unforgivable. We should strive for zero avoidable cancellations, and projects like this are the first step to realising that across the NHS."

Study lead Dr Wendy Bertram added the findings will be used to "build programmes that will prevent cancellation" and support patients while they wait.

Cut waiting times

An NHS spokesperson said it recognised the frustration caused by cancellations and added 123 surgical hubs have been opened since the period of the study, with dedicated beds and staffing to carry out more procedures and cut waiting times.

"NHS teams are taking further steps, including ensuring patients are fit for surgery by offering personalised support to help lose weight, stop smoking and manage their mental health, as well as by getting patients home on the same day as their operation which frees up beds," they added.