Research Highlights Frequency and Financial Impact of Delays
Cancelling knee replacement surgeries is “unforgivable”, according to academics whose new research shows the scale of disruption and financial loss caused by last-minute postponements. A University of Bristol study examining six NHS hospitals found that one quarter of scheduled total knee replacement operations between 2018 and 2023 were cancelled with less than 24 hours’ notice. The researchers calculated that each cancellation carried a minimum loss of £6,500, resulting in a financial impact of more than £15.5m over the five-year period and contributing to longer waiting lists.
An NHS spokesperson said the number of knee replacements carried out has risen by nearly a third since the period covered in the study, though acknowledged “there is further to go to prevent cancellations”.
Cancellations Across Four Nations of the UK
The study reviewed cancellations between April 2018 and March 2023 at hospitals in England, Scotland, Wales and Northern Ireland. In that time, 17,223 total knee replacement operations were completed, while 9,403 were cancelled. Of those cancellations, 25% occurred less than 24 hours before the scheduled surgery, and 60% took place within two to 14 days.
Patients Describe the Experience of Short-Notice Cancellations
Former Bristol Rovers captain Peter Aitken, 71, said his surgery was cancelled while he was waiting in hospital. His operation, first scheduled for November 2023, was postponed after a pre-operative appointment due to blood-thinning medication. The procedure was rescheduled for March 2025. He arrived at the hospital on the day, but after waiting seven and a half hours, he was told the operation could not go ahead because the team had run out of time.
Researchers Call for Action to Reduce Avoidable Cancellations
Study author Dr Mark Eveleigh, a consultant anaesthetist at Gloucestershire Hospitals NHS Foundation Trust, said cancellations represented more than lost financial resources. He said each case involved a patient who had rearranged major parts of their life to attend hospital, often at personal cost. He described the situation as “unforgivable” and said the NHS should aim for zero avoidable cancellations. Study lead Dr Wendy Bertram said the findings would be used to “build programmes that will prevent cancellation” and better support patients waiting for surgery.
NHS Says New Measures Aim to Reduce Disruption
An NHS spokesperson said they recognised the frustration caused by cancellations. They said 123 surgical hubs with dedicated beds and teams have been opened since the study period to carry out more procedures and reduce waiting times. The spokesperson added that NHS teams are offering personalised support to ensure patients are fit for surgery — including help with weight loss, smoking cessation and mental health — and increasing same-day discharge to free up beds.
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