Main Theme: General
Introduction: Same-day cancellations (SDCs) waste theatre capacity and compound elective surgery backlogs1. In Q4 2025/26, NHS England reported 23,056 last-minute non-clinical elective cancellations2. GIRFT recommendations emphasise timely pre-assessment and pathway review to reduce same-day surgery cancellations in ENT3.
Methods: We retrospectively reviewed paediatric ENT theatre cancellations at the Royal London Hospital between October and December 2025. SDCs were confirmed from electronic patient records. Following our intervention, we assessed SDCs between March and May 2026. SDC rates were compared using chi-square/Fisher exact tests, with Wilson 95% confidence intervals.
Intervention: From March 2026, we implemented electronic consent forms that were sent to parents 48 hours prior to surgery. These included reminder messages providing families with contact details of the scheduling team in the event their child was unwell or unable to attend their surgery.
Results: Confirmed SDCs decreased from 30/230 ENT cases (13.0%) to 19/253 (7.5%; risk difference -5.5%; p=0.044). Among cancelled ENT cases, SDCs decreased from 30/51 (58.8%) to 19/43 (44.2%; p=0.157). Cancellations because surgery was no longer needed, fell from 8/30 to 0/19 (p=0.016). However, administrative/capacity causes rose from 1/30 to 7/19 (p=0.004).
Conclusion: A 48-hour digital prompt was associated with fewer confirmed SDCs and elimination of SDCs due to resolution of symptoms. Rates were still above the NHS England average of 5%. Residual operational causes, small samples, winter baseline effects, post-cycle unknowns and inconsistent avoidability coding limit inference. Better documentation and earlier clinical review will be the focus in the next cycle.
References
1. The King’s Fund. Waiting times for elective (non-urgent) treatment: referral to treatment (RTT). The King’s Fund; 2025 Dec [cited 2026 Jan 16]. Available from: https://www.kingsfund.org.uk/insight-and-analysis/data-and-charts/waiting-times-non-urgent-treatment
2. NHS England. Cancelled Elective Operations Data. Available from: https://www.england.nhs.uk/statistics/statistical-work-areas/cancelled-elective-operations/cancelled-ops-data/
3. Marshall A. Ear, Nose and Throat Surgery: GIRFT Programme National Specialty Report. London: Getting It Right First Time; 2019. Available from: https://gettingitrightfirsttime.co.uk/wp-content/uploads/2019/12/ENT-Report-Nov19-M.pdf