Winter cancellations of elective surgical procedures in the UK: a questionnaire survey of patients on the economic and psychological impact

Abstract

Objectives: To quantify the economic and psychological impact of the cancellation of operations due to winter pressures on patients, their families and the economy.

Design: This questionnaire study was designed with the help of patient groups. Data were collected on the economic and financial burden of cancellations. Emotions were also quantified on a 5-point Likert scale.

Setting: Five NHS Hospital Trusts in the East Midlands region of England.

Participants: We identified 796 participants who had their elective operations cancelled between 1 November 2017 and 31 March 2018 and received responses from 339 (43%) participants.

Interventions: Participants were posted a modified version of a validated quality of life questionnaire with a prepaid return envelope.

Main outcome measures: The primary outcome measures were the financial and psychological impact of the cancellation of elective surgery on patients and their families.

Results: Of the 339 respondents, 163 (48%) were aged <65 years, with 111 (68%) being in employment. Sixty-six (19%) participants had their operations cancelled on the day. Only 69 (62%) of working adults were able to return to work during the time scheduled for their operation, with a mean loss of 5 working days (SD 10). Additional working days were lost subsequently by 60 (54%) participants (mean 7 days (SD 10)). Family members of 111 (33%) participants required additional time off work (mean 5 days (SD 7)). Over 30% of participants reported extreme levels of sadness, disappointment, anger, frustration and stress. At least moderate concern about continued symptoms was reported by 234 (70%) participants, and 193 (59%) participants reported at least moderate concern about their deteriorating condition.

Conclusions: The cancellation of elective surgery during the winter had an adverse impact on patients and the economy, including days of work lost and health-related anxiety. We recommend better planning, and provision of more notice and better support to patients.

Keywords: National Health Service; economic impact; elective operations; psychosocial impact; winter cancellations.