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

Abstract

ObjectivesTo quantify the economic and psychological impact of the cancellation of operations due to winter pressures on patients, their families and the economy.DesignThis 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.SettingFive NHS Hospital Trusts in the East Midlands region of England.ParticipantsWe identified 796 participants who had their elective operations cancelled between 1 November 2017 and 31 March 2018 and received responses from 339 (43%) participants.InterventionsParticipants were posted a modified version of a validated quality of life questionnaire with a prepaid return envelope.Main outcome measuresThe primary outcome measures were the financial and psychological impact of the cancellation of elective surgery on patients and their families.ResultsOf 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.ConclusionsThe 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.

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“… 25 , 26 More recently, a study examining nearly 400 patients who experienced a surgical cancellation revealed that over 30% reported extreme emotional impacts (e.g., extreme sadness, stress, anger) and nearly 60% reported moderate concern about their deteriorating health condition as a result of the cancellation. 27 The lower value from the current study may reflect the fact that the majority of patients eventually underwent surgery, meaning the adverse impacts of their surgical cancellations/postponements may have been less salient at the time of the survey.…”

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“…This has a significant impact, both on the capacity of the surgical system as well as at a personal level, causing extreme stress and anxiety for patients. One study showed that 30% of patients who had operations cancelled during winter pressures complained of extreme stress and frustration as well as 59% reporting moderate or severe concern about a deterioration in their condition [104], in addition to the impact on a patient's family as well.…”