The impact of postponements and cancellations of recent or planned care or appointments
This was against the context of the rising elective list, the ongoing impact of the pandemic and industrial action by NHS staff, and the proactive sharing of information by the public with the Healthwatch network about the impact of disrupted care caused by staff strikes.
Key findings
Initial research identified that 55% of a nationally representative sample of 1,038 people, in 2023, had used or were waiting to use NHS services (planned elective care, outpatient appointments and community health appointments).
25% of those NHS users had had their care cancelled.
To look beyond those topline statistics, we boosted the research to reach a total sample of 1,084 people whose care had been cancelled in 2023, to find:
- 39% had had their care cancelled on two or more occasions.
- 18% said their care was cancelled at the last minute (on the day or upon arrival).
- Certain groups were more likely to report that their care had been cancelled multiple times. These included disabled people, 52%; neurodivergent people, 51%; and people on lower incomes, ethnic minorities and LGBTQ+ being affected the most, 49% respectively.
- 66% reported significant impacts on their lives due to the cancelled care, such as worsening mental health, ongoing pain and disrupted sleep.
- Certain groups were more likely to report these impacts. These included unpaid carers, 84%, and neurodivergent people, 83%; followed by people on low incomes, 80%; and those from minority ethnic backgrounds, 75%.
- 25% had not been given a new date for their care.
- 79% said they had been offered 'very little' or 'no' support to manage mental health needs during their new wait.
- 15% said the NHS told them their cancellation was due to strikes, 25% believed this was the reason, 41% said another reason and 20% didn't know why.
Findings: The cancellation experience
- 39% of the 1,084 people who had care cancelled, said this happened on two or more occasions.
- 45% said the cancellation happened between one and seven days beforehand.
- 18% had had their care cancelled at the last minute (on the day or on arrival at their appointment, to use the NHS definition of last-minute cancelled elective care).
Information and support while waiting
- 24% of the 1,084 people whose care had been cancelled, had not been given a new appointment or procedure date and of this group, 82% said the NHS hadn't told them when they would receive a date.
- 79% said they had been offered 'very little' or 'no support' by the NHS to manage mental health needs during their wait.
- 52% said they had not been offered support by the NHS to manage their medical symptoms during their wait.
- 24% said they had a 'a lot of support' during their wait to manage needs.
- 21% said they had received 'a little support'.
Reasons for cancelled care
- 15% of 1,084 people said the NHS told them that their cancellation was due to strike action.
- A further 24% of people thought strike action was the reason.
- 41% said the cancellation was for another reason.
- 20% didn't know why.
Healthwatch England's calls for change
NHS England, Integrated Care Boards and NHS providers should do more to:
- Collect and publish official data on cancellations to understand what is driving non-clinical, clinical and or patient-led reasons for delay.
- Use this data to reduce the high number of last-minute cancellations.
- Offer more significant support to those most affected by new delays, especially with mental health needs.
- Improve admin and communication to close the gap for those who are left in limbo with no new date.
- We also renew calls to government and unions to reach a resolution to mitigate the impact of strikes on cancellations or postponements.
Download the full report below or read it on the Healthwatch England website.
