According to the BBC, the number of NHS operations cancelled at the last minute in English hospitals increased by almost 2,500 at the end of 2004.   Between October to December 17,402 operations were cancelled at short notice for "non-clinical" reasons. But have no fear, a health ministry bureaucrat said, "the vast majority  of patients were getting faster access to treatment." It seems that things are getting worse, but its still okay.

The cause of this "non-problem?"  A lack of available down stream beds and theatre staff shortages are the main culprits.  Their current solution includes throwing more beds at the problem and some patient flow optimization by working to keep out patients out of in patient beds.  Having met with a group of NHS nurse executives last summer in NYC, I know that the majority of their hospitals are highly regimented (fixed rooms for specific patient classifications) and could increase patient flow, reduce transfers and shorten LOS by adopting universal beds.

Ironically, another government program to improve service may be gumming up the works.   A spokeswoman for the British Medical Association said: "The BMA is also concerned that in order to meet the four-hour A&E waiting list target inappropriate hospital admissions are being made. This would obviously lead to reduced bed capacity and elective surgery being cancelled. The BMA is looking into this." (For you non-anglophiles, A&E is Accident & Emergency, their term for the ED.)

In another example of bureaucratic fixing, this paper on surgical waiting times in Canada's health service has this startling conclusion:  shorter surgery waiting lists result in shorting waiting times for those patients on the list.  The authors suggested that, "Hospital managers may also use the findings to reduce uncertainty in reporting expected waits given the current list size, thereby improving resource planning."  In fairness, there are some interesting bits about queuing priorities and optimizing limited resources.