SP4.04 A Standards-Based Audit of Elective Procedures in a Tertiary Care Vascular Surgery Department in London

Aims In accordance with the NHS Constitution, our centre mandates that if a procedure (open or endovascular) is cancelled for non-clinical reasons, it must be rescheduled within 28 days. In this paper we aim to:Evaluate the department’s compliance with NHS guidelines for rescheduling cancelled procedures within 28 days.Identify avenues for improvement in current outcomes. Methods Procedure outcomes from 1st March to 31st August 2024 were reviewed, including number of procedures listed (scheduled, completed and cancelled), reasons for cancellations, and if cancellations were rescheduled within 28 days. This was communicated to the Consultants, the Admissions and Waiting List Manager, and the Cardiovascular Service Manager. Data from 1st October–30th November 2024 was collected using the same metrics to evaluate changes in performance. Results Of 402 initially scheduled procedures, 165 were cancelled. Rescheduling rates at 28 days were 14.75% (17.5% for open and 12.0% for endovascular). Following implementation of targeted departmental collaboration, the second data cycle reported improved rates of rescheduling - 65.2% (15/23) for open and 87.7% (57/65) for endovascular procedures. However, bed unavailability remained the major reason for cancellations. Conclusion Surgical postponement and cancellations are currently a major challenge as highlighted in the nationwide project, PACE (Postpone and Cancellations in Elective care). Our study indicates that facilitating structured dialogue within a surgical department and increasing awareness of guidelines enhanced compliance with performance targets.