The RCoA Centre for Research and Improvement (CR&I), in collaboration with UCL and the University of Nottingham led our first "Super-SNAP" - a simple, rapid, service evaluation on cancellations and delays to surgery.

Data collection for Super-SNAP1 has ended and our team are working to analyse the data. Thank you to all the individuals who helped us run this study. We will post results in due course.

Why did we want to do this study?

Our colleagues around the country are increasingly beleaguered as a result of the pressures on acute and critical care, and the impact this is having on delivering surgery. We know that cancellations are rife and service efficiency can be poor, and that this is causing massive disruption to lists, colleagues and most importantly to patients.

The purpose of Super-SNAP1 was to help inform NHS England and Improvement, and administrations in the devolved nations, about the current rates and reasons for cancellations, the types of surgery being done and the challenges faced by surgical/perioperative teams. We aimed to identify any variation between countries and types of hospital in order to support policy making around equitable access to care as we remain so busy in theatres and critical care.

The NHS collects data on waiting list times, hospital or critical care "stress" (using OPEL and CritCon scores), hospital and critical care occupancy and so on, which we hope to be able to link local data from Super-SNAP1 to, in order to develop a rich picture of the challenge being faced by different trusts, systems and regions, to inform the national debate on elective recovery and critical care / perioperative capacity.

What did we want to do?

We aimed to undertake a very simple two-day service evaluation to answer the following questions:

  • What was the rate of last-minute cancellation for planned surgery and what were the reasons/risk factors for cancellations
  • Was operating/interventional list efficiency and productivity being affected by factors outside your control - e.g. uncertainty over bed availability, IPC issues, availability of staff
  • Was there variation in operating list characteristics, efficiency and cancellations between different parts of the country, or between hospitals of different types (e.g. acute vs. 'cold' site; big tertiary centre vs. smaller DGH etc)
  • Was emergency surgery being provided within the desired timeframe for patients?

What did it involve?

For two days (48h), on Tuesday 11th and Wednesday 12th January 2022, we asked collaborators to collect four short datasets:

  • Basic demographics about patients cancelled on the day or the day before planned surgery
  • Basic demographics about patients having emergency surgery and the timeliness of their surgery
  • A brief questionnaire providing an overview of the efficiency of operating/interventional lists
  • A brief questionnaire providing an overview of all surgical/interventional activity on each day of the study

What next?

The team are working hard to analyse the data. We will post results here in due course. 

In the meantime, thank you as always, for everything you are doing for your patients, your hard work and perseverance.


Study Documents

Please click here if you require study documents for Super-SNAP1.

Thank you for the fantastic response from our SuperSNAP-1 Principal Investigators (PIs). Please see below for details of the PI at your hospital.

Airedale NHS Foundation Trust

  • Airedale General Hospital - Dr Julian Hood


Alder Hey Children's NHS Foundation Trust

  • Alder Hey Childrens Hospital - Dr James White


Ashford & St Peters NHS Foundation Trust

  • Ashford Hospital - Dr Mark MacGregor
  • St Peter's Hospital - Dr Mark MacGregor


Barnsley Hospital NHS Foundation Trust

  • Barnsley Hospital - Dr Sunil Chaurasia


Barts Health NHS Trust

  • Newham University Hospital - Dr Bhavesh Gohil
  • The Royal London Hospital - Dr Neil McDonald and Dr Jennifer Overend
  • St Bartholomew's Hospital - Dr Selina Ho
  • Whipps Cross University Hospital - Dr Cathal McCabe


Birmingham Women's and Children's NHS Foundation Trust

  • Birmingham Women's Hospital - Dr Jane Pilsbury


Blackpool Teaching Hospitals NHS Foundation Trust

  • Blackpool Victoria Hospital - Dr Dzmitry Zabauski


Bolton NHS Foundation Trust

  • Royal Bolton Hospital - Dr Sarah Corsan


Bradford Teaching Hospitals NHS Foundation Trust

  • Bradford Royal Infirmary - Dr Jonathan Sanders
  • St Luke's Hospital - Dr Jonathan Sanders


Buckinghamshire Healthcare NHS Trust

  • Stoke Mandeville Hospital - Dr Ronak Patel and Dr N Smith


Calderdale and Huddersfield NHS Foundation Trust

  • Calderdale Royal Hospital - Dr Meg Barker
  • Huddersfield Royal Infirmary - Dr Meg Barker


Cambridge University Hospitals NHS Foundation Trust

  • Addenbrooke's Hospital - Dr Milena Georgieva


Chelsea and Westminster Hospital NHS Foundation Trust

  • Chelsea and Westminster Hospital - Dr Ami Kotecha
  • West Middlesex University Hospital - Dr Priyakam Chowdhury and Dr Stephen Harrison


Countess of Chester Hospital NHS Foundation Trust

  • Countess of Chest Hospital - Dr Shady Salama


County Durham and Darlington NHS Foundation Trust

  • Bishop Auckland Hospital - Dr Jothika Thimappa
  • Darlington Memorial Hospital - Dr Chandrasekar Janarthanan
  • University Hospital of North Durham - Dr David Hamilton


Croydon Health Services NHS Foundation Trust

  • Croydon University Hospital - Dr Ashok Raj


Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust

  • Bassetlaw Hospital - Dr Venish Vincent


East and North Hertfordshire NHS Trust

  • Lister Hospital - Dr Chloe Chan


East Kent Hospitals University NHS Foundation Trust

  • Queen Elizabeth The Queen Mother Hospital - Dr Katyayani Katyayani


East Lancashire Hospitals NHS Trust

  • Burnley General Hospital - Dr Mohammed Akuji
  • Royal Blackburn Hospital - Dr Mohammed Akuji


East Suffolk and North Essex NHS Foundation Trust

  • Colchester General Hospital - Dr Jo Simpson
  • Ipswich Hospital - Dr Julia Jenkins


Epsom and St Helier University Hospitals NHS Trust

  • Epsom General Hospital - Dr Martin Gardiner and Dr Martin Akioyame
  • St Helier Hospital - Dr Martin Gardiner and Dr Martin Akioyame


Frimley Health NHS Foundation Trust

Heatherwood Hospital - Dr Husam Kaskos
Wexham Park Hospital - Dr Husam Kaskos

Great Ormond Street Hospital for Children NHS Foundation Trust

Great Ormond Street Hospital for Children - Dr Marc Cohen

Great Western Hospitals NHS Foundation Trust

  • The Great Western Hospital, Swindon - Dr Julian Stone


Guy's and St Thomas' NHS Foundation Trust

  • Evelina London Children's Hospital - Dr Aileen Tan
  • Guy's Hospital - Dr Kariem El-Boghdadly and Dr Danny Wong
  • St Thomas' Hospital - Dr Kariem El-Boghdadly and Dr Danny Wong


Hampshire Hospitals NHS Foundation Trust

  • Basingstoke and North Hampshire Hospital - Dr Christina Timmons
  • Royal Hampshire County Hospital - Dr Christina Timmons


Harrogate and District NHS Foundation Trust

  • Harrogate District Hospital - Dr Mohannad Mohyeldin and Dr Karim Elfaham


Imperial College Healthcare NHS Trust

  • Charing Cross Hospital - Dr Ed Costar


Isle of Wight NHS Trust

  • St Mary's Hospital, Isle of Wight - Dr Gabor Debreceni


James Paget University Hospital NHS Trust

  • James Paget University Hospital - Dr Hala Eid


Kettering General Hospital NHS Foundation Trust

  • Kettering General Hospital - Dr Dumisani Ncomanzi


King's College Hospital NHS Foundation Trust

  • Princess Royal University Hospital - Dr Sylvia Martin


Leeds Teaching Hospitals NHS Trust

  • St James's University Hospital - Dr Joana Faris


Lewisham and Greenwich NHS Trust

  • Queen Elizabeth Hospital, Woolwich - Dr Charlotte Smith
  • University Hospital Lewisham - Dr Akhil Gupta and Dr Manju Agarwal


Liverpool University Hospitals NHS Foundation Trust

  • Aintree University Hospital - Dr Dermot Maloney


London North West Healthcare NHS Trust

  • Central Middlesex Hospital - Dr Prabhu Aparna
  • Ealing Hospital - Dr Prabhu Aparna and Dr Leena Ali
  • Northwick Park and St Mark's Hospitals - Dr Prabhu Aparna


Maidstone and Tunbridge Wells NHS Trust

  • Maidstone Hospital - Dr Mark Howells
  • Tunbridge Wells Hospital - Dr Mark Howells


Manchester University NHS Foundation Trust

  • Manchester Royal Eye Hospital - Dr Kailash Bhatia
  • Manchester Royal Infirmary - Dr Kailash Bhatia and Dr Shilpa Munirama
  • Royal Manchester Children's Hospital - Dr Rosalind Morley
  • St Mary's Hospital, Manchester - Dr Sujesh Bansal
  • Trafford General Hospital - Dr Neeraj Bhardwaj
  • Wythenshawe Hospital - Dr Elias Delis


Medway NHS Foundation Trust

  • Medway Maritime Hospital - Dr Kirsty Bromage


Mid Essex Hospital Services NHS Trust

  • Broomfield Hospital - Dr Syed Qureshi


Mid Yorkshire Hospitals NHS Trust

  • Dewsbury and District Hospital - Dr Helen Buglass
  • Pinderfields Hospital - Dr Helen Buglass
  • Pontefract Hospital - Dr Helen Buglass


Milton Keynes University Hospital NHS Trust

  • Milton Keynes General Hospital - Dr Wassum Shamsuddin


Moorfields Eye Hospital NHS Foundation Trust

  • Moorfields Eye Hospital (including all Satellite sites) - Dr Louisa Pavlakovic


Norfolk and Norwich University Hospitals NHS Foundation Trust

  • Norfolk and Norwich Hospital - Dr Nicholas Saunders


North Bristol NHS Trust

  • Southmead Hospital - Dr Sarah Martindale


North Middlesex University Hospital NHS Trust

  • North Middlesex University Hospital - Dr Tanmay Patil


North Tees and Hartlepool NHS Foundation Trust

  • University Hospital of Hartlepool - Dr Prabhakar Paranthaman


North West Anglia NHS Foundation Trust

  • Hinchingbrooke Hospital - Dr Ravindra Mallavilli
  • Peterborough City Hospital - Dr Matt Ellington


Northampton General Hospital NHS Trust

  • Northampton General Hospital - Dr Sunjay Bhadresha


Northern Devon Healthcare NHS Trust

  • North Devon District Hospital - Dr Katy Pyatt


Nottingham University Hospitals NHS Trust

  • Nottingham City Hospital - Dr David Hewson and Dr Samira Hussain
  • Queen's Medical Centre - Dr David Hewson


Oxford University Hospitals NHS Foundation Trust

  • Churchill Hospital - Dr Trina Crilley and Dr Akshay Shah
  • Horton General Hospital - Dr Trina Crilley and Dr Akshay Shah
  • John Radcliffe Hospital - Dr Trina Crilley and Dr Akshay Shah
  • Nuffield Orthopaedic Centre - Dr Trina Crilley and Dr Akshay Shah


Portsmouth Hospitals NHS Trust

  • Queen Alexandra Hospital - Dr Genevra Pillinger


Queen Victoria Hospital NHS Foundation Trust

  • Queen Victoria Hospital, East Grinstead - Dr Glenn Wearne


Royal Brompton and Harefield NHS Foundation Trust

  • Harefield Hospital - Dr Marco Scaramuzzi


Royal Devon and Exeter NHS Foundation Trust

  • Axminster Hospital - Dr Helen Gilfillan
  • Heavitree Hospital - Dr Helen Gilfillan
  • Royal Devon and Exeter Hospital, Wonford - Dr Helen Gilfillan
  • Tiverton and District Hospital - Dr Helen Gilfillan


Royal Free London NHS Foundation Trust

  • Barnet General Hospital - Dr Rajeev Jha
  • Chase Farm Hospital - Dr Rajeev Jha
  • Royal Free Hospital - Dr Girish Murthy


Royal National Orthopaedic Hospital NHS Trust

  • The Royal National Orthopaedic Hospital - Dr Rachel Baumber and Dr Narendra Siddaiah


Royal Papworth Hospital NHS Foundation Trust

  • Royal Papworth Hospital - Dr Estefania Arenas Bermejo


Royal United Hospitals Bath NHS Foundation Trust

  • Royal United Hospital - Dr Lesley Jordan


Salisbury NHS Foundation Trust

  • Salisbury District Hospital - Dr Xantha Holmwood


Sandwell and West Birmingham Hospitals NHS Trust

  • City Hospital, Birmingham - Santhanagopalan Kannan
  • Sandwell General Hospital - Santhanagopalan Kannan


Sheffield Children's NHS Foundation Trust

  • Sheffield Children's Hospital - Dr Kate Wilson


Sheffield Teaching Hospitals NHS Foundation Trust

  • Weston Park Hospital - Dr Kate Wilson


Sherwood Forest Hospitals NHS Foundation Trust

  • King's Mill Hospital - Dr Irena Guzik
  • Newark Hospital - Dr Irena Guzik


Shrewsbury and Telford Hospital NHS Trust

  • Royal Shrewsbury Hospital - Dr Simon Leach
  • The Princess Royal Hospital, Telford - Dr Karthikeyan Selvaraju


South Tees Hospitals NHS Foundation Trust

  • Friarage Hospital - Dr Johanna Paterson
  • The James Cook University Hospital - Dr Johanna Paterson


South Tyneside and Sunderland NHS Foundation Trust

  • South Tyneside District Hospital - Dr Riccardo Scano


South Warwickshire Foundation Trust

  • Warwick Hospital - Dr Ish Suri


Southend University Hospital NHS Foundation Trust

  • Southend University Hospital - Dr Giri Bhat and Dr Syed Shah


Southport and Ormskirk Hospital NHS Trust

  • Ormskirk District General Hospital - Dr Emilia Ardelean
  • Southport and Formby District General Hospital - Dr Emilia Ardelean


St George's Hospitals NHS Foundation Trust

  • Queen Mary's Hospital, London (Roehampton) - Dr Carolyn Johnston
    St George's Hospital - Dr Carolyn Johnston


St Helens and Knowsley Teaching Hospitals NHS Trust

  • St Helens Hospital - Dr Janet Slee
  • Whiston Hospital - Dr Janet Slee


Taunton and Somerset NHS Foundation Trust

  • Musgrove Park Hospital - Dr Alison Gordon


The Christie NHS Foundation Trust

  • The Christie Hospital - Dr Mahesh Trivedi


The Dudley Group NHS Foundation Trust

  • Corbett Hospital - Dr Anser Ali
  • Guest Hospital - Dr Antony Pynadth and Dr Vishal Amin
  • Russells Hall Hospital - Dr Anser Ali


The Hillingdon Hospitals NHS Foundation Trust

  • Hillingdon Hospital - Dr Julia Ng
  • Mount Vernon Hospital - Dr Julia Ng


The Newcastle Upon Tyne Hospitals NHS Foundation Trust

  • Freeman Hospital - Dr Deepak Gregory and Dr Amhad Chishti
  • The Freeman Hospital Cardiothoracic Centre - Dr Deepak Gregory


The Rotherham NHS Foundation Trust

  • Rotherham Hospital - Dr Elinor Cromarty


The Royal Marsden NHS Foundation Trust

  • The Royal Marsden, Chelsea, London - Dr Shaman Jhanji


The Royal Wolverhampton NHS Trust

  • Cannock Chase Hospital - Dr Pete Checketts
  • New Cross Hospital - Dr Pete Checketts


Torbay and South Devon NHS Foundation Trust

  • Torbay Hospital - Dr Michael Swart


University College London Hospitals NHS Foundation Trust

  • National Hospital for Neurology and Neurosurgery - Dr Jeremy Radcliffe
  • University College Hospital - Dr Janis Ferns and Dr Sam Bampoe
  • University College Hospital at Westmoreland Street - Dr Janis Ferns and Dr Sam Bampoe


University Hospitals Birmingham NHS Foundation Trust

  • Good Hope Hospital - Dr Alina Popon
  • Heartlands Hospital - Dr Alina Popon
  • Solihull Hospital - Dr Alina Popon


University Hospitals Bristol NHS Foundation Trust

  • Bristol Eye Hospital - Dr Nicola Harvey
  • Bristol Heart Institute - Dr Carly Webb
  • Bristol Royal Hospital for Children - Dr Jessica Vanderwalt
  • Bristol Royal Infirmary - Dr Nicola Harvey
  • South Bristol Community Hospital - Dr Carly Webb
  • University of Bristol Dental Hospital - Dr Jessica Vanderwalt


University Hospitals Dorset NHS Foundation Trust

  • Poole Hospital - Dr Michael Girgis


University Hospitals of Derby and Burton NHS Foundation Trust

  • Royal Derby Hospital - Dr Nagendra Prasad


University Hospitals of Leicester NHS Trust

  • Hinckley and District Hospital - Dr Akeeban Maheswaran
  • Leicester General Hospital - Dr Ninad Nigalye
  • Leicester Royal Infirmary - Dr Akeeban Maheswaran
  • Loughborough Hospital - Dr Akeeban Mahesawaran
  • Melton Mowbray Hospital - Dr Akeeban Maheswaran
  • County Hospital, Stafford - Dr Moses Chikungwa
  • Royal Stoke University Hospital - Dr Moses Chikungwa


University Hospitals Plymouth NHS Trust

  • Derriford Hospital - Dr Matt Julian
  • Tavistock Hospital - Dr Matt Julian


University Hospitals Sussex NHS Foundation Trust

  • Princess Royal Hospital (including Hurstwood Park theatres) - Dr Georgina Wilson
  • Royal Alexandra Children's Hospital - Dr Georgina Wilson
  • Royal Sussex County Hospital - Dr Georgina Wilson
  • Southlands Hospital - Dr Shane Weinmann and Dr Marek Parera
  • St Richard's Hospital - Dr Emily Dana
  • Sussex Eye Hospital - Dr Georgina Wilson
  • Sussex Orthopaedic Treatment Centre - Dr Georgina Wilson
  • Worthing Hospital - Dr Shane Weinmann and Dr Marek Parera


Walsall Healthcare NHS Trust

  • Walsall Manor Hospital - Dr Manu Rangaiah


Warrington and Halton Hospitals NHS Foundation Trust

  • Nightingale Building - Dr Niamh Sexton
  • The Captain Sir Tom Moore Building - Dr Vicky Wroe
  • Warrington Hospital - Dr Andrew Martin


West Suffolk NHS Foundation Trust

  • West Suffolk Hospital - Dr Nicholas Levy


Weston Area Health NHS Trust

  • Weston General Hospital - Dr Alison Smith


Whittington Health NHS Trust

  • Whittington Hospital - Dr Miltsios Kostas


Worcestershire Acute Hospitals NHS Trust

  • Alexandra Hospital, Redditch - Dr Simon Garstang
  • Kidderminster Hospital and Treatment Centre - Dr Simon Garstang
  • Worcestershire Royal Hospital - Dr Simon Garstang and Dr Alag Raajkumar


Yeovil District Hospital NHS Foundation Trust

  • Yeatman Hospital - Dr Sam Maese
  • Yeovil District Hospital - Dr Jo Kerr


York Teaching Hospital NHS Foundation Trust

  • Bridlington and District Hospital - Dr Andrzej Sladkowski
  • Scarborough General Hospital - Dr Andrzej Sladkowski

Isle of Man Department of Health and Social Services

  • Noble's Hospital, Isle of Man - Dr Alison Hool


States of Jersey

  • Jersey General Hospital - Dr Alan Thompson

Belfast Health and Social Care Trust

  • Belfast City Hospital - Dr Brenda Daly
  • Musgrave Park Hospital - Dr Edmund Skibowski
  • The Royal Belfast Hospital for Sick Children - Dr Adam Glass


South Eastern Health and Social Care Trust

  • Downe Hospital - Dr Leanne Laverty
  • Lagan Valley Hospital - Dr Leanne Laverty
  • The Ulster Hospital - Dr Leanne Laverty


Southern Health and Social Care Trust

  • Craigavon Area Hospital - Dr Brian Donnelly
  • Daisy Hill Hospital - Dr Alison Blair
  • South Tyrone Hospital - Dr Brian Donnelly

NHS Ayrshire and Arran

  • University Hospital Ayr - Dr Rose McRobert
  • University Hospital Crosshouse - Dr Philip Jacobs


NHS Borders

  • Borders General Hospital - Dr David Love


NHS Dumfries and Galloway

  • Dumfries and Galloway Royal Infirmary - Dr David Wright
  • Galloway Community Hospital - Dr David Wright


NHS Fife

  • Queen Margaret Hospital, Dunfermline - Dr Emily Hatton-Wyatt
  • Victoria Hospital, Kirkcaldy - Dr Emily Hatton-Wyatt


NHS Forth Valley

  • Forth Valley Royal Hospital - Dr Jonathan Richards


NHS Grampian

  • Aberdeen Maternity Hospital - Dr Nanda Kumar
  • Aberdeen Royal Infirmary - Dr Nanda Kumar
  • Royal Aberdeen Children's Hospital - Dr Nanda Kumar
  • Woodend Hospital - Dr Nanda Kumar


NHS Greater Glasgow and Clyde

  • Glasgow Royal infirmary - Dr Barbara Crooks
  • Institute of Neurosciences and Spinal Unit - Dr Urmila Ratnasabapathy
  • New Stobhill Hospital - Dr Barry Evans
  • Queen Elizabeth University Hospital Glasgow - Dr Urmila Ratnasabapathy
  • Royal Alexandra Hospital, Glasgow - Dr Gavin Fletcher
  • Royal Hospital for Children, Glasgow - Dr Adele King
  • Vale of Leven Hospital - Dr Catherine Peutherer


NHS Highland

  • Raigmore Hospital - Dr Dan Baraclough


NHS Lothian

  • Royal Infirmary of Edinburgh - Dr Zoey Dempsey
  • St John's Hospital at Howden - Dr Catherine Stretton
  • The Princess Alexandra Eye Pavilion - Dr Zoey Dempsey
  • The Royal Edinburgh Hospital - Dr Zoey Dempsey
  • The Royal Hospital for Children and Young People, Edinburgh - Dr Pamela Winton
  • Western General Hospital - Dr Andrew Marchant and Dr Ian Scot


NHS Orkney

  • Balfour Hospital - Dr Ian McConachie


NHS Scotland Special Board

  • Golden Jubilee National Hospital - Dr Ndollo Eboumbou


NHS Tayside

  • Perth Royal Infirmary - Dr Chloe Chang and Dr Param Chockalingam

Betsi Cadwaladr University Health Board

  • Abergele Hospital - Dr Catherine Gardner-Thorpe
  • Glan Clwyd Hospital - Dr Catherine Gardner-Thorpe
  • Wrexham Maelor Hospital - Dr Chris Littler


Cwm Taf Morgannwg University Health Board

  • Prince Charles Hospital - Dr Omar Pemberton
  • Princess of Wales Hospital - Dr Dermot Nicholson


Hywel Dda University Health Board

  • Bronglais General Hospital - Dr Maria Hobrok
  • Glangwili General Hospital - Dr Stuart Gill
  • Prince Philip Hospital - Dr Malgorzatap Kuipers
  • Withybush General Hospital - Dr Malgorzatap Kuipers


Powys Teaching Health Board

  • Brecon War Memorial Hospital - Dr Omar Pemberton


Swansea Bay University Health Board

  • Morriston Hospital - Dr Christine Range
  • Neath Port Talbot Hospital - Dr Christine Range
  • Singleton Hospital - Dr Christine Range

We thank the members of the Super-SNAP1 Project Team for their hard work throughout this project:

  • Prof Ramani Moonesinghe - Chief Investigator
  • Prof Iain Moppett - RCoA CR&I Deputy Director
  • Dr Martha Belete - RCoA CR&I Fellow
  • Ms Sarah Hayden - UCL
  • Dr Andrew Kane - RCoA CR&I Fellow
  • Dr Justin Kua - RCoA CR&I Fellow
  • Dr Emira Kursumovic - RCoA CR&I Fellow
  • Dr Georgina Singleton - RCoA CR&I Fellow
  • Dr Eleanor Warwick - RCoA CR&I Fellow