What is the Gera Cancelled Operations Index?

The Gera Cancelled Operations Index (GCOI) is a single 0–100 score that measures how reliably the NHS in England honours the 28-day standard for patients whose operation is cancelled at the last minute for non-clinical reasons. It is the share of those cancelled patients who WERE treated within 28 days. For Q2 2025/26 it stands at 78.8 / 100 — meaning 78.8% of last-minute-cancelled patients were re-treated inside the standard and 21.2% were not. It is computed directly from NHS England's published Cancelled Elective Operations (QMCO) figures.

How is the index calculated?

It is the complement of NHS England's published breach rate: GCOI = 100 − breach rate, where the breach rate is the percentage of last-minute-cancelled patients not treated within 28 days. For Q2 2025/26, NHS England reported 4,274 breaches out of 20,189 last-minute cancellations, a breach rate of 21.2%, so the index is 100 − 21.2 = 78.8. There is no weighting and no free parameter — every input is NHS England's real published figure, and the method is set out in full on the methodology page.

How many NHS operations are cancelled at the last minute?

In Q2 2025/26, NHS England reported 20,189 elective operations cancelled at the last minute for non-clinical reasons by NHS providers in England — 0.9% of all elective activity. "Last minute" means the operation was cancelled on the day the patient was due to arrive, after they had arrived, or on the day of surgery. This cancellation volume is reported alongside the index as context but is not an input to the score, which is only about the 28-day rebooking standard.

Is NHS performance on cancelled operations improving?

Slightly. The index for Q2 2025/26 is 78.8 / 100, up 1.5 points on Q2 2024/25 (77.3 / 100). Across the 6 quarters NHS England publishes, the index has ranged from 76.5 (Q4 2024/25) to 78.8 (Q2 2025/26). Roughly one in five last-minute-cancelled patients is still breaching the 28-day standard throughout the period.

Is a higher score good or bad?

Higher is better. A higher Gera Cancelled Operations Index means more of the patients whose operation was cancelled at the last minute were re-treated within the 28-day standard, and fewer were left breaching it. A score of 100 would mean every last-minute-cancelled patient was treated within 28 days; no recent quarter approaches that.

How often is the index updated?

NHS England publishes the Cancelled Elective Operations (QMCO) collection quarterly, around six weeks after each quarter ends. Gera refreshes the index on each NHS England quarterly release. The figures here are from the Q2 2025/26 release (published 13 November 2025).

Does the index cover the whole UK or private hospitals?

No. It covers NHS providers in England only, and NHS England's figures explicitly exclude Independent Sector Organisations (private providers). Scotland, Wales and Northern Ireland run their own separate collections. NHS England also noted that Wye Valley NHS Trust did not submit data for Q2 2025/26. For any specific hospital, check its own published performance.

What does the index NOT show?

It is about non-clinical last-minute cancellations and the 28-day rebooking standard — not operations cancelled for clinical reasons, not planned waiting times (that is the separate NHS RTT collection), and not the reasons behind a cancellation. It is a national summary, not hospital-level, and it is information, not medical advice. GeraClinic is a private telemedicine service and is not part of, or affiliated with, the NHS or NHS England.

GeraClinic / Cancelled Operations Index

The Gera Cancelled Operations Index

One number for how reliably the NHS honours its 28-day standard when an operation is cancelled at the last minute. The Gera Cancelled Operations Index is a 0–100 score over the real NHS England Cancelled Elective Operations release, where 100 means every last-minute-cancelled patient is re-treated within 28 days. For Q2 2025/26 it stands at 78.8 / 100 — 21.2% of the 20,189 patients cancelled at the last minute were not treated in time.

Latest period: Q2 2025/26 (quarter ending 30 September 2025)· NHS England Cancelled Elective Operations (QMCO), published 13 November 2025 · Open Government Licence v3.0 · England · NHS providers only (excludes independent-sector)

How reliably does the NHS meet its 28-day standard for cancelled operations?

The Gera Cancelled Operations Index stands at 78.8 / 100 for Q2 2025/26, computed from NHS England's Cancelled Elective Operations release. Of 20,189 operations cancelled at the last minute for non-clinical reasons (0.9% of elective activity), 21.2% of patients — 4,274 people — were not treated within 28 days. Source: NHS England (OGL v3.0).

Source:NHS England — Cancelled Elective Operations (QMCO), Q2 2025/26 statistical commentary·as of Q2 2025/26 (quarter ending 30 September 2025)updated quarterly, on NHS England release (last: 3 July 2026)

Gera Cancelled Operations Index78.8 / 100England, Q2 2025/26 — under pressure (higher = fewer 28-day breaches)How this index is calculated

The index is the complement of NHS England’s published breach rate: 100 − breach rate. Every input is NHS England’s real published figure; only the restatement as a 0–100 “standard met” score is Gera’s, and it is set out in full in the methodology.

Index

78.8 / 100

under pressure

Cancelled (non-clinical)

20,189

0.9% of elective activity

Not treated in 28 days

4,274

21.2% breach rate

Treated within 28 days

15,915

78.8% met the standard

Cancelled operations, by quarter

NHS England publishes the collection quarterly. Across the 6 quarters currently published, the Gera Cancelled Operations Index has ranged from 76.5 / 100 (Q4 2024/25) to 78.8 / 100 (Q2 2025/26). The latest Q2 2025/26 score of 78.8 is up 1.5 points on the same quarter a year earlier (Q2 2024/25, 77.3 / 100). Throughout the period, roughly one in five last-minute-cancelled patients is still not treated within the 28-day standard.

Gera Cancelled Operations Index by quarter — NHS England, England (from Q1 2024/25)
Quarter	Cancelled Operations Index	Cancelled (non-clinical)	Not treated in 28 days	Breach rate	Cancellation rate
Q2 2025/26	78.8 / 100	20,189	4,274	21.2%	0.9%
Q1 2025/26	77.7 / 100	19,268	4,303	22.3%	0.9%
Q4 2024/25	76.5 / 100	21,820	5,122	23.5%	1.0%
Q3 2024/25	78.6 / 100	22,681	4,856	21.4%	1.0%
Q2 2024/25	77.3 / 100	21,249	4,825	22.7%	1.0%
Q1 2024/25	76.5 / 100	19,583	4,606	23.5%	0.9%

The cancelled-operations, breach and rate columns are NHS England’s own published figures; the “Cancelled Operations Index” column is 100 minus the published breach rate for that quarter (see methodology).

What counts as a “last-minute” cancellation

NHS England counts an operation as cancelled at the last minute when it is cancelled by the hospital for non-clinical reasons on the day the patient was due to arrive, after the patient has arrived in hospital, or on the day of the operation or surgery. The 28-day standard is a pledge in the Handbook to the NHS Constitution: any such patient must be offered another binding date within 28 days, or have their treatment funded at the time and hospital of their choice. A patient still not treated 28 days later is recorded as a breach — and it is that breach rate the index turns into a 0–100 score.

How the index is built (methodology) →

Gera Cancelled Operations Index: FAQs

What is the Gera Cancelled Operations Index?: The Gera Cancelled Operations Index (GCOI) is a single 0–100 score that measures how reliably the NHS in England honours the 28-day standard for patients whose operation is cancelled at the last minute for non-clinical reasons. It is the share of those cancelled patients who WERE treated within 28 days. For Q2 2025/26 it stands at 78.8 / 100 — meaning 78.8% of last-minute-cancelled patients were re-treated inside the standard and 21.2% were not. It is computed directly from NHS England's published Cancelled Elective Operations (QMCO) figures.
How is the index calculated?: It is the complement of NHS England's published breach rate: GCOI = 100 − breach rate, where the breach rate is the percentage of last-minute-cancelled patients not treated within 28 days. For Q2 2025/26, NHS England reported 4,274 breaches out of 20,189 last-minute cancellations, a breach rate of 21.2%, so the index is 100 − 21.2 = 78.8. There is no weighting and no free parameter — every input is NHS England's real published figure, and the method is set out in full on the methodology page.
How many NHS operations are cancelled at the last minute?: In Q2 2025/26, NHS England reported 20,189 elective operations cancelled at the last minute for non-clinical reasons by NHS providers in England — 0.9% of all elective activity. "Last minute" means the operation was cancelled on the day the patient was due to arrive, after they had arrived, or on the day of surgery. This cancellation volume is reported alongside the index as context but is not an input to the score, which is only about the 28-day rebooking standard.
What is the NHS 28-day cancelled operations standard?: It is a pledge in the Handbook to the NHS Constitution: every patient whose operation is cancelled, on or after the day of admission (including the day of surgery), for non-clinical reasons must be offered another binding date within 28 days — or have their treatment funded at the time and hospital of their choice. When a patient is still not treated 28 days after a last-minute cancellation, NHS England records it as a breach of the standard.
Is NHS performance on cancelled operations improving?: Slightly. The index for Q2 2025/26 is 78.8 / 100, up 1.5 points on Q2 2024/25 (77.3 / 100). Across the 6 quarters NHS England publishes, the index has ranged from 76.5 (Q4 2024/25) to 78.8 (Q2 2025/26). Roughly one in five last-minute-cancelled patients is still breaching the 28-day standard throughout the period.
Is a higher score good or bad?: Higher is better. A higher Gera Cancelled Operations Index means more of the patients whose operation was cancelled at the last minute were re-treated within the 28-day standard, and fewer were left breaching it. A score of 100 would mean every last-minute-cancelled patient was treated within 28 days; no recent quarter approaches that.
How often is the index updated?: NHS England publishes the Cancelled Elective Operations (QMCO) collection quarterly, around six weeks after each quarter ends. Gera refreshes the index on each NHS England quarterly release. The figures here are from the Q2 2025/26 release (published 13 November 2025).
Does the index cover the whole UK or private hospitals?: No. It covers NHS providers in England only, and NHS England's figures explicitly exclude Independent Sector Organisations (private providers). Scotland, Wales and Northern Ireland run their own separate collections. NHS England also noted that Wye Valley NHS Trust did not submit data for Q2 2025/26. For any specific hospital, check its own published performance.
What does the index NOT show?: It is about non-clinical last-minute cancellations and the 28-day rebooking standard — not operations cancelled for clinical reasons, not planned waiting times (that is the separate NHS RTT collection), and not the reasons behind a cancellation. It is a national summary, not hospital-level, and it is information, not medical advice. GeraClinic is a private telemedicine service and is not part of, or affiliated with, the NHS or NHS England.

Working in or heading into NHS surgical and theatre care?

NHS England has repeatedly linked last-minute cancellations to bed, staffing and theatre-capacity pressures. If you are a doctor or nurse — including internationally-qualified professionals independently considering the UK — GeraClinic's pathway pages explain GMC and NMC registration and the route into NHS roles. Gera is not a recruitment agency, charges no placement fee, and does not actively recruit from countries on the WHO health-workforce safeguard list.

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Related NHS data

Sources

The Gera Cancelled Operations Index is computed only from the real NHS England publication below — every figure on this page traces back to it. The index (100 minus the published breach rate) is the Gera contribution and is fully specified on the methodology page; no value is invented. GeraClinic is a private telemedicine service and is not part of, or affiliated with, the NHS or NHS England.

Contains public sector information published by NHS England and licensed under the Open Government Licence v3.0. Source: NHS England — Cancelled Elective Operations (QMCO), Q2 2025/26 statistical commentary (Q2 2025/26 (quarter ending 30 September 2025), published 13 November 2025).

Contains public sector information published by Gera Systems and licensed under the Open Government Licence v3.0 (source data). Source: Gera Cancelled Operations Index — derived from NHS England QMCO data (Q2 2025/26 (quarter ending 30 September 2025), published 3 July 2026).