GeraClinic / Cancelled Operations Index / Methodology
How the Gera Cancelled Operations Index is calculated
The Gera Cancelled Operations Index is a reproducible 0–100 score derived entirely from NHS England’s published cancelled elective operations figures. This page sets out the exact formula, a worked example, the data provenance and the limitations — so anyone can reproduce or challenge the number.
What the index measures
The index answers one question: when the NHS in England cancels an operation at the last minute for non-clinical reasons, how often does it honour the 28-day standard? NHS England publishes a breach rate — the percentage of those patients not treated within 28 days. The index simply restates that as a “standard met” score, where 100 means every last-minute-cancelled patient was re-treated in time and lower means more patients breached the standard.
The formula
1. NHS England’s breach rate
breachRate = breaches ÷ cancelledOperations × 100
“Breaches” are patients still not treated 28 days after a last-minute cancellation; “cancelled operations” are those cancelled at the last minute for non-clinical reasons. Both are NHS England’s own published counts.
2. The index (GCOI)
GCOI = 100 − breachRate (rounded to 1 dp)
The complement of the breach rate is the share of last-minute-cancelled patients who were treated within the 28-day standard. Higher = better. This is the only Gera-computed layer; every input is NHS England’s real published figure, and there is no weighting or free parameter.
Worked example — Q2 2025/26, England
- NHS England reported 20,189 operations cancelled at the last minute for non-clinical reasons, of which 4,274 patients were not treated within 28 days.
- breachRate = 4,274 / 20,189 × 100 = 21.2 (NHS England published 21.2)
- GCOI = 100 − 21.2 = 78.8 / 100
The recomputed breach rate matches NHS England’s published one-decimal figure exactly — the index adds no data, only the 100 − rate restatement.
Every input, every quarter
These are the exact NHS England figures behind the index for all 6 published quarters. Nothing is estimated or imputed.
| Quarter | Elective spells | Cancelled (non-clinical) | Not treated in 28 days | Breach rate | Index |
|---|---|---|---|---|---|
| Q2 2025/26 | 2,221,357 | 20,189 | 4,274 | 21.2% | 78.8 / 100 |
| Q1 2025/26 | 2,179,112 | 19,268 | 4,303 | 22.3% | 77.7 / 100 |
| Q4 2024/25 | 2,215,093 | 21,820 | 5,122 | 23.5% | 76.5 / 100 |
| Q3 2024/25 | 2,230,009 | 22,681 | 4,856 | 21.4% | 78.6 / 100 |
| Q2 2024/25 | 2,197,243 | 21,249 | 4,825 | 22.7% | 77.3 / 100 |
| Q1 2024/25 | 2,133,268 | 19,583 | 4,606 | 23.5% | 76.5 / 100 |
Data provenance
The figures come from NHS England’s quarterly Cancelled Elective Operations (QMCO) statistical commentary — the Q2 2025/26 release, published 13 November 2025 by the Elective Analysis Team, NHS England. The release covers NHS providers in England and excludes Independent Sector Organisations. NHS England’s Table 1 reports, per quarter, elective spells, breaches of the standard, cancelled operations, the breach rate and the cancellation rate; those figures are transcribed verbatim. No value is estimated or imputed.
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).
What the index does NOT show
- It covers England only and only NHS providers — NHS England’s figures exclude independent-sector (private) providers, and Scotland, Wales and Northern Ireland run separate collections.
- It is about non-clinical last-minute cancellations and the 28-day rebooking standard — not cancellations for clinical reasons, and not planned waiting times (that is the separate NHS RTT collection).
- It is a national quarterly summary, not hospital-level, and not a judgement about your own care. NHS England noted that Wye Valley NHS Trust did not submit data for Q2 2025/26.
- The index is information, not medical advice. GeraClinic is a private telemedicine service and is not part of, or affiliated with, the NHS or NHS England.
Update cadence
NHS England publishes the Cancelled Elective Operations (QMCO) collection quarterly, around six weeks after each quarter ends. Gera refreshes the index on each release. The figures here were last compiled on 3 July 2026.