Health Workforce Factors in Elective Surgery Cancellations: Evidence from Four South African Referral Hospitals
1
School of Public Health, Walter Sisulu University, Mthatha, South Africa
2
Global Centre for Human Resources for Health Intelligence, Walter Sisulu University, East London, South Africa
3
School of Population Health, University of New South Wales, Sydney, Australia
4
Society and Health Research Institute, Walter Sisulu University, Mthatha, South Africa
5
Institute for Clinical Governance and Healthcare Administration, Walter Sisulu University, East London, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A3547
ABSTRACT
BACKGROUND:
Elective surgical case cancellations reflect broader health system inefficiencies and directly affect patient care, quality of life, and hospital costs1,2. A single cancellation can disrupt subsequent surgical schedules and erode patient and family trust in healthcare services1,2,3,4,5.
METHODS:
A cross-sectional survey was conducted among theatre and surgically affiliated nurses and doctors in four South African referral hospitals across Mpumalanga and the Eastern Cape provinces between October 2025 and February 2026. A standardised, self-administered questionnaire collected data on participant demographics and common reasons for elective surgery cancellations. Numerical data were tested for normality using the Shapiro–Wilk test, while categorical data were summarised with frequencies, percentages, and graphs. Complete case analysis was applied to missing data.
RESULTS:
Of 109 participants, 73.4% (n=80) were female, with ages ranging from 23 to 61 years (mean = 42.8, standard deviation = 10.1). Most respondents (62.4%, n=68) were aged 30–49 years, and 51.4% (n=56) were professional nurses. Among 103 reported reasons for cancellations, staff shortages accounted for 33.0% (n=33), overbooking of cases for 16.5% (n=17), patient not optimised for 4.9% (n=5), and late staff arrival or poor communication for 1.9% (n=2).
CONCLUSIONS:
Health workforce-related factors are the leading contributors to elective surgical case cancellations in the surveyed hospitals. Strengthening workforce capacity and addressing organisational inefficiencies are essential to improving surgical service delivery, patient outcomes, and trust in the healthcare system.
Elective surgical case cancellations reflect broader health system inefficiencies and directly affect patient care, quality of life, and hospital costs1,2. A single cancellation can disrupt subsequent surgical schedules and erode patient and family trust in healthcare services1,2,3,4,5.
METHODS:
A cross-sectional survey was conducted among theatre and surgically affiliated nurses and doctors in four South African referral hospitals across Mpumalanga and the Eastern Cape provinces between October 2025 and February 2026. A standardised, self-administered questionnaire collected data on participant demographics and common reasons for elective surgery cancellations. Numerical data were tested for normality using the Shapiro–Wilk test, while categorical data were summarised with frequencies, percentages, and graphs. Complete case analysis was applied to missing data.
RESULTS:
Of 109 participants, 73.4% (n=80) were female, with ages ranging from 23 to 61 years (mean = 42.8, standard deviation = 10.1). Most respondents (62.4%, n=68) were aged 30–49 years, and 51.4% (n=56) were professional nurses. Among 103 reported reasons for cancellations, staff shortages accounted for 33.0% (n=33), overbooking of cases for 16.5% (n=17), patient not optimised for 4.9% (n=5), and late staff arrival or poor communication for 1.9% (n=2).
CONCLUSIONS:
Health workforce-related factors are the leading contributors to elective surgical case cancellations in the surveyed hospitals. Strengthening workforce capacity and addressing organisational inefficiencies are essential to improving surgical service delivery, patient outcomes, and trust in the healthcare system.
| eISSN: | 2654-1459 |
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