Elective Surgery Before, During and After the COVID-19 Pandemic in England 2015 - 2022: A Database Study

ObjectiveTo track elective surgery activity before, during and after the COVID-19 pandemic in England. To examine for hypothesised differences in use of independent vs NHS hospitals, and more urgent vs less urgent operations over the pre- and post-COVID time windows. DesignWe extracted data from the Hospital Episodes Statistics database from 1st April 2015 to 30th April 2022. This database contains all emergency and elective patient admissions, outpatient appointments and A&E attendances funded by the NHS in England. SettingNHS and Independent hospitals in England. ParticipantsAdult patients (over 18 years) admitted for elective surgery between April 2015 and April 2022, who were classified as being in priority groups 3 or 4. Main OutcomesTotal operations, operations by hospital type, and NHS England priority ranking. ResultsThe data show that there was a large reduction in the number of elective operations during lockdown with incomplete recovery thereafter. Also the proportion of more urgent surgeries and surgeries in independent hospitals increased in the post-COVID vs pre-COVID time windows. ConclusionUnder conditions of high-demand, higher value elective surgery procedures are awarded increasing priority and the Independent sector bears a larger share of the load.