With spring, and the return of the sun, come bank holidays. Some NHS services will still run at reduced capacity or revert to emergency lists only, but many Endoscopy units opt to fully close down for most bank holidays.

This ties neatly in with one of the major discussion points from an event the THRIVE team recently attended which was,

‘What are the NHS’ short and long term priorities?’

There were a number of leading answers to this question like ‘patient experience’ and ‘finances’, but the major theme seemed to be reducing the number of patients waiting over 6+ weeks for a diagnostic test.

These figures were slowly building during the 2010s to a critical point but skyrocketed following the COVID-19 pandemic. Since that point, waiting lists have been significantly over the accepted threshold and while they do show signs of reduction, that reduction isn’t coming quickly enough.

As of March 2025 (the most up to date figures at the time of writing) the percentage of patients waiting over 6+ weeks for a diagnostic endoscopy procedure was 23.4%, well above the 1% operational standard. This is why it is important to understand the impact of bank holidays and the capacity that can be lost due to them. 

In the next chart can be seen some figures (taken from the 25,157 lists recorded so far in 2025 on THRIVE) that showcase the difference in performance between a weekday, weekend and any of the 4 most recent bank holidays.

	Bank Holidays				01.01.2025 > 29.05.2025
	Good Friday	Easter Monday	Early May	Spring	Weekday Average	Weekend Average
Lists	44	22	18	23	207	73
Completed Procedures	233	113	78	134	929	395
Cancelled Procedures	27	19	13	15	149	57
Avg Planned Points	11.29	10.63	9.63	11.39	9.83	10.93
Avg Achieved Points	10.24	9.35	8.66	10.36	8.69	9.72
Did Not Attend Rate	1.15%	4.55%	4.40%	3.36%	4.96%	4.60%
Hospital Cancellation Rate	2.31%	5.30%	3.30%	2.68%	3.33%	2.31%
Patient Cancellation Rate	5.00%	3.03%	6.59%	2.01%	4.31%	3.37%

Within this we can see some obvious impacts and some perhaps unexpected ones too. As could be predicted, the number of lists taking place across the trusts (that use THRIVE) plummets on bank holidays; below even the numbers on usual weekend levels where many insourcing lists usually take place.

An additional surprise, however, are the points and cancellation rates of bank holidays when compared with regular work weeks and weekends. Over these four bank holidays we saw no significant increase in cancellation rates, in fact the ‘Did Not Attend Rate’ was actually lower on all four bank holidays when compared with the average weekday/end. This would suggest that patients are still willing to come in on their own time, and are in fact more likely to do so than compared with when they must take time out of work.

Likewise the planned and achieved points on each of these bank holidays was very good, excelling even the weekends in some cases. This goes some way to dispelling the idea that only emergency lists or reduced capacity lists were taking place on bank holidays and proves that some units will still operate to the highest level and use their entire capacity where possible.

However, the most notable part must be the significant drop-off in lists and subsequently completed procedures. Had these days not been bank holidays we may have expected to see an extra 700 lists performed and over 3,000 additional procedures.

Looking exclusively at 6+ Week Waiting Lists for Colonoscopies, Gastroscopies and Flexible Sigmoidoscopies there were 26,690 patients as of March 2025, meaning the additional procedures that could have taken place in just four select days would have reduced this by over 10%. It is also important to note here that THRIVE currently covers only the North West of England and sections of the North East, suggesting that the total reduction in waiting lists had all trusts in the NHS operated at full capacity would have been much larger again.

But, as always, it is important to refer back to what the overall goals are. If 6+ Week wait patients are the primary focus, then how much does staff morale need to factor in? How about the financing that goes alongside increased working on bank holidays? While they may not be our primary focus, both are still vital in running any service and need to be considered if changes are envisioned.

Staff must be able to strike a good workload balance and it is important for trusts to enable this. So, trusts and the NHS must ask themselves whether the loss of performance due to bank holidays outweighs the benefits. They must also ask what adjustments they are willing to make in order to compensate for that.

Is the NHS willing to use more insourcing to ensure full service is delivered on bank holidays? Is the NHS willing to pay its staff overtime for working bank holidays, or offer additional days holiday back in return?

Reduced capacity doesn’t have to mean reduced impact. With smart planning, better use of digital tools, and more flexible staffing models, the NHS can continue to support its workforce while ensuring patients aren’t left behind. 

Bank holidays might offer a pause – but they could also become an opportunity for innovation – what do you think? Let us know your thoughts in an email to info@informpeople.com