Patients across Burnley, Pendle and the Ribble Valley face long waits for elective operations which are cancelled last-minute to be rescheduled at the East Lancashire Hospitals NHS Trust, new figures show.
Surgeons warn that delays to surgery can cause harm to patients, and are calling for extra hospital beds to be provided across England.
The trust cancelled 183 non-urgent operations, such as hip or knee surgeries, in the three months to December, the latest period covered by NHS England data.
This was a decrease from the same period during the previous year.
However, 3% of these procedures were not rescheduled within the mandatory 28-day waiting period - the worst record for the same three month period since 2010-11.
The data covers cancellations that were for non-clinical reasons, such as bed or staff shortages.
A spokeswoman for the Royal College of Surgeons said: "Waiting for surgery is a very stressful and worrying time for patients and their families, and such long waits are simply unacceptable.
"The longer patients wait, the more risk there is that their conditions may deteriorate."
A last-minute cancellation is defined as being either on the day that a patient was due to arrive, after the patient has arrived, or on the day of the operation itself.
According to the NHS Constitution, the trust must offer a new date within a maximum period of 28 days after a non-urgent operation has been cancelled.
If it is unable to do so, it must instead fund the treatment with another hospital and forfeit its payment from the NHS Clinical Commissioning Group that funds healthcare in the area.
There were 20,145 last minute cancellations across England in the three months to December, a slight fall on the same period last year.
More than 1,660 of these patients - 8% of the total - did not have their operations rescheduled within 28 days, the highest proportion for this three month period in 14 years.
The RCS blamed pressure on A and E departments for the delays in rescheduling surgery.
It also warned that the drop in last-minute cancellations could be masking the fact that more operations are simply being cancelled in advance.
"Recent NHS data shows that January saw the worst A&E performance on record," the spokeswoman continued.
"It is inevitable that this pressure on A&E will have a knock-on effect for bed capacity - and therefore on planned surgery - during the coming months.
“The RCS strongly believes that the NHS needs to commit to increasing hospital bed capacity.
"Without extra beds, we fear hospitals will struggle to properly tackle long waits for surgery.”
An NHS England spokesman said: “The number of cancelled routine operations has fallen, despite significant pressure on emergency services.
"Fewer than 1% of operations are postponed on the day, and nurses, doctors and NHS leaders across the country are also rightly prioritising emergency patients over the winter period.”
Tony McDonald, Deputy Director of Operations for East Lancashire Hospitals NHS Trust, said: “The decision to postpone or cancel an operation is only taken after a great deal of thought.
“We do sympathise with the frustration felt by patients, but there are times when medical emergencies have to take priority over elective (planned) operations, and occasionally, operations are cancelled for reasons beyond our control.
“Our staff work hard to keep patient cancellations to the absolute minimum and the opening of the Lancashire Elective Centre at Burnley General Teaching Hospital, where a large number of elective operations now take place, has helped to ensure cancellations are minimised.
“The most recent statistics from NHS England – showing that the number of cancelled operations at East Lancashire Hospitals fell by 19% in comparison to the same period in 2017 – is evidence that our efforts to tackle the situation are proving to be effective.”