Thousands of planned operations and appointments are cancelled because there are no doctors or theatres available, an NHS watchdog has reported.
The report looks at how NHS beds are used
A report from the Audit Commission found that, on average, trusts cancel 6% of planned operations within a week of the intended admission date, often for non-clinical reason such as the lack of a suitable bed, no theatre time or no surgeon or anaesthetist.
One in five of those cancellations takes place after the patient has been admitted, the commission found.
And around 10% of operating sessions currently have to be cancelled due to lack of staff or bed space.
The Audit Commission said while some hospital trusts would benefit from investment to provide more operating theatres or beds, many simply needed to look at new ways of using the resources they already had.
Many of the solutions are relatively simple
James Strachan, Audit Commission
Its report also found one in 10 trusts cancels 20% of outpatient appointments, often because staff have not given enough warning they will not be available.
Another 10% of appointments are cancelled because the patient fails to turn up.
Lack of staff
There are also wide variations in the amount of time operating theatres are used each week.
One in four trusts was found to use their operating theatres for just 65% of the time.
The Audit Commission said this could often be down to theatres not being ready for the start of operating sessions, and doctors and patients not being there on time.
It estimates a well-used unit would average around 40 hours a week. But the figures reported ranged from eight to 57 hours a week.
Other factors, such as not admitting non-urgent patients in the order in which they came onto the waiting list meaning some patients waited longer than they needed to, also needed to be addressed, the Audit Commission said.
It recommended combining doctor's individual lists into lists for specialties and making better use of beds by speeding up the diagnosis, treatment and the discharge of emergency patients to help hospitals run more efficiently.
The report looked at four areas of hospital care; operating theatres, bed management, outpatient services and waiting lists.
One 190 trusts across England and Wales took part in the evaluation.
James Strachan, chairman of the Audit Commission said managers and doctors had to work together to improve the running of hospitals.
He added: "The variation in performance is too wide and many trusts could deliver better services if they managed their exiting resources more effectively.
"The reports show that many of the solutions are relatively simple.
"We support the need for additional resources and freedoms in the NHS, but call on the government to ensure that trusts can demonstrate that they make the best use of their existing capacity before being allocated extra resources."
A spokesperson for the Department of Health said the NHS was making progress.
But she added: "We recognise that there are still improvements to be made.
"We need to continue to invest in the NHS and reform the service, to ensure these improvements are made across the NHS and for the long term."
Shadow Health Secretary Liam Fox said: "Before the government throws any more cash at the NHS, they must ensure that they are making efficient use of current resources."