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Lookup NU author(s): Steven Powell, Kim Keltie, Rachel O'Leary, Dr Paola Cognigni, Rosalyn Parker, James O'HaraORCiD, Dr Ben Talks, Dr Andrew SimsORCiD
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© 2026 John Wiley & Sons Ltd. Objectives: To characterise adult tonsillectomy procedures conducted in the NHS from routine administrative data in England and investigate trends in their associated complications over time. Design: Retrospective observational cohort study using routine data from Hospital Episode Statistics (HES). Setting: Acute NHS trusts in England are conducting adult tonsillectomy. Participants: Adults (> 16 years old) undergoing tonsillectomy procedure with a primary diagnosis of any non-malignant indication, and with no current or historic cancer, or benign neoplasm. Main Outcome Measures: Number of procedures, in-hospital complications, readmissions within 28 days and trends over time. Results: A total of 198 130 adult patients had a tonsillectomy between 1 April 2008 and 31st March 2023 in NHS trusts in England. The total number of procedures is falling over time. It is more commonly undertaken in women (68.3%), with 79.3% performed for tonsillitis. The majority (59.6%) are discharged on the same day, with 37.5% staying 1 night in hospital. 1.5% of patients had an in-hospital complication, with a total of 1967 patients having a haemorrhage or surgical arrest of post-operative bleeding from the tonsillar bed or adenoid; occurring more frequently in men (1.7% versus 0.7%, p < 0.001). A total of 33 934 patients were readmitted as an emergency within 28 days of surgery, almost doubling between 2008/09 and 2022/23. Readmission with bleeding within 28 days has also increased from 8.8% in 2008/09 to 15.6% in 2022/23. The return to theatre rate during readmissions has been relatively stable over the study time period with a higher proportion of admissions being managed without a further operative procedure. Conclusions: Tonsillectomy is a very common operation in the NHS in England. It currently has a readmission rate of 1 in 5 adults and this information is important for informed consent and local resource planning.
Author(s): Powell S, Keltie K, O'Toole E, O'Leary RA, Richardson H, Cognigni P, Parker R, O'Hara J, Talks B, Donne A, Stafford F, Swift AC, Sims AJ
Publication type: Article
Publication status: Published
Journal: Clinical Otolaryngology
Year: 2026
Pages: Epub ahead of print
Online publication date: 05/06/2026
Acceptance date: 18/05/2026
ISSN (print): 1749-4478
ISSN (electronic): 1749-4486
Publisher: John Wiley and Sons Inc.
URL: https://doi.org/10.1111/coa.70130
DOI: 10.1111/coa.70130
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