A Bristol hospital trust has been issued a warning for canceling too many operations.

Frenchay and Southmead hospitals have received a performance notice because more than one per cent of pre-planned surgery is being cancelled.

NHS Bristol, which picks up the bill for healthcare in the city, issued the warning to the hospital after it failed to meet its targets for operations during the past six months.

It will now monitor the performance of North Bristol NHS Trust (NBT) monthly for three months to see if there is an improvement.

Cancelled operations was one of the areas where the trust was marked down in the annual health check published by regulator the Care Quality Commission earlier this month.

Managers at NBT said they were working hard to reduce the number of operations cancelled for non-clinical reasons either on or before the day.

In a letter to NBT, chief executive of NHS Bristol, Deborah Evans, said: "This is an area that impacts significantly upon patient experience and one I know that you and your board have prioritised this year as a service improvement initiative, in recognition of its importance and your poor historic performance.

"That said, your organisation's performance continues to be below the standard we have agreed upon and thus we have notified your director of operations of our intention to issue this performance notice."

If NBT does not turn things around within three months it may receive a more serious notice from NHS Bristol.

The trust's chief executive, Sonia Mills said operations could be cancelled for a range of reasons, from bed availability to whether the equipment was available and staffing.

She said: "Sometimes it is because we have not gone through enough pre-op assessment of patients and they are cancelled because they are not fit enough. These are all quite difficult problems to correct. We are changing one of our wards to make a centre for pre-operation and pre-admission assessment, which should help with people not coming in and those who are not fit for operations."

It has also put in place better scheduling of theatre lists to ensure there is always equipment available and that operating slots start on time.

Director of operations Ruth Brunt said NBT is working with the primary care trusts to identify in advance the type of patients who might be at risk of canceling if they are unwell.

An NHS Bristol spokesman said NBT was meeting the majority of its targets and provided good standards of care.

She said: "With these and other measures, we have made significant improvements in this area over recent weeks and are confident that we can meet the target in the timeframe given in the PCT's performance notice."

A spokesman for NHS Bristol said: "NBT are meeting the majority of their targets and provide good standards of patient care.

"This notice relates to one very specific issue where they have cancelled 1.39 per cent of non-emergency operations often as a result of unexpected surges in emergency operations."