abstract: Cut-throat competition: operations are being cancelled at the last minute due to the condition of surgical equipment being returned from outsourced decontamination services, theatre nurses have reported. Nurses have complained that surgical equipment has been returned late, with blood and bone clearly visible, and that instruments have been labelled off-site wrongly. A survey of around 8,500 theatre nurses by the Association for Perioperative Practice suggests that almost three quarters have had bad experiences associated with outsourced decontamination arrangements.