More action needed to prevent ‘tsunami’ of cancelled operations – surgeons

Surgeons at work Credit: PA Archive/PA Images

A "tsunami of cancellations" due to Covid-19 will hit planned operations unless hospital beds are "ring-fenced" this winter, surgeons have warned.

A survey for the Royal College of Surgeons of England found most surgeons thought the NHS could not meet its targets to get surgery back to pre-pandemic levels.

Sir Simon Stevens, the head of the NHS in England, wrote to NHS trusts in July saying that, in September, they should hit at least 80% of their last year’s activity for both overnight planned procedures and for outpatient or day case procedures.

In October, this figure should rise to 90%, the letter said.

But the Royal College of Surgeons said its analysis showed trusts were not hitting the target, with issues including surgeons being forced to wait for coronavirus test results and a lack of access to operating theatre space.

In a survey of nearly 1,000 surgeons, the college found that only 14% could treat the same number of patients in a session as they did pre-Covid.

Almost half (48%) of surgeons said they needed access to more theatres and facilities to avoid surgical “down time” during deep cleaning, with many citing the need for more ring-fenced surgical beds.

The poll found particular problems in trauma and orthopaedics – such as hip or knee replacements and repair – with 58% of these specialist surgeons saying activity had fallen below half of that seen in normal times.

And testing continues to be a key issue, with a quarter of surgeons saying members of their team are waiting more than 48 hours for a Covid-19 test result, meaning they have to stay off work and self-isolate until they heard back.

Surgeons also reported issues accessing “Covid-light” hubs, which keep surgical patients separate from Covid patients.

Of all those surveyed, 39% of surgeons in England said planned surgery levels were running at less than 50% of those achieved last year, and nearly half (48%) said they were between 50% and 80% of those seen in 2019.

Two-thirds (65%) did not think it was realistic for their trust to meet the 80% target, and just 26% thought it could be achieved.

As the virus becomes more prevalent again, there is a real risk of a tsunami of cancelled operations unless surgical beds are funded and protected

Neil Mortensen, Royal College of Surgeons

It comes as all patients on the NHS waiting list for treatment are set to be contacted with a view to prioritising those in most urgent need.

It could mean those with the least-pressing problems are forced to wait longer as more urgent cases take priority.

More than two million people in England are currently waiting longer than 18 weeks for treatment, with 83,000 waiting more than a year.

Professor Neil Mortensen, president of the Royal College of Surgeons of England, said: “Patients waiting for operations cannot be left behind indefinitely by the Covid crisis.

“Many are in serious pain, with their conditions deteriorating while they are on the list.

“As the virus becomes more prevalent again, there is a real risk of a tsunami of cancelled operations unless surgical beds are funded and protected.

“That means building up theatre capacity and designating beds exclusively for those who need an operation.

“These facilities must be kept ‘Covid-light’ with a rigorous regime of testing for patients and staff.”

Prof Mortensen also said the independent sector needed to be used more to help clear the backlog.

An NHS spokesman said: “The NHS has flexed its hospital capacity and community services as needed throughout the pandemic, treating over 110,000 severely ill people for Covid-19, and doubling the number of non-urgent operations since April.

“More people are also set to benefit from the deal struck with independent hospitals to make use of their bed capacity.

“Covid inpatient numbers are rising and much depends on keeping the virus under control through continued public action on hands-face-space, Test and Trace service, and rapid action to control local outbreaks.”