By multimedia producer Elisa Menendez
Thousands of hospital and GP appointments scheduled for the day of the Queen's funeral are being postponed in England.
Some NHS trusts have confirmed that "non-urgent" procedures, operations and appointments at their hospitals will be re-scheduled, while some GP surgeries have confirmed they will close.
Other hospitals and GPs say they will be operating as usual on the Monday, 19 September bank holiday, which was announced in the days following the monarch's death.
It comes after NHS England wrote to GPs informing them they are permitted to close on Monday to mark the bank holiday.
Health leaders were told to ensure there was “sufficient” out-of-hours cover and for scheduled Covid booster care home visits to be carried out as planned.
Hospital trusts are also expected to make their own decisions around appointments based on local staffing levels, and whether or not local transport will mean patients and staff are unable to attend.
But the announcement has provoked concern among some patients and health professionals, who cite the ongoing NHS backlog and nationwide GP shortage.
NHS England hospitals have been urged to contact all patients who have appointments booked on Monday, irrespective of whether or not their appointment has been postponed.
It comes at time when there is a record high of 6.8 million people in England on waiting lists, as stretched teams work to clear the mammoth Covid backlog.
The announcement has worried some patients, who voice their concerns on social media.
One person wrote: "Life-threatening illnesses and cancer don't take bank holidays".
Some complained their hospital appointments they have waited six months for or longer have been cancelled, while others said the earliest date to reschedule vital blood tests, or GP appointments, was in a month.
Medics and GPs ITV News spoke to pointed out that they are entitled to a day off to mark the bank holiday.
However, some were uncomfortable with the decision - citing the logistical difficulties of rearranging appointments and dealing with staffing issues at such short notice.
Dr Selvaseelan Selvarajah, a GP Partner in east London, told ITV News the last-minute announcement - although "understandably unavoidable" - has caused "quite a bit of disruption".
"Our team are busy cancelling pre-booked appointments and we are having to squeeze patients in other booked days," he said.
"Demand in primary care has gone up by 20% since the pandemic and closing invariably inconveniences patients already struggling with access.
"This also means additional pressure will be put out on GP out of hours and other urgent care services. We are doing our best to get the clinicians recruited for these urgent slots."
He said he fully supports a national bank holiday and his practice is "keen that our staff pay their respects to the Queen and remember her in their own way".
But he added it would have been easier for the NHS to manage their response if the funeral had been held on a weekend.
Another GP, who wished to remain anonymous, told ITV News that hospitals will experience a "huge loss of service commitments" and agreed the bank holiday will be "very disruptive".
He asked: "Patients who are waiting months or years for specialist appointments, operations, scans – when will they get rescheduled?
"If patients are already waiting that long, when is it going to happen for them?"
He highlighted that there are an estimated one million GP appointments every day in England and moving them will be a "huge task" for many surgeries - particularly if they are already full.
The doctor said his practice has chosen to "honour patients" and prioritise pre-booked appointments as they have staff willing to work.
He highlighted that this has become a "personal decision" due to NHS England's announcement and agreed that staff are entitled to a bank holiday too, while some may now have child care complications with schools closing.
"I sympathise with patients. I’m also a patient as well as a doctor," he added. "It’s very disruptive but you do need the staff to do this. We are employees… you can’t angle anger at staff, it’s a ministerial decision."
A letter to all NHS organisations, sent from NHS England on Saturday, states: “For patients with planned appointments that may be affected by the day of the funeral, please ensure they are informed in advance of any changes by utilising direct patient communications.
“Where planned appointments are going ahead it will also be important to confirm this is the case.”
Some NHS trusts have urged patients to wait to be contacted with news about their hospital and specialist appointments.
Bedfordshire Hospitals NHS Foundation Trust said: “Following the announcement of the plans for the late Her Majesty The Queen’s state funeral on Monday September 19, 2022, some non-urgent planned care appointments/procedures across Bedfordshire Hospitals will be postponed.
“We will contact all relevant patients if their appointment or procedure is to be re-scheduled.
“However we must clarify that both hospitals (Bedford and the Luton and Dunstable) will remain open with urgent planned and unplanned/emergency care continuing as normal.”
Bolton NHS Foundation Trust said that “some changes may be made to appointments” due to the bank holiday.
“If this affects your appointment, we’ll contact you as soon as possible to rearrange,” it added.
Queen Victoria Hospital in Sussex, which provides reconstructive surgery, burns care and rehabilitation service, said: “Our team is contacting patients with planned appointments or surgery on the day of the Queen’s state funeral (Monday September 19) to make new arrangements.
“Thank you in advance for helping us to make these changes at short notice. Please do not call us, our staff can best work through this if we call you.
“NHS emergency services, including the minor injuries unit at QVH, will continue to work as normal.”
The Clatterbridge Cancer Centre, which operatesoncology services in the Wirral, Aintree and Liverpool, said that services will be operating “as usual”.
“Our clinical services will be open as usual on Monday September 19 2022. This includes outpatient clinics, tests and treatment,” it said in a statement.
“If you would prefer to cancel/postpone your appointment, please let us know ASAP by contacting us via the details in your appointment text or letter.”
Meanwhile, the public has been urged to check they have enough medication over the bank holiday.
NHS officials in North East Essex and Suffolk said: “GP practices will be closed on bank holiday Monday September 19 for the funeral of Queen Elizabeth II.
“If you have an appointment booked for that day you will be contacted to reschedule. If you use repeat prescription medicine please check you will have enough to last.”
Oxford Health NHS added: “Patients across Buckinghamshire, Oxfordshire and Berkshire West are being reminded to order repeat prescriptions in plenty of time for the coming bank holiday weekend.”
A spokesperson for the NHS in England said: “As with any bank holiday, NHS staff will work to ensure that urgent and emergency services, including urgent dental and GP appointments, are available — and patients will be contacted by their local trusts, if necessary, regarding their existing appointments.
“Covid vaccination services, particularly in care homes, are being asked to continue their work given the importance of protecting people ahead of winter and the public should access NHS services in the usual way, including through 111 online or 999 in an emergency.”