When do you think (non cancer) surgery will start back up?

[user1471468912]

I had a 'clinically urgent' surgery cancelled a few weeks ago, as the number of Covid cases climbed and just before lockdown. I was told that they would be in touch but that they had no idea when that would be. Obviously no one had a crystal ball then and no one has one now.

I am not sure I can see it happening any time fast, and I wonder about anaesthetists being busy on COVID wards, ventilators being used on the COVID wards etc. As well as the risks of going into hospital healthy, but then picking up the virus immediately after the operation when your immune system is lower. So part of me thinks I will be looking at 2021. Especially as there is no vaccine so things aren't about to change.

But then I also wonder about whether there might be a window of opportunity over the summer, before another potential lockdown in the Autumn as the cases climb again. And surely, sooner rather than later, the NHS needs to try to address some of the surgery cases on what must surely be a rapidly growing waiting list.

But what do you think? When might the NHS start picking up their non cancer surgery cases again?

[EnglishRain]

This will affect how NHS hospitals work for at least a year, possibly more. We are already recovery planning at my Trust, but it is likely that services will be rationalised for a long time going forwards. A lot of hospitals had long waits anyway, and it simply won't be possible to catch up with everything. We physically won't be able to do it. However, in the same breath, there are plenty of low priority procedures that the NHS has been doing that we should not, so in a sense it's right that those should stop because they shouldn't still be routinely done anyway.

[PleaseSirMyGoat]

It depends where you are I guess and what the procedure is. We're still doing genuinely clinically urgent surgery. Not trying to say yours isn't, just that clinicians have had to reassess all the urgents and determine which ones really are urgent, as in can't wait.

[sickofPPEtalk]

Definitely depends on how affected by covid your trust is and how much ripping up of the normal services and infrastructure they had to do to get covid ready.

In our trust we are looking at the next phase and 'maybe' doing some non life threatening surgery but it has to be balanced against the chance of increasing transmission plus using resources required for any further covid peaks/surges. The message is still very much non face to face work as much as is humanly possible - to get the covid count down low.

[user1471468912]

@PleaseSirMyGoat - Yes, good point, I don't actually think my surgery is genuinely clinically urgent (even though that's how they phrased it). It is not life threatening and is not getting massively worse. It is just not going to get any better. I know that as they scrubbed people off the list, I was kept until the very last edit though.

@sickofPPEtalk - don't think our trust has been badly affected with COVID patients. But I think that they did a lot of closing and cancelling and repurposing theatres in 'just in case' preparation. And to be fair, I really don't know how it has been affected.

@EnglishRain - thank you for replying. What kind of things do you think will stop being done on the NHS? And do you think there is any change more semi urgent/necessary surgery patients will get moved to private hospitals on the NHS to get things started?

It really is all how long is a piece of string isn't it!

[ihatethecold]

Addenbrooke’s Hospital are opening 4 or 5 theatres. I saw it on the local paper website.

[EnglishRain]

We are already not meant to do things like grommets and varicose veins routinely, but many trusts still do. I would expect the amount of those being done to go down. IVF is considered to be a low priority procedure but is obviously not funded in many areas already. Cataracts are another one, these can always be done later on, the risk is a patient being more prone to having a fall the worse their sight gets. But retinal patients for example, will go blind if they aren't getting the outpatient treatment they need very regularly, the damage is irreversible. There have been cataract backlogs up and down the country for a long time now because they are lower down the priority list. Sadly we've had to make these kinds of decisions for a long time, it's not a new thing. I have every confidence that people who need urgent treatment will get it. There will be increased waits, but you will get treatment.

I think it's possible we may have a stronger relationship with the private sector after this. We have what they don't, which is emergency treatment, and they have extra capacity that we don't. We've been training up nurses from private hospitals in ITU as they haven't done it before, and they're currently working on our wards. We've also just bought some equipment which is to go to a private hospital so we can do certain cancer ops there to prevent the disruption if we have more covid issues on site. I would personally say this is very positive. More vulnerable and urgent patients will be less likely to get cancelled at short notice, and have that bit more separation from anyone with covid, because they will be in the NHS hospitals and not the private ones. In London that is partly what the nightingale is for, to take covid patients so the trusts can start looking at getting their elective procedures going again.

Part of the issue at the moment is theatre turnaround. We have had to halve our cases per list because the theatres can't be 'cleaned' quickly between patients at the moment. We have to expect all patients to have covid even if they haven't been tested.