Should hospital outpatient shut?

[Zombiemum1946]

Should hospitals shut their outpatients departments and staff redeployed (is it unreasonable) ? If you're keeping kids off school would you still take them to a hospital app ? I work there and there're over 2000+ people pass through the outpatients dept every week . The depts are scattered all over the hospital and inpatients are seen in the clinics as well as outpatients. Appointments are generally 10-15 mins apart so you can't deep clean between patients. The waiting rooms are usually packed as is the cafe.

Mine have rang and said they are trying to rearrange as many as possible and do as many as they can over the phone if possible too.

I agree that some appointments could be swapped to by phone or video.
That’s better than cancelling because less chance that something could get missed, also less to catch up on when this is all over (hopefully) one day.

There will be a LOT that can’t be delayed though without potentially bad effects. The last thing we can afford at the moment is for currently fairly healthy but monitored people to get sicker because something was missed.

My US state has declared a civil emergency - among other things that includes:

Postponing all non-urgent medical procedures, elective surgeries, and appointments at hospitals and health care providers across the state until further notice.

YABU for posting in the wrong place.

Blood tests for our patients are generally done by GP practice or at a treatment centre where they take out stitches, change dressings etc. Our urgent patients are generally seen within 2 weeks. I think the phone app are an excellent way of keeping some apps and reducing footfall, reducing the risk to more complex patients , it would also increase capacity for urgent patients. We do have patients who it would be okay if their app was moved back by a month or managed by telephone and only seen on our rapid access clinic if there was a problem.

I think it depends on the reason for the appointment

^ this

@phonetwattery I was curious as to whether people thought it was an unreasonable action to take ? More than happy for it to be moved.

@1ForAllnAllFor1I think many GP surgeries are closing, except for a telephone service?

If non urgent surgery is suspended it would free up consultants and specialist nurses to carry out telephone apps, they would also be able to support itu and hdu staff with airway support/care.

Some hospitals have started some outpatients clinics in hotels etc. There is also discussion that pregnancy scans may be outsourced to a private provider so pregnant women go into hospitals as little as possible.

@grumpyhoonmain that's an excellent idea.

Cancer tests are outpatients. Don’t cancel them.

Like everything, it needs to be risk assessed. Not as "outpatients" as a whole, but east type of appointment. There will be many that can't be cancelled as they would have a significant impact on someone's health and well-being. For some it would be life or death.
So you can't really just ask "should outpatient appointments be cancelled" That's far too simplistic.

(Speaking as a NHS AHP!)

My dh has a CT scan yesterday and I’m surprised they didn’t cancel

Perhaps GP surgeries should shut too, and do all of the check ups online if urgent or direct to NHS111. So GPS surgeries could be deployed for Coronavirus treatments

Ours has. There was a notification over the weekend that all appointments are cancelled inc blood tests, clinics, etc.

Funny that whenever people suggested GPs make more use of phone, email and skype, they said seeing people face to face was essential - now they've decided it isn't!

I guess a bit issue with blanket cancelling is the backlog that will cause / add to. Particulalry where those involved couldn't effectively be used elsewhere. So for example an orthopaedic surgeon might cancel his outpatient reviews/ no emergency operations but then they have to be rescheduled, and if that surgeon/dept is already working close to the deadlines for treatment then this puts their while waiting list over time. This surgeon and his/her team are specialists in what they do - not in respiratory stuff which would be useful to covid 19 patients. Yes there is an issue of space and no specialist nurses but surely the specialists need to carry on with their specialty as long as possible so as to not bring the already stretched system to its knees afterwards?

I’ve just had an appointment through for cardiology- clearly my GP thinks it’s urgent as she only referred me last week! I’m not sure what to do.

My dad is having radiotherapy as an outpatient so it wouldn't be great if his appointments were stopped. I had to go today for a blood test and to drop off a sample but my next appt isn't until July so hoping it still goes ahead. I could manage if it was postponed though.

Given how quiet the clinics at the hospital I am at with Ds are compared to normal today then it’s obviously having a knock on effect either through clinics being cancelled or people cancelling

Absolutely risk assessed. No cancer tests would be cancelled nor cancer review cancelled . With consultant triage and suspension of theatres, those appointments could be spread out in a clinic with the ability to deep clean between if needs be.

I work in outpatients. Some of the specialties have changed their appointments to telephone consultations from today but others require physical examinations and can't

Not sure what will happen going forward yet. It was business as usual at work today really

I've got a MRI scan on Friday. I've waited months and months for it so while I'll understand if it is postponed it'd still upset me.

I think it depends as while some appointments may not be "essential", if departments are already overstretched then cancelling routine appointments is going to help in the short term, but then in the long term it is going to be disastrous as clinics try to balance their waiting lists and appointments and try to get back on an even keel.

Also you have to balance the usefulness of cancelling - why are you doing it? Is it to free up space? Free up personnel? Reduce risk of infection? Etcetc Depending on the answer the usefulness of cancelling appointments will change.

For example, I am under a consultant for an elective, but medical, issue. Due to the specialism I have to travel to a hospital 2 hours away in a different NHS Trust as there is nowhere closer that has this specialist department. There was an 18 month wait just for my referral and I have been seeing the consultant every 2 months for the last 12 months. As per my treatment path I am on track to have surgery within the next 6 months but I must be continuously monitored at 2 month increments for at least 12 months prior to the surgery being approved. If my appointments were cancelled then the last 2.5 years waiting were for nothing as my 12 month monitoring would have to begin from scratch and my surgery will be postponed for a minimum of 12 months but, considering all the other patients who will be in the same boat, probably at least 18 months.

Tl;dr no cancellation of routine appointment = my treatment complete within the next 6/8 months.

Cancellation of routine appointment = my treatment completed in a minimum of 18 months/2 years.

@Zombiemum1946 : Glad you asked this question.
I've been trying to convince my Consultant (renal) for years that we could have a telephone consultation.
She's not convinced!
She says there's nothing to compare with seeing the person in front of you.
Many, if not all, of her clinical decisions, are made by reviewing my blood test results.
I'm more than happy to go anywhere necessary to have bloods done, but cutting down/out the face to face consultations would reduce my attendance at hospital by 50%.

Hospitals are not the greatest places to be at the best of times and even more so now with Coronovirus doing the rounds.
Not only from an infection control point of view - more people = more bugs, but also from a global warming viewpoint.
Why have people driving miles to hospitals if it's not essential? Public transport is often non-existent or impractical.

I'm immunosuppressed.
It really is no different ( going to hospital ) than going to a busy pub or restaurant! - well, it is - it's not as much fun!

I have an appointment in approx 3 weeks and I'm hoping to hear something in the next week or so, to advise it will be a phone Consultation.
It would be a great relief.

Everyone's circumstances are different though, so one size will definitely not fit all with this matter.

Pats on the back all round for our NHS staff.
You're doing a sterling job under bloody awful circumstances.👍👍👍👍👍

Dh was due to see the renal consultant tomorrow. He's had bloods done which are as expected, so rang the consultant's secretary to suggest he did not attend but would be at home (virtually self isolating) should the consultant feel she needs to speak to him. He was told he was not the only cancellation.