Is the NHS going to be able to catch up?

[Coughpatrol]

At the start of all this, my niece had an operation cancelled. She’s was contacted last week and offered a (virtual) appointment for 2 weeks time to discuss but told Actual procedure is unlikely to be soon by her dr.

Just wondered if anyone else has had ops/services cancelled during this and where you’re at now, if you’ve had a date for new op? Are waiting times going to be even more crazy now than they once were? Are the nhs planning to utilise private hospitals/nightingale buildings etc to ‘catch up’?

It was very long waits before this but surely it’s going to be extremely busy now with all the catching up needed?

Various media outlets have carried the story over the last couple of days, where it's estimated that there'll be 10 million on NHS waiting lists at the end of the year. That figure is dependant on how long it takes the NHS to get back to full capacity. Can't imagine that'll be a problem

No, ironically people will probably end up having complications from the underlying conditions that they are meant to shield from covid because they are shielding from covid

Nope, they won’t. Cleaning and ppe means less capacity than before. They couldn’t cope pre-COVID no hope post.

I don't know but I'm worried about this too. My nearly 6 year old was 3 months into a 9 month waiting list for squint correction surgery and 5 months into a 12 month wait for an autism assessment when lockdown began. We haven't heard anything about how delayed these are going to be. Also my 7 year old's grommets have fallen out this week. It would normally be over a 12 month wait to get them replaced but I dread to think how long it will be this time.

We've been very lucky here in the south west my 2yr was supposed to have a minor op the week we went into lockdown which was cancelled they rang at the start of may to offer the op for the following week but i said no due to covid worries. Theyve rang again last week and he's all booked in for the end of June. The service i have received has been 1st class.

I was chatting to a friend who is a surgical registrar about this last weekend.

She's had maybe 20% workload since early March (full pay, don't worry).

She has no idea about the catchup, they aren't seeing a backlog because they still don't have things filtering through.

The thing is they normally work at capacity, so can't really stretch to bring down a long waiting list very easily.

But her best guess is actually that they won't see a long waitlist when operating normally. She thinks that because all the normal procedures that see people filtering through to surgery have been closed, when they open up again they won't be able to push more than normal numbers through to her.

She's currently working on a cancer removal rotation, so you can work our for yourselves what's happening to all the people who have had 4+ months of extra cancer growth.

No. It'll take years. (I'm a GP).

The south west has been lucky re covid numbers. The BRI had a lot of empty beds in the last two months.

Highly unlikely.

We can't restart services because there isn't enough room for everyone to work with all the covid reshuffling and red zones which have to be kept.

We also won't have enough staff once key worker spaces are gone and part time schooling comes in. Over 50% of my team will have to go onto largely unpaid leave to manage.

I work with cancer patients and fear a huge surge in referrals once things get moving again. Things have been pretty quiet during lock down but I fear we are going to overwhelmed in a few months time.

My OH still hasn't had his cancer treatment re-started since they suspended it mid March. The NHS really needs a kick up the arse to get moving again. A few weeks of cancelling everything when Covid kicked off in order to re-organise was one thing, but it's 3 months on and still barely functioning. But why are we surprised, NHS management couldn't run a piss up in a brewery at the best of times.

I was supposed to have laser surgery for glaucoma in May. That was cancelled and my next appointment just to be seen in clinic is December so I think I'm looking at a delay of at least a year for the surgery. I think I'll be OK but if that waiting time is typical then a LOT of people are going to go blind. This wont kill them though so it probably wont make the news.

My daughter had a phone consultation with the doctor yesterday even though the paediatric building is self contained and no where near the main hospital, and there aren't many Covid patients (maybe two dozen max), so I don't understand why we couldn't go in for him to see her. She has three pending referrals, none very urgent, but we've been waiting since November.
However my friend who was diagnosed with cancer had her op within a week in late March.

DH had an urgent one week cancer referral but, due to the pandemic, our hospital were unable to see him. The GP referred him to one on the other side of the city who also weren't running any clinics. He was then referred to yet another hospital where a Consultant telephoned him and said he'll see him in 3 months. So much for urgent referrals.

My cousin has had 2 operations for Melanoma and 2 consultations since lockdown began.

My Dh has had an appointment for melanoma come through incredibly quickly. Came through within a week on NHS. Ditto GP telephone appointments( I needed one for DS and DH needed one re a hernia)A letter for him re hernia to give to his private provider came within the week. Dh has private cover with work.

Don’t get me started re CAMS though, that has been truly woeful.

I am having to pay to see a Rheumatologist privately by phone as my NHS appointments have been cancelled and I was in a flare.

I'm waiting to be transferred to his NHS service, which has been operating at about 60-70% capacity during lockdown via remote consultations. He told me yesterday that the Rheumatology service has 900 referrals waiting and his normal patient load is 700. So it's going to take a long time to get through.

I work in the nhs. We assess for autism - we can’t assess while either party is wearing a mask.

Not only is it potentially distressing for the person to wear it, we also can’t see their face. One of the things we ‘score’ is facial expressions.

I also work in a private clinic doing the same job. Rules are different because it’s not NHS, so we are able to be more creative. We are wearing visors instead. The private clinic has been able to operate throughout lockdown by doing developmental interviews over Skype and waiting for lockdown to end before completing the assessments. We are now completely up to date with all assessments that were planned between March and June.

My DM had an operation (we were very lucky) for a newly diagnosed cancer two weeks ago. The consultant said that each operation takes twice as long, because they have to anaesthetise people for longer (intubate, then change their air in the room and have the anaesthetist change PPE) and can only use half as many beds because of social distancing.

So they can only do 1/3 of the normal operations going forward. This means that far from catching up, the NHS is surely only going to fall further and further behind.

Protecting the NHS was meant to be about saving lives. Assuming that in the case of cancer patients, at least, many will die without surgery (my mother had a very fast-growing aggressive tumour) it's hard to see that the focus on covid after the initial three-week emergency shutdown has been anything other than a health disaster.

@hopsalong

My DM had an operation (we were very lucky) for a newly diagnosed cancer two weeks ago. The consultant said that each operation takes twice as long, because they have to anaesthetise people for longer (intubate, then change their air in the room and have the anaesthetist change PPE) and can only use half as many beds because of social distancing.

So they can only do 1/3 of the normal operations going forward. This means that far from catching up, the NHS is surely only going to fall further and further behind.

Protecting the NHS was meant to be about saving lives. Assuming that in the case of cancer patients, at least, many will die without surgery (my mother had a very fast-growing aggressive tumour) it's hard to see that the focus on covid after the initial three-week emergency shutdown has been anything other than a health disaster.

Wholeheartedly agree

'Protect the NHS' morphed into three month lockdown. You were all very selfless to put others before yourselves for so long and now this is the bill. 10 million waiting list will take a few years to clear.

The hospitals are taking ages to get going. As a GP at least I'm my own boss and can make my own risk assessment. There are some outpatient things that could get going. We are seeing more and more patients, we are doing contraceptive implants and bloods etc etc...one problem we are finding is the hospitals are getting us to do their bloods now which means we have to deal with their results as IT systems mean we can't get the result sent straight to the consultant. So we can't fit our own patients in. We've taken on several secondary care tasks out of goodwill during this crisis but we need the tasks taken away again so we can start our own chronic disease monitoring.

The idea that private hospitals could be used by the NHS to ease the backlog is a fallacy too. I was due to have a procedure privately just before lockdown. I've now heard that it will be September at least, because the private hospital has such a backlog to get through.

Yes, DH works in a private hospital and is going back to private surgery in three weeks. The nhs only used their hospital minimally. The private industry is separate and wants to crack on now.

will take ages. Initially everything stopped because staff were redeployed to wards and ICU's.Hospitals had to be reconfigured to make wards into covid wards and to expand ICU's into other areas for capacity, staff were redeployed.We had opthamology clinic nurses and theatre odp's with us.So their own services ground to a halt. Now they are trying to get back going but like everywhere the space needs to adhere to governement covid safe guidelines. So you cant have a waiting room packed with patients waiting for a clinic 2/3rds of the chairs need to be blocked off. Patients for routine surgery are being covid tested prior to surgery and asked to self isolate following the test until they come in so their negative will hopefully stay negative.

Everything takes at least twice as long a you need due to ppe use and cleaning down between each patient.

They might bring in waiting initiative lists to carry out routine surgery at weekends and in private hospitals, but that depends on whether the govenement is willing to pay all that overtime.

Also we still dont know whether there will be a further spike once lockdown is released more, which would send us back to the beginning of march again.

It also depends on whether the NHS staff are willing to work that overtime.