Surgeons warn of ‘tsunami of cancellations’

The Royal College of Surgeons has called for hospital beds to be ring-fenced for planned operations, to avoid a ‘tsunami of cancellations’ during the second wave of coronavirus.

The RCS has published new data showing that the NHS has been unable to meet its target of returning surgery to 80 per cent capacity by the end of September. The service set an objective in July to return to 90 per cent capacity by the end of October, but RCS England’s findings show efforts to meet the target falling behind.

Planned surgery for everything from knee operations to replacement heart valves was put on hold in March, to free up NHS capacity for coronavirus patients. The NHS asked hospitals to start surgery again beginning in mid-June but professionals cite multiple barriers, including a lack of access to fast-testing for patients, a lack of staff, and a lack of critical care beds.

A survey of nearly 1,000 surgeons showed that: only 14 per cent of surgeons can treat the same number of patients in a session as pre-coronavirus; 48 per cent said they need 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; 39 per cent said that elective activity levels were running at less than 50 per cent of those achieved last year; and 65 per cent did not think it was realistic for their trust to meet the 80 per cent target, with just a quarter thinking it could be achieved.

For the first time, more than two million people in England have been waiting longer than 18 weeks, with 83,000 waiting more than a year.

In a new report, RCS England calls for guaranteed access to fast coronavirus tests for surgical staff, to keep the virus off surgical wards.  In addition they say more ring-fenced ‘Covid-light’ beds are needed, with more nursing staff assigned to surgery, and greater use of the independent sector to expand capacity.  

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.

“In addition to protecting surgical wards in the NHS, we need to see more capacity bought in from the independent sector, to help get through the backlog. This is a national crisis requiring a truly national effort across all hospitals – private and NHS alike.

“Surgery is a team effort, requiring nursing staff and anaesthetists, who likewise must be allocated to getting through the backlog, rather than being diverted elsewhere. Huge strides are being made to get surgery going despite major productivity constraints, but it is essential our recommendations are heeded to avoid a major setback.”