Covid-19 was officially declared a pandemic by the World Health Organisation on 12 March 2020. As a result the UK declared a lockdown on 23 March 2020.
A lot of things had to change, including the medical care for those patients who had Covid-19 and those who did not. The NHS did its best to ensure that plans were in place to protect all patients.
There is no doubt that the NHS has done a great job and we must all fully appreciate the work done and sacrifices made to save lives during these difficult times. The pandemic was real and required serious measures to be taken:
- All non-urgent elective operations were postponed for a period of at least three months. Emergency admissions, cancer treatment and other clinically urgent care were to continue unaffected.
- All hospital in-patients who were medically fit to leave were urgently discharged.
It has been estimated that these unprecedented measures have resulted in 516,000 cancelled surgeries, including 36,000 cancer procedures.
Once the pandemic is over, the NHS will have to ensure that new measures are implemented to catch up with all the surgeries that have been postponed. It has been predicted that even if the NHS increases the number of surgeries performed each week by 20% compared to pre-pandemic activity, it will take 11 months to clear the backlog.
While these emergency measures were implemented to increase capacity for hospitals to treat patients presenting with COVID-19 symptoms, they were not meant to affect patients without COVID-19 who still required urgent care. There are situations when treatment cannot simply be rescheduled without detrimental effect on the patient, or if it is, the treatment needs to take place as soon as possible and measures must be put in place to ensure this happens.
For example, cancer patients will need to be seen and treated within an appropriate time frame. Any delay can cause their condition to deteriorate rapidly. Likewise there are serious general surgery and orthopaedic cases where delays can cause serious complications, such as appendicitis which untreated can rupture and result in a life threatening situation. Also serious fractures need to be treated within appropriate time frame because delays to treat those can result in non-unions which can then leave patients with lifelong complications despite of later treatment.
Even where it is reasonable to postpone an operation or treatment, this decision should never be made lightly and the possible consequences need to be carefully considered by the medical expert, who has a duty of care to ensure that the patient receives any required treatment within a reasonable timeframe.
For patients being discharged from hospital, it is necessary that they are assessed as being fit for discharge. An early discharge can result in a deterioration in their condition requiring the patient to be readmitted again. Some patients cannot simply be discharged home and suitable alternative accommodation should be found first. This often applies to elderly patients who require professional care after their treatment.