Posted on: Fri 07-08-2020

The NHS will be inflicting pain, misery and risk of death on tens of thousands of patients if it shuts down normal care again to deal with a second wave of Covid-19, doctors and surgeons’ leaders are warning. They are urging NHS bosses not to use the sweeping closures of services that were introduced in March to help hospitals cope with the huge influx of patients seriously ill with Covid-19.

“The NHS must never again be a Covid-only service. There is a duty to the thousands of patients waiting in need and in pain to make sure they can be treated”, said Prof Neil Mortensen, the president of the Royal College of Surgeons of England.

The leader of Britain’s doctors also said hospitals should not leave patients “stranded” by again suspending a wide range of diagnostic and treatment services.

Dr Chaand Nagpaul, chair of council at the British Medical Association (BMA), said: “We cannot have a situation in which patients are unable to access diagnostic tests, clinic appointments and treatment which they urgently need and are simply left stranded. If someone needs care … they must get it when they need it.”

The senior clinicians’ comments come amid growing fears about a second wave of Covid-19 and mounting concern that the disruption to hospital care that began in March, and patients’ fears about going into hospital, led to thousands of patients dying avoidably of cancer and heart disease and could also lead to further fatalities in the years ahead.

More than 1 million fewer patients underwent planned surgery in England in April, May and June and 30,000 to 40,000 could not start cancer treatment as hospitals discharged thousands of patients and suspended many of their usual services to concentrate on treating those with Covid-19.

Unavailability of care, in tandem with patients’ reluctance to go into hospital while the pandemic was unfolding, have been linked to the fact that in England ‘There is a duty to the thousands of patients waiting in pain’ Prof Neil Mortensen Royal College of Surgeons

12,000 more people than usual have died of illnesses not linked to Covid19 in recent months, such as heart attacks, according to the Office of National Statistics. One cancer expert has estimated that anywhere between 7,000 and 35,000 patients could die over the next year as a direct result of not receiving NHS care in recent months.

“The NHS had to stop almost all planned surgery at the beginning of the crisis, and we cannot let that happen again. Things will need to be done differently in the face of any further spike,” Mortensen told the Guardian. Nagpaul added: “While not publicised in the daily briefings, these [12,000] excess deaths are just as much a tragedy and loss to loved ones as those occurring from the virus.”

Mortensen and Nagpaul’s warnings come amid mounting fears about growing numbers of Covid-19 infections and the recent rise in the R number (infections passed on by each victim) in some regions of England and Scotland, leading to local lockdowns for towns in both countries, such as Leicester and Aberdeen.

Hospitals should set up more

“Covid-light” sites so surgeons can resume doing common operations such as hip and knee replacements and cataract removals, and make good use of the NHS’s £400m-a-month deal to use private hospitals, Mortensen suggested. The NHS should also look at using the seven Nightingale hospitals it created early in the pandemic as extra capacity for non-Covid care, added Nagpaul.

The NHS is trying to arrange care for the large number of patients who missed out in recent months, many facing a long delay before they can be seen. Its waiting list could soar if there was a repeat of the shutdown the NHS England, chief executive, Simon Stevens, ordered in March, Nagpaul said

“Aside from the individual distress, pain and potentially life-threatening impact that delaying care would have on individuals, there’s a risk that increasing the backlog further would have a grave consequence for the NHS in the future. "The knock-on of not addressing this now and delaying further care during a potential second wave could mean that we are constantly trying to catch up with the missed care,” said Nagpaul.

The NHS Confederation, which represents hospitals, has already acknowledged that the service’s unprecedented pausing of normal care involved “a terrible cost” for patients needing non-Covid care. But Niall Dickson, its chief executive, said: “The NHS can flex and will be there for patients again if there is a second wave. The challenge this time will be to run both Covid and non-Covid services in parallel as far as is possible.”

Hospitals arae working hard to clear the backlog, but they are hampered by social distancing limiting the number of patients they can have on-site and staff having to wear personal protective equipment, reducing the number of operations they can perform.

Newcastle upon Tyne hospitals trust has begun running ophthalmology clinics at the weekend to tackle its backlog of patients awaiting diagnostic tests. Ninety patients will attend this Saturday and Sunday. Patients awaiting a CT or MRI scan, which play a crucial role in diagnosing cancer, are also being invited to attend new weekend radiology clinics.

The medical leaders’ intervention drew a sharp response from NHS England, which refused to rule out a second shutdown.

“Even at the height of coronavirus, for every one Covid patient in hospital there were two other inpatients being treated for other conditions, so it is factually untrue to suggest the NHS was ever a ‘Covid-only service’”, said an NHS spokesperson.

“More than 5m urgent tests, checks and other treatments took place during the peak of the virus, including 65,000 patients getting vital cancer treatment. How the health service has to respond to any further Covid peak will partly depend on just how big it is.”

Stevens last week told hospitals to get back to providing 80% of planned operations by September and 90% by October to reduce the backlog before a second wave.

Source: Theguardian 

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