DIAGNOS TICS
are now longer too as time is needed in between appointments to disinfect rooms and minimise the spread of infection. Furthermore, social distancing practices have led to a reduced number of available beds in care settings. However, this reduction in resource and capacity is not only due to the COVID-19 pandemic. Prior to the outbreak, more than 4 in 5 English hospitals had ‘dangerously low’ spare capacity,5
with the COVID-19
outbreak simply exacerbating this issue. The NHS is facing the same issue even as we emerge from the COVID outbreak; as COVID-19 in-patients decrease, elective care patients increase. The NHS simply cannot keep up with this level of demand, and we must find ways of effectively managing capacity to ensure patients in need are not delayed in accessing healthcare. Another extremely important issue is that the public remain fearful of visiting hospitals, and understandably are reluctant to for the fear of contracting COVID-19. Throughout the pandemic, the Government have urged the public to continue visiting healthcare settings, as they normally would, and have consistently assured the public that it is safe to do so.
NHS Chief Executive, Sir Simon Stevens, even warned the public that ‘ignoring problems can have serious consequences – now or in the future’ but despite their best efforts to convince the public, the number of people attending A&E dropped by more than 50% during the lockdown compared to 2019 levels.6
The fear of attending hospital settings is even more acute for patients who suspect, or already suffer with an illness that makes them ‘high-risk’. Cancer patients have been far more reluctant to attend hospitals, and Cancer Research UK reports that more than one-third of cancer patients have had
Delaying the diagnosis of fatal diseases, such as cancer, results in a wave of deaths that have been implicitly caused by COVID, but do not appear in the official statistics.
their treatment impacted by COVID-19. Among these figures, a further 42% of Cancer patients have had vital tests to find out whether their cancer had spread or returned.7
The culmination of these factors leaves the NHS in a state of vulnerability that remains to be exacerbated in the event of a predicted second wave of COVID-19. If the NHS is to cope with the growing backlog of treatment, in the context of COVID-19, and in the face of a possible second wave, they must innovate and look toward other solutions that minimise impact on resources and staff, while maintaining public trust and ensuring patient safety.
Diagnosing during COVID-19 There are some aspects of elective care that, of course, require NHS healthcare staff and a typical hospital setting, such as surgeries, as well as ongoing treatment using specific equipment, such as chemotherapy. Other aspects of elective care diagnosis, however, such as testing and routine check-ups, can be conducted just as effectively in non-hospital settings. As we look toward supporting elective care to relieve pressure on the NHS, while meeting the needs of patients, we must focus on the clear fixes – those aspects of care that are the easiest to deliver outside of the hospital setting. Histopathology reporting is a prime example in streamlining elective care, as this can be easily outsourced to a trusted provider. Histopathology reporting refers to the
study of any tissues, such as tumours, placentas or moles. Histopathology reporting is used for diagnosing the majority of tumour-based illnesses, such as cancers. Testing in elective care is vitally important, particularly early testing,8
as it
can completely change the outcome of a patient’s illness. The earlier an illness is identified directly impacts how a treatment plan is developed. It can speed up a patient’s ability to start treatment, as well as making their condition significantly easier to treat, thereby significantly improving patient outcomes.
During the COVID-19 pandemic, testing levels for non-COVID related illnesses dropped significantly. An estimated 300,000 pathology tests are normally carried out each day – equating to 14 tests per person in England and Wales being performed annually.9
During the lockdown, tests such as these were on the list of appointments that were forced to be cancelled or delayed, having an untold impact on the ability to diagnose illnesses, and subsequently put in place treatment plans. Cancer Research UK estimates that around 1,000 patients are diagnosed with a form of cancer each day10
– meaning that for
each day that passed during the lockdown period, whereby specimens were unable to be taken, and therefore histopathology reporting was unable to go ahead, hundreds of thousands of people would have been unable to be tested and diagnosed with illnesses.
Delaying the diagnosis of fatal diseases, such as cancer, results in a wave of deaths that have been implicitly caused by COVID, but do not appear in the official statistics. Elective care patients are the hidden victims of the Coronavirus and will continue to struggle to access the elective care they need in the wake of COVID-19.
The solution? Remote elective care and outsourcing
One benefit of the COVID-19 outbreak is that it has set the precedent for remote testing, reporting and other elective services, such as virtual GP appointments. COVID testing has predominantly taken place away from traditional healthcare settings – instead, we have seen drive-through, tent and mobile vehicle testing facilities, as well as home testing kits where the sample is sent straight to the testing laboratory.
82 l
WWW.CLINICALSERVICESJOURNAL.COM NOVEMBER 2020
©arcyto -
stock.adobe.com
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100
