ENDOSCOPY
COVID-19: supporting the NHS recovery
With demand increasing and capacity limited, how can private service providers, suppliers and partners support the nation’s public health system at this time? Taking a look at the risks posed by a pause in elective procedures and exploring the resumption of endoscope services, Brian King discusses how private-public sector collaboration and sharing educational resources could be key to aiding recovery.
During the early days of COVID-19, the NHS postponed non-urgent procedures, erected new hospitals, while ICU and ventilator availability was increased across the country. This incredible response – in a matter of weeks – demonstrated the resilience and resourcefulness of our public health service, despite the challenges it has faced as a result of chronic underfunding over recent years.
Now that lockdown measures are being eased across the UK, from bars and restaurants reopening to the reduction of social distancing, the NHS is navigating a new way of operating. Elective care procedures are being resumed, many of which already had lengthy waiting lists even before the pandemic hit our shores. This temporary pause in appointments and procedures has had stark consequences. There were 530,000 fewer elective admissions in April, according to NHS CEO Sir Simon Stevens. As the NHS considers how to resume elective care, a report found that waiting lists are expected to double from 4.2 million to approximately 10 million by Christmas. Further, a postponement of some services has meant delays in diagnosis and treatment for life-limiting conditions. Even a delay of a few months can result in significant complications or disease progression for some patients. DATA-CAN, a Health Data Research Hub, has suggested the pandemic could lead to 35,000 ‘excess’ cancer deaths, with a backlog in screenings resulting in missed or delayed diagnosis. While elective procedures and screenings are resuming, another challenge lies in capacity. There are certain elective care procedures – such as bronchoscopies – which have seen increase in capacity, though many departments are reporting significantly reduced capacity, as a result of staff shortages
and increased infection control measures. There are clear challenges on the horizon for the NHS. It will take a monumental effort for elective care systems to return to pre- pandemic levels, and possibly even a complete reimagining of some services. Therefore, is there a key role that we as private suppliers, service providers and partners can play in supporting the NHS’ recovery, as the public health service resumes these procedures in line with new COVID-secure guidance?
Resuming screening services Taking a look at endoscopies, for example, the National Endoscopy Database found that total endoscopic activity fell to 5% of normal levels while the UK navigated the
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first COVID-19 peak, with a fall from 35,000 procedures per week to 1,700 in April. A paper in the British Medical Journal’s most recent issue of Gut discussed the importance of infection prevention and control (IPC) strategies, along with patient and procedural factors, when resuming endoscopic procedures. It noted that capacity would be cut by more than 65% if all procedures were to be conducted in full PPE, departments adhered to patient flow stringently and IPC recommendations for cleaning were followed to the letter. It presents a challenge, noting that incorporating robust COVID-19 patient screening might be necessary. For departments where infection
OCTOBER 2020
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