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COMMENT
CSJ THE CLINICAL SERVICES JOURNAL Editor
Louise Frampton
louiseframpton@stepcomms.com
Technical Editor Kate Woodhead Business Manager
Dean Walford
deanwalford@stepcomms.com
Sales Executive Holly Goldring
hollygoldring@stepcomms.com
Journal Administration
Katy Cockle
katycockle@stepcomms.com
Design Steven Dillon Publisher
Geoff King
geoffking@stepcomms.com
Publishing Director Trevor Moon
trevormoon@stepcomms.com
THE CLINICAL SERVICES JOURNAL is published in January, February, March, April, May, June, August, September, October and November by Step Communications Ltd, Step House, North Farm Road, Tunbridge Wells, Kent TN2 3DR, UK. Tel: +44 (0)1892 779999 Fax: +44 (0)1892 616177 Email:
info@clinicalservicesjournal.com Web:
www.clinicalservicesjournal.com
A slow, painful recovery
At the time of writing this, the latest waiting time figures had shown that just 46.8% of patients were treated within 18 weeks, against a statutory target of 92%. A record two-million patients were waiting more than 18 weeks. The President of the Royal College of Surgeons of England, Professor Neil Mortensen commented that he had hoped to see routine surgery recovering by July; instead, the stats show the worst waiting times ever on record. “Patients who have now been waiting many months, even a year or more for their treatment, cannot afford to wait until next spring,” said Prof Mortensen. “For those unable to return to work due to their condition, this is not only a health issue, but an economic one too.”
He highlighted the need to urgently build up hospital reserves and warned that flu and continuing local COVID outbreaks must not bring surgery to a standstill again, or “thousands more will suffer”. To winter- proof the NHS, he called for protected and separate ‘COVID-light’ facilities, with regular testing of staff and patients, and a stockpile of PPE.
© Step Communications Ltd, 2020 Single copy: £19.00 per issue. Annual journal subscription: UK £114.00 Overseas: £150.00
ISSN No. 1478-5641
The Publisher is unable to take any responsibility for views expressed by contributors. Editorial views are not necessarily shared by the journal. Readers are expressly advised that while the contents of this publication are believed to be accurate, correct and complete, no reliance should be placed upon its contents as being applicable to any particular circumstances. This publication is copyright under the Berne Convention and the International Copyright Convention. All rights reserved, apart from any copying under the UK Copyright Act 1956, part 1, section 7. Multiple copies of the contents of the publication without permission is always illegal.
Since July, there has been a worrying rise in cases. Although this has not yet translated into a significant increase in people being admitted to hospital, this may well change in the coming weeks and months. Worryingly, access to testing has reached a critical state. In recent weeks, the UK headlines have been filled with reports of individuals being asked to travel long distances, in some instances over 100 miles, to obtain a test. The Prime Minister has now announced plans for tests to be ‘rationed’ and the public has been blamed for ‘taking tests without symptoms’. This feels like passing the buck and we are seeing a trend emerge; healthcare workers were previously blamed for shortages of PPE, with accusations by the Health Secretary that staff were ‘overusing’ stocks, during the height of the pandemic. A lack of resources, a legacy of under- investment and flawed strategies are in no way to blame, according to Ministers; it is ‘people abusing the system’. While the blame game continues, healthcare workers will be left with the task of struggling to get the NHS back on track. As the Nuffield Trust’s John Appleby points out, expectations for recovery may
OCTOBER 2020
need to be reset and the public may have to accept that access to care is going to become more difficult for some time. He issued a grave warning: “With
COVID-19 cases appearing to be on the rise again, there is a very real risk we are a few weeks away from an upturn in hospital admissions as a result of the virus, just as the system will be battening down for additional winter pressure alongside efforts to recover. All of this points to one of the most difficult winters the NHS will face.” As Trusts try to return to a new normal, we are seeing hospitals having to grapple with difficult decisions over how to treat patients with COVID – not simply in terms of treating the disease itself, but whether it is safe to delay surgery on patients with a positive diagnosis. At the same time, what
Patients who have now been waiting many months, even a year or more for their treatment, cannot afford to wait until next spring.
protocols should be followed, if surgery absolutely must go ahead? How can we ensure the safety of patients and staff at all times?
A team of cardiothoracic surgeons and microbiologists, at St Bart’s Hospital, London, has sought to determine the safety of deferring surgery and the earliest safe period for surgery. Their illuminating findings can be read in this issue, along with other key insights on the recovery of services in the wake of the pandemic.
Louise Frampton l Editor
louiseframpton@stepcomms.com
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