Patients waiting for elective surgery dates will continue to face unspecified delays because of the lasting impact of the Covid 19 pandemic, the Medical Specialist Group has warned.
During the crisis two of the Day Surgery Units at the Princess Elizabeth Hospital were converted to Covid 19 wards, creating a backlog of surgical work.
In a statement the Health and Social Care Committee said that although capacity in operating theatres continued to improve, it was not back to pre Covid 19 capacity because of ‘staffing challenges’ which they were working to address.
There is a particularly heavy caseload of orthopedic procedures, which will create the longest wait times.
In an online Q&A the MSG says anyone seeking an exact date for their surgery can not presently be given that information. Waiting list time will inevitably be beyond the normal eight weeks of referral. If a patient’s condition worsens they are advised to return to their GP for advice.
In a statement HSC said
‘Staff across Children & Family, Adult Community, Adult Disability and those within Mental Health Services are expected to be able to restore their full service provision in the shortest timeframes now that Phase 5 has been entered. Services across the Acute care sector, provided from the Princess Elizabeth Hospital have experienced the greatest degree of disruption however, and specific plans will need to be delivered to address the waiting list issues that have arisen which will in turn require the continued understanding and support of the community.’
Dr Peter Rabey, HSC Medical Director said:
‘During the entire lockdown period, all ‘Priority 1 & 2’ surgical operations were delivered throughout the pandemic. This work involves the most critical and urgent casework, including cancer responses and trauma treatments.
‘Additionally, MSG worked hard to provide their routine outpatient services during lockdown.
‘The outpatient activity that has been delivered during lockdown however has added to the overall lists of patients requiring a day or inpatient procedure, with no ability during lockdown for staff to address this work. Additionally, now that more islanders have the confidence to visit their GP, outpatient activity is expected to increase significantly, adding further caseload across the specialities for those that require a surgical intervention.
‘Now that we are in Phase 5, many patients who are on inpatient waiting lists will be anxious to understand when their operation will be delivered, and HSC and MSG are working hard to respond and support patients at this time. A new ‘Frequently Asked Questions’ has been created and posted on the MSG website www.msg.gg/faqs-waiting-times and the States of Guernsey website www.gov.gg/peh
to answer the common queries that patients may have in respect of their operation.,
Patients are asked to review this FAQ in the first instance to allow staff to focus on the scheduling of operations now that all PEH facilities are becoming available again. Within the PEH, clinical staff are maximising the services that they can deliver across the working week to support the delivery of surgical work.
Dr Gary Yarwood, MSG Chairman said that sending patients to the mainland for elective surgery was not a viable option because of similar pressure on hospitals there.
‘Patients who have read the FAQs and do contact the MSG to enquire about their operation date will not unfortunately receive definitive information at this time. We are anticipating increased referrals from Primary Care now that patient confidence to visit healthcare settings has returned and although continuing to improve, PEH theatres are not yet back to full capacity.
MSG staff will therefore only be able to provide a guide at the present time, based on the wait times experienced by individuals who have recently received surgery, but this may not be indicative of future cases if demand outstrips capacity. There are particularly heavy caseloads to work through in orthopaedics, and specialties such as Ear, Nose & Throat will still have restrictions as to the work they can deliver safely in Phase 5 because of the aerosol-generating nature of the related procedures.
Undoubtedly, and principally because of the theatre disruption experienced throughout the pandemic, almost all surgery will be delivered outside of an 8 week wait, for which we apologise.’
It will not be possible to achieve full capacity immediately within the PEH, and operations are sometimes unavoidably postponed if the condition of a patient worsens, if urgent emergency work has to be prioritised or if specialised nursing/operating department practitioners for whatever reason are unavailable. The impact on the PEH of the need to respond to a further COVID-19 outbreak would of course also materially impact what can be delivered. Despite these challenges, HSC and MSG staff are aiming to achieve their pre COVID-19 ‘business as usual’ average workload of approximately 460 day patient and 100 inpatient surgical cases per month as soon as possible.
In terms of looking off island for additional capacity to support the Guernsey waiting list management, this is not felt to be viable at the present time owing to the pressures on the NHS and their own waiting lists which have lengthened considerably owing to the ongoing pandemic. The option will however remain under review.
To manage increasing patient demand on island, and to keep pace with the needs and requirements of our changing community, HSC are delivering a major ‘Hospital Modernisation Programme’ which, subject to States’ approvals, will break ground in 2021, providing the facilities, services and capacity required by our community into the future.