A third of surgeons unable to restart surgery

The Royal College of Surgeons of England has stressed the importance of creating ‘Covid-light sites’ to improve patient safety and has reiterated its call for contracts with the independent sector to be extended as one route to achieving that.

With more than one million people waiting over 18 weeks for hospital treatment, a new college survey of 1,741 UK surgeons found one-third have been unable to restart surgery.

This comes one month after NHS England outlined how elective surgery should safely be able to resume.

Among those surgeons who are unable to restart elective procedures, one-third (33.4%) say lack of access to fast Covid tests for patients remains a barrier. 

The college wants Covid-light sites in the independent sector, where necessary, and in the NHS.

Same-day testing

It is urging that surgical teams across the UK have access to same-day test results for patients, on the basis of these findings. The survey found time taken to get test results varied widely.

  • Just 10% of surgeons could get test results for surgical patients within 8 hours; 
  • A further 31% of respondents could get test results within 24 hours;
  • A further 34% could get results within 48 hours;
  • A further 13% could get results within 72 hours.

College president Prof Derek Alderson said: ‘The speed at which tests results can be returned is a crucial factor in enabling more elective surgery to take place safely. The aim should be for surgeons to have access to same-day test results, so that they can test patients both before and on admission, and again upon discharge – nine in ten surgeons we asked agree.

‘If patients have a negative Covid result on the same day of their surgery and have isolated for a fortnight as recommended, then the surgical team can proceed with greater confidence. Operating on a patient who has Covid-19 is not a good idea, so the more we can do to reduce that risk, the better.’

Other barriers

Testing was not the only barrier surgeons cited, but it is likely the fastest to solve, the college said. Other major barriers included ‘a lack of capacity in interdependent services such as diagnostics, anaesthesia and sterile processing’ (46%) and a ‘lack of staff’ (35%).

Full findings are included in a college report ‘Elective surgery during Covid-19’.  

Prof Alderson added: ‘Covid-light sites must be established across the UK, both in the NHS and, where necessary, the independent sector. We need these protections in place to keep surgical patients safe, and right now a quarter of surgeons still don’t have access to a Covid-light site. We have a window of opportunity this summer, before a potential second wave or the arrival of flu in the autumn.

‘If we don’t get organised now, then tens of thousands of people will be waiting until next year for an essential operation. Part of getting this country back to work is finding a way safely to treat those patients who are off work because of a health condition.

‘We know that a joint replacement can enable someone to go back to work, so it’s both a duty for us as doctors to help address their pain, and key to both that individual’s well-being and well-being of the country.’