Health & Fitness Covid-19 pandemic ‘led to 1.5 million NHS operations cancelled or postponed’
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More than 1.5 million operations were cancelled or postponed at hospitals across England and Wales during 2020, according to the first national study to measure the effect of theon NHS surgery.
The overall shortfall will increase to 2.4 million cancelled operations by the end of this year with millions more patients feeling the effect for years to come, the authors warn.
The investigation, by doctors at Swansea University Medical School and Queen Mary University of London, used hospital and patient data, describing every episode of NHS hospital care in England and Wales during 2020. These statistics were then compared to the surgical activity during the four years prior to the study period.
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Surgical procedures were categorised according to urgency using the four classes defined by NHS England. Across all categories, there was an overall drop of 33.6 per cent in surgical activity over the year.
The largest number of cancelled or postponed operations occurred in Class 3 (semi-urgent surgery, such as prostate cancer or removing a gall bladder) with over 900,000 cancelled procedures.
The greatest decrease in surgical activity was seen in Class 4 (elective surgery, such as hip or knee replacement) with nearly half a million fewer admissions and more than one in two procedures cancelled.
The lowest number of surgical admissions were observed during the month of April 2020, following the first national lockdown of the pandemic. Surgery fell by 73 per cent overall.
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Only 2.3 per cent of expected elective surgery operations were carried out, 18.4 per cent of semi-urgent procedures, just under 50 per cent of urgent procedures, and 67 per cent of emergency procedures.
The study comes at a time when NHS England has paused the collection and publication of official statistics on cancelled operations.
The authors calculate the recovery of surgical activity has to date been incomplete, hampered by increased hospital staff sickness, reduced operating room capacity and an enhanced regime of infection controls. This will mean a cumulative shortfall of almost 2.4 million procedures by the end of the year, the equivalent of more than six months of pre-pandemic surgical activity.
Co-lead author Dr Tom Abbott, from Queen Mary University of London, said: “Our study reveals the true impact of the Covid-19 pandemic on surgical care in England and Wales, including both emergency and elective care.
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The long-term consequence of the disruption is unclear, but we anticipate that for many patients their quality of life will be severely affected. The backlog of surgery is likely to take many years to clear, particularly as the speed with which surgical treatments can be delivered is now slowed by infection control procedures.”
An NHS spokesperson said: “This study is wrong to compare the data in this way because actually the reduction in this activity occurred because fewer people came forward for care – this is why the NHS has been running a campaign throughout the pandemic encouraging people to access services when they need to, as normal.
NHS staff have ensured routine operations have rebounded quickly, with 1.1 million people beginning elective treatment in April alone, and the NHS is supporting hospitals with an extra £1 billion to restore care to pre-pandemic levels.”
A separate England-wide study of all patients undergoing NHS surgery during the pandemic, by the same doctors, reveals the high risk of death among patients who acquire Covid-19 during or immediately after their hospital stay.
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The analysis of 2.6 million patients found that while only 1.1 per cent acquired the infection at the time of their operation, where patients did succumb to the virus, the mortality rate was extremely high.
Overall, surgical patients who became infected with Covid were 6 times more likely to die within 90 days of their operation. Patients undergoing elective surgery who became infected were 25 times more likely to die.
The authors say these statistics indicate that current infection prevention and control policies are highly effective – but cannot be relaxed.- The studies are published in the British Journal of Anaesthesia.
Meanwhile, a separate study found one in eight (12 per cent) of all adults over 50 had a hospital operation or treatment cancelled last year and this rose to one in five (20 per cent) for those with two or more existing medical conditions. The most common treatments cancelled were eye and cancer related surgery, according to research led by UCL.
The research, published as a briefing paper on Friday, also shows that fewer cases of dementia were diagnosed in lockdown compared to before the pandemic but diagnoses for arthritis, chronic lung disease, diabetes and hypertension all increased during the pandemic.
For the study, the researchers analysed data from over 7,000 adults who are participants of the English Longitudinal Study of Ageing and living in England.
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