People with advanced cancer have had their urgent surgery cancelled at a leading London hospital trust that is treating the largest number of Covid patients in the NHS.
Patients who were due to undergo an operation to treat their disease at Barts Health NHS trust have been told the pressures the resurgent Covid-19 is putting hospitals under was to blame.
The procedures involved are known in the NHS as “red flag” cancer cases and are classed by the NHS as “priority two” surgery, which means they should be done within 28 days of the decision to operate. Any delay risks the patient’s disease spreading or becoming inoperable.
Barts is the second big hospital trust in London known to have cancelled operations as a result of the strain on the NHS, which led to the UK’s four chief medical officers issuing an unprecedented warning last week that parts of the service were close to collapse.
The Guardian revealed last week that King’s College hospital in south London had halted urgent cancer surgery, though others are understood to have done so too.
Staff in Barts’ surgical division approached the Guardian to disclose that cancellations had been happening there since before Christmas after reading a statement in the Observer by Sir David Sloman, the NHS’s regional director for the capital, that “urgent cancer surgery is not being cancelled in London”.
One member of staff said last week: “This [statement] is not true. At the Royal London hospital we have not been able to do any non-emergency surgery since 23 December. We have not done any cancer surgery, except emergency procedures, since then. [There is] no clarity yet on when or where we can restart our elective surgery.”
Barts is understood to have taken the decision reluctantly because so many of its intensive care unit beds were occupied by Covid patients and also because staff who usually work in surgery have been redeployed to help care for them at the Royal London, which has the UK’s biggest ICU.
NHS England wanted trusts to retain essential services for people with cancer, heart problems and other conditions. But the number of people being hospitalised, and record levels of staff absence due to people sick or isolating because of Covid, has left a growing number of trusts unable to deliver both Covid and non-Covid care at the same time.
Barts declined to say how many cancer operations it had postponed since 23 December or why it had taken that step. It said some of its patients whose surgery was most urgent would be able to have their procedure at a private hospital. However, the Health Service Journal reported last week that NHS England and the private hospital sector were in talks about using the latter’s facilities to treat NHS patients during this phase of the pandemic.
Stephen Edmondson, Barts’ chief of surgery and clinical director for London’s cardiac network, said: “While we continue to provide urgent and emergency cancer surgery, Covid-19 pressures over Christmas have meant some patients are being rescheduled.
“Where patients’ appointments have been deferred, we will arrange treatment through both NHS and independent sector facilities on a clinically prioritised basis to ensure those most in need are seen as soon as possible.”
In Northern Ireland the NHS trust that runs hospitals in Belfast has also had to cancel urgent cancer surgery, the BBC reported.
Prof Neil Mortensen, the president of the Royal College of Surgeons of England, said Covid-related staff shortages were a key reason for cancellations, voiced concern about the impact on patients’ health, and warned that operations may be called off for months ahead.
He said: “The large numbers of Covid patients in hospitals increases the risk of planned surgeries, including cancer surgeries, needing to be cancelled. We have heard from our colleagues in London that their hospitals are experiencing a shortage of staff in wards and theatres, either because they are isolating due to Covid or because they are being redeployed to look after Covid patients.
“We are concerned that operations such as cancer surgeries are being postponed. The reality we face is that it will take some time before the vaccinations and the new lockdown combine to ease the pressures on hospitals.”
It was “extremely critical” that the NHS and private health operators reached an agreement so that as many NHS patients as possible could continue to have cancer and other urgent surgery, he added.
