Covid: Disruption to surgery ‘will affect millions’

Disruption to surgery in England and Wales during the pandemic will continue to affect millions of patients for many years, researchers say.

Hospitals completed 1.5 million fewer surgical procedures in 2020 than would be expected from trends in previous years, a drop of about 33%, they say.

The NHS says the shortfall was “because fewer people came forward for care”.

The figures include 108,000 (13%) fewer emergency operations, such as for heart disease, appendicitis or broken bones.

In England some planned, non-urgent surgery was postponed from mid- April 2020 to allow the health service to focus on the pandemic, and again in December 2020 in response to the second wave. A similar picture was seen in Wales.

The researchers accept:

They found the biggest shortfall in operations – about 900,000 – was in the semi-urgent category, such as gall-bladders operations and reconstructions following burns.

And there were nearly half a million fewer admissions for planned procedures – such as hip and knee replacements – compared with previous years.

Researcher Tom Dobbs, from Swansea University Medical School, said the interruption of surgical treatment would be felt by millions of patients for many years and called for urgent and major reorganisation of services.

“Delays in the diagnosis and surgical management of cancer patients will lead to an increase in deaths, while those waiting for semi-urgent and elective surgery are likely to experience a worsening of their condition,” he added.

Royal College of Surgeons of England president Prof Neil Mortensen said the research underscored the gravity of the growing elective backlog.

“We have called for the government to commit £1bn for surgery every year for the next five years to bring surgery back up to more sustainable levels,” he said.

“Importantly, capacity needs to be built into the system so that more beds and more surgical staff are available.”

Swansea University Medical School and Queen Mary University of London researchers compared hospital data for all adults having surgery in England and Wales in 2020 with the average levels over the past four years, adjusted for an ageing population.

But an NHS official 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 £1bn to restore care to pre-pandemic levels.”

The study is published in the British Journal of Anaesthesia.

A separate study in the same journal looked at 2.6 million patients having surgery in England and found 1.1% had been infected with coronavirus around the time of their operation. People with the infection had a higher risk of death in the 90 days following surgery.