As Covid-19 continues to have a devastating effect on everyday life, the National Health Service (NHS) is still facing mounting challenges to their ability to provide urgent treatment unrelated to Covid-19.
Particular attention has been drawn by the media to delayed cancer operations in the major London hospitals. A recent report by the BBC revealed that “priority 2” cancer operations have been postponed due to a lack of available intensive care beds at King’s College Hospital Trust in South London. Although not considered the most urgent surgery clinically, priority 2 operations are still potentially life-saving surgery that is usually performed within 28 days. This alarming situation at King’s College Hospital has not been seen nationwide yet but with the increasing rates of Covid-19 infection and the resulting strain on the health service, Cancer charities, such as Cancer Research, have expressed their concern that this could be a deteriorating situation.
What is the potential effect of delays with cancer treatment?
The most urgent cancer surgery has continued to be performed throughout the Covid pandemic but the delays with lower priority surgery raises issues that patients will be left untreated with a progressively worsening disease. The result of this delay could be the cancer spreading and the patient losing the opportunity to have surgery as the cancer becomes inoperable.
Cancer Research has expressed concern that, in time, we could see the negative impact on cancer survival and recovery statistics. The effect will vary between different types of cancer and different patients but overall, it is clearly understood that prompt, early treatment results in increased chances of recovery, with a few weeks sometimes making all the difference.
The NHS prioritises cancer treatment based on clinical need and other forms of cancer treatment, such as radiotherapy, continues to be offered. Patients are being encouraged to contact their GP if they develop symptoms, but concerns persist that in addition to pressure on cancer surgery, there is also significant delay in patients being investigated for suspected cancer.
What about delays with cancer diagnosis due to Covid-19 delays?
Figures show that the number of scans undertaken in England between April and September 2020 was approximately 4.4 million fewer compared to the same period in 2019. This reduction arose during the period when the NHS grappled with the huge pressures placed on it by the first wave of the Covid-19 infection. This had the consequence of a backlog of scans developing, with hundreds of thousands of patients waiting more than 3 months. NHS guidance stipulates that patients should be undergoing a scan within 6 weeks of referral.
Why is there a backlog of scans to diagnose cancer?
NHS staff have worked incredibly hard to tackle the backlog and some services are returning to pre-Covid levels but professional bodies remain concerned that delays in cancer diagnosis, due to the scan backlog, will mean some patients face a far worse, more aggressive, cancer. The backlog of patients requiring scans has been exacerbated by a shortfall in experienced radiologists and an insufficient number of scanners. Available resources have regularly been allocated to tackling the pandemic so that scanners are reserved for Covid-19 patients and radiologists are assigned to Covid teams.
While the vast majority of patients remain grateful for the high level of treatment provided by the NHS and also sympathetic to the pressures and risks they face as a result of the pandemic, there is also a feeling among some patients that those with potentially life-threatening cancer have been deemed a lower priority than Covid-19 patients.
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