Increase in cancer surgery and other urgent procedures for Central Lancashire patients as part of Covid recovery plan

The trust which runs the Royal Preston and Chorley and South Ribble hospitals is to step-up surgery for cancer and other serious conditions, as part of nationwide plans to increase NHS activity unrelated to coronavirus.

Thursday, 30th April 2020, 3:30 pm
Updated Friday, 1st May 2020, 9:53 am

The most urgent cancer operations and non-surgical treatments – including chemotherapy and radiotherapy – have continued at Lancashire Teaching Hospitals NHS Foundation Trust (LTH) throughout the crisis so far, as demanded by national guidelines.

However, the organisation has told the Local Democracy Reporting Service that it is this week beginning to further increase capacity for “time-critical surgery” for cancer and other complaints – both at its own hospitals and private facilities.

The independent sector has already been used for some Central Lancashire cancer procedures during the pandemic, while the most complex cases have been treated on-site at the Royal Preston.

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The most complex cases will be seen at NHS facilities, while others could be moved to the private sector

Anybody with symptoms of cancer is being urged to seek medical help, after figures published earlier this week from a study by University College London suggested that there had been an average 76 percent drop in attendence for cancer referral appointments.

NHS England has written to all trusts asking them to “release and redeploy” some of the space reserved for the surge seen in Covid-19 patients, to allow high priority services to return to pre-pandemic levels over the next six weeks. This includes treatment for cancer, cardiovascular disease and stroke - but the letter stresses that infection prevention and control must be the "guiding principle".

Hospitals have also been told to consider whether they can restart “at least some” non-urgent, pre-planned procedures. NHS England ordered that these be brought to a stop over several weeks up to mid-April in order to cope with the impact of Covid-19 on hospital capacity.

But no date has been set for the resumption of such services at LTH, with trusts being given flexibility to draw up their own local plans based on Covid infection and hospital admission rates in their own areas.

LTH medical director Gerry Skailes said that caring for cancer patients ”remains a priority”.

She added: “Urgent surgical, non-surgical treatment and diagnostics have continued throughout the pandemic.

“This week, we are commencing additional time-critical surgery for cancer and other serious conditions and have been working with the Lancashire and South Cumbria Cancer Alliance to prioritise patients, including utilising capacity in our local private hospitals for some cases.

“It is really important that patients attend their appointments to ensure their best possible chance of a good recovery and we are also ensuring that patients coming in for planned procedures are cared for in Covid-free areas.

“There isn’t yet a timetable for the commencement of non-urgent procedures but the situation is reviewed on a regular basis and we will comply with national guidance on this issue as it emerges.”

NHS England has warned trusts that they should retain their ability to reinstate additional Covid capacity should it be needed. Across England, the number of patients with the virus being treated in hospital has fallen by around 5,000 over the past fortnight.

Bed occupancy figures for Covid patients are not published at a Lancashire level, but the county’s director of public health, Dr. Sakthi Karunanithi, last week said that cases of coronavirus admitted to hospital have begun to show signs of “plateauing” – although he added that Lancashire had probably not yet its reached its peak.

As part of its plans to deal with demand from coronavirus patients, LTH last month temporarily reconfigured its services to create a 400 percent increase in critical care bed capacity.

The Royal Preston’s current day case theatres and day case and medical escalation wards have been housing confirmed and suspected coronavirus patients away from the rest of the A&E department, while the A&E at Chorley Hospital has been closed to create a single point of access for Covid patients.

The Local Democracy Reporting Service (LDRS) understands that Lancashire is one of 21 ‘cancer hubs’ in England which were announced earlier this week. However, unlike in some parts of the country, where a single ‘virus-free’ centre has been identified for treating cancer patients, Lancashire is making use of private facilities operating as a series of mini-hubs.

The NHS Midlands and Lancashire Commissioning Support Unit said that a “significant amount” of non-complex cancer surgery was already being carried out in partnership with private providers Spire Healthcare and Ramsay Healthcare. Last month, the NHS at a national level announced a deal to enlist the entire capacity of the private hospital network to provide Covid and non-Covid services ‘at cost’ until at least June.

The new NHS guidance sates that cancer "referrals and diagnostics (including direct access diagnostics available to GPs) and treatment must be brought back to pre-pandemic levels at the earliest opportunity to minimise potential harm, and to reduce the scale of the post-pandemic surge in demand". It also calls for trusts to take "urgent action" to receive patients referred with suspected cancer within the two-week target time.

The LDRS approached all NHS trusts in Lancashire regarding their response to the new guidance about increasing non-Covid activity.

University Hospitals of Morecambe Bay NHS Foundation Trust, Blackpool Teaching Hospitals NHS Trust and East Lancashire Hospitals NHS Trust issued a joint statement from Kevin McGee, chief executive of the latter two organisations.

He said: “Hospital services have been working together across Lancashire and South Cumbria to respond to the coronavirus pandemic, while at the same time ensuring that essential and urgent care in areas such as cancer can continue.

“In all hospitals, we are taking strict precautions to ensure both staff and patients remain safe. If you do have to go to the hospital, please be assured that it is safe – NHS staff have worked hard to put in place measures which will allow people to access care safely – such as splitting services into Covid and non-Covid zones or providing telephone and video consultations in some of our outpatient departments.

“One thing that we can be certain of is that if people put off seeking urgent medical help when they are having stroke or heart attack symptoms, they put their life at risk,” Mr. McGee added.