The Presidents of the Royal College of Surgeons of England (RCSEng) and the Royal College of Emergency Medicine (RCEM) have issued a joint memorandum to MPs calling for urgent action to help the NHS recover from COVID.
The memorandum details the measures needed, including reconfiguring the use of space and providing sufficient facilities for the NHS to resume surgical and emergency services safely.
The Royal Colleges argue that the NHS “cannot continue to function as a ‘COVID-only’ service”, and press for planning now to deal with a ‘hidden waiting list’ of patients who have not yet been referred, and to avoid further suspension of life-saving treatments if there is a second wave of COVID-19.
Measures would include creating more side rooms to protect patients who are at high risk of dying from hospital-acquired infections and more diagnostic facilities as scanners cannot be used interchangeably between COVID patients and others. Where a Trust has split sites, allocating one as the ‘COVID-light’ facility is also recommended.
One of the biggest challenges is overcrowding and although hospital A&E attendances are down still at the moment they are starting to increase*. As life begins to return to normal for many people, the NHS will not be able to sustain a return to record overcrowding in the Emergency Department and delays to admission whilst also maintaining safe social distancing and infection control. “The challenge this represents must not be underestimated and will require a systemic transformation across our health and care service.”
The memorandum cites early results from a survey of 1,692 surgeons, which indicates a quarter do not yet have access to ‘COVID-light’ facilities for their patients. Results from a survey of 1,167 RCEM members indicates that seven out of ten do not think they have enough side rooms for patients in their Emergency Department.
Commenting, Professor Derek Alderson, President of the Royal College of Surgeons of England says: “An enormous effort is being made on the frontline to get the NHS back on its feet again, but restarting services is proving more complex than switching them off. The NHS has coped with COVID by suspending almost all planned surgery, creating a huge backlog of patients waiting for treatment, many waiting in pain and distress. We need to see urgent action to develop more COVID-light sites, where surgery can take place safely. This would allow some surgery to continue even in the event of a second wave of the virus.”
Dr Katherine Henderson, President of the Royal College of Emergency Medicine adds: “The NHS has done well to cope during this period, but we need to find ways of balancing treatment of COVID-19 with routine and emergency care. Much work needs to be done to get this balance right. Going back to overcrowded Emergency Departments would be a disaster and would seriously risk spreading COVID-19. We need to ensure that A&Es are physically large enough to keep patients safe and have adequately resourced alternative care pathways available 24/7 including primary care and NHS 111 services.”
*The latest data show 234,000 more type-1 attendances at A&E in May than in April, and 55,000 more admissions.
