Surgeons operating at 50 per cent capacity

Medics fear time bomb as cancer tests plummet and treatment waiting lists soar due to lockdown measures

NHS SURGEONS are working at around 50 per cent capacity, the president of their royal college has disclosed, despite record waiting times for crucial surgery.

Official figures show that more than 50,000 people have waited a year for treatment – up from 1,117 a year ago.

The majority of NHS surgery and other routine treatment was stopped for months during lockdown. But medics said efforts to restore services were moving too slowly.

Prof Neil Mortensen, president of the Royal College of Surgeons, said the NHS was struggling to restore services, with a lack of routine testing for NHS staff hindering Covid-free zones. Prof Mortensen said many patients had been left in pain and distress, after their routine surgery was suspended.

While some surgeons were left frustrated and “didn’t have much to do” for months, they were now finding that procedures intended to protect against Covid meant they could only cope with half their normal workload.

“Most surgeons would say productivity is around half what it was before,” he said.

Dr Chris Moulton, former vice-president of the Royal College of Emergency Medicine, said too great a reliance on “virtual” consultations, and encouraging patients to “phone first” before attending casualty meant people were being denied basic care. Dr Moulton said: “My worry is that a number of organisations, including the NHS, are using Covid as a reason to distance themselves from people and that carries risks.”

Rod Hughes, consultant rheumatologist at St Peter’s Hospital in Surrey, said he was “working in a medical version of the Mary Celeste” because so few face-to-face clinics were being run.

An NHS spokesman said: “Elective surgery has already rebounded from around 30 per cent of its usual rate during the peak of Covid … to over 60 per cent earlier this month, and is steadily increasing beyond that.”

CANCER testing was reduced to less than half of normal NHS capacity during lockdown, according to official figures which show the scale of the crisis now facing the service.

In April alone, there were 2million fewer tests for the disease – leaving Britain facing a ticking time bomb.

Medics are concerned that as hospitals enter autumn they are ill-prepared to catch up on a deadly backlog, as well as record numbers of patients waiting more than a year for routine treatment.

Critics say that changes introduced in response to Covid have left some hospitals “almost at a standstill”.

Just 1.4million diagnostic tests, such as MRI, CT and ultrasound scans, were carried out in the month after lockdown began, compared with 3.7million in the same month the previous year.

With forecasts warning that the health service could be overwhelmed by Covid, the decision was taken in March to stop most planned surgery, tests and treatment. Now experts fear the long-term consequences could yet prove more deadly than the virus.

Cancer Research UK estimates that lack of access to services in recent months, and the number of patients who kept away from GPS as a result of messages to “stay home”, could mean an extra 35,000 cancer deaths.

Separate studies show many of these deaths are among those far younger than the lives cut short by Covid. One study, by King’s College London, suggests that, on average, every death due to delays in diagnosing cancer in lockdown will mean 20 years of life lost.

Sarah Woolnough, Cancer Research UK’S director of policy and information, says Britain went further than other countries in the extent to which it stopped routine services, but had little choice, because it lacked capacity.

She is among many experts concerned that the health service has not taken sufficient steps to reopen services for “non-covid” patients, and to provide assurances on safety. “Cancer patients have been terrified of becoming infected, there has been work done creating Covid-secure cancer hubs, but we need staff to be tested regularly.”

At the height of the pandemic, referrals from GPS for suspected cancer fell by 75 per cent, official figures show.

“The NHS was very effective in telling people to stay away,” says Ms Woolnough, with statistics showing 30,000 fewer treatments between April and June this year, compared with last year.

Patients denied care

Official figures show 50,971 patients have now waited at least a year for treatment, up from 1,117 a year ago.

They include 11,284 patients waiting for orthopaedic and trauma surgery, with elderly patients in need of hip and knee replacements left in pain.

“I know of people who have seen major deteriorations in mobility,” says Prof Neil Mortensen, president of the Royal College of Surgeons, citing a patient who, until recently, used to fellrun but is now in a wheelchair.

Sir Simon Stevens, head of the NHS, has instructed hospitals to restore activity to at least 80 per cent of previous levels by next month, and 90 per cent by October. But Prof Mortensen says that is “a tall order” without the creation of sufficient “Covid-free” zones and regular testing for staff.

NHS England says the decision on whether to introduce such testing is one for the Chief Medical Officer.

Behind the astonishing NHS statistics are thousands of people waiting for procedures, which not only relieve misery, but save lives. A year ago, just 41 heart patients had been waiting 12 months for treatment by cardiology departments; now the figure is 922.

Prof Stephen Westaby, one of Britain’s most eminent cardiac surgeons, now retired, fears “hysteria” about Covid could do more damage than the virus. “Surgeons were put on hold, left twiddling their thumbs,” he says.

Chris Moulton, former vice president of the Royal College of Emergency Medicine, fears that policies to make services “Covid-secure” will mean many patients lose access to basic care.

“My worry is that a number of organisations including the NHS are using Covid as a reason to distance themselves from people, and that carries risk,” he says. He cites trial schemes to encourage patients to call before attending A&E, and GP consultations conducted by video and phone. “I worry that the actions intended to stop the spread of Covid are harming more people than they are helping.”

‘Mary Celeste’ hospitals

In March, the head of the NHS instructed hospitals to empty more than 30,000 beds, to clear the decks for Covid patients. The action was to prove controversial, as it preceded the introduction of routine testing of patients discharged to care homes.

Some say the NHS had little choice. Chris Hopson, chief executive of NHS Providers, which represents hospitals, says: “To avoid the desperate situation we saw in northern Italy, the NHS had to create 33,000 beds for potential Covid patients.

“But it was not a Covid-only service. Even at the height of the pandemic, for every one Covid-19 patient in hospital, there were two non-covid patients.”

While certain parts of the NHS scramble to catch up, some experts fear others are “almost at a standstill”.

Dr Rod Hughes, consultant rheumatologist at St Peter’s Hospital in Surrey, says his unit became “a medical version of the Mary Celeste”, with most physical checks replaced by phone calls.

“There comes a point where we have to balance the risks,” he says. “We’re caught in limbo, while more people suffer as their conditions worsen.”

An NHS spokesman said: “Elective surgery has already rebounded from around 30 per cent of its usual rate during the peak of Covid, when hospitals were looking after 108,000 coronavirus inpatients, to more than 60 per cent earlier this month.”

‘A number of organisations are using Covid as a reason to distance themselves from people, and that carries risk’

‘We have to balance the risks ... we’re caught in limbo, while more people suffer as their conditions worsen’