While hospitals across the north of England have been forced to start cancelling routine operations in the last 10 days, maintaining cancer and emergency surgery had been a red line for bosses given the risk to patients from any delays.
Cancer Research UK said it was “extremely concerning” that some operations had been postponed and called for urgent action and investment to make sure treatments were not curtailed further.
Nottingham University Hospitals Trust confirmed on Tuesday it had been forced to cancel surgery for four cancer patients because of pressure on its critical care bed capacity. The operations would be rescheduled and the trust said there was no plan for wider cancellations of cancer surgery.
The trust’s medical director Keith Girling appealed to the wider public to help support the hospital by following rules and reducing the spread of the virus.
He also revealed the pressures on the trust had triggered a contractual deal with three local private hospitals that will allow the NHS to take over the use of their sites from next Wednesday.
The trust has cancelled many of its routine surgeries for the next two weeks with 283 Covid-19 patients in its beds on Tuesday, higher than the peak in April with 21 patients in critical care.
Nottingham and parts of the surrounding area will move into the Covid tier 3 alert level on Thursday for 28 days after it recorded some of the highest rates of infection in the country.
The prevalence of the virus has also meant staff and other patients in the hospital have become infected. As of Tuesday, the hospital was reporting 14 outbreaks on its wards which meant some wards being closed and other areas sealed off, further hampering its ability to provide services.
It is not the only area affected by the surge in cases. Leeds Teaching Hospitals Trust announced it now had more patients than at the peak in April with “only essential operations” going ahead.
The latest coronavirus statistics saw 367 deaths as of Tuesday, the highest since May with more than 9,199 patients in hospital across the UK. A total of 22,885 people tested positive for the virus on Tuesday.
In a statement to The Independent, Nottingham University Hospitals medical director Keith Girling said: “We’ve had to make the extremely difficult decision to postpone operations for four of our cancer/pre-cancer patients this week due to pressure on our intensive care units from both Covid-19 and non-covid related emergencies.
“We expect to treat one of the postponed patients next week, and we’re in contact with the others to arrange a new date, which will be imminent. This delay, however short, will be incredibly hard for the patients and their families, and I’m truly sorry for any distress this will have caused.
“We are working closely with partners, and from next week we will be increasing our work with the independent sector to ensure we can continue to carry out urgent and cancer operations.”
He added: “In this phase of Covid we have seen an increase in the number of staff and patients who are positive for coronavirus and not displaying symptoms but who are able pass it on to others who may then become seriously ill.
“We’re doing all we can to stop the spread in our hospitals, including testing all of our frontline staff, planned patients and everyone admitted as an emergency. We need our community to work with us to help decrease the spread by adhering to government guidance; wearing a face mask over your nose and mouth, washing your hands regularly and keeping a distance of two metres from others.”
Responding to news that cancer patients had been affected Emlyn Samuel, Cancer Research UK’s head of policy development, added: “The pandemic has already had a devastating impact on the lives of cancer patients and it’s extremely concerning to hear if patients are not getting the care they need through a second wave.
“It’s imperative that lessons learnt so far are taken forward to ensure urgent cancer treatment continues and there are no further delays. Covid protected spaces for cancer services must be maintained to provide diagnosis and treatment safely, supported by frequent and fast Covid-19 testing of all staff – whether they have symptoms or not.
“Investment is also urgently needed to make sure the NHS has the staff and equipment it needs to provide patients with life-saving diagnosis and treatment, giving them the best chance of surviving their disease.”
Sarah Scobie, from the Nuffield Trust thinktank added: “While there is understandably a desire to maintain non-Covid services in hospitals, this is coming up against the reality of rising numbers of cases and severely ill patients in the worst-affected regions. What’s more, cancelled operations are just one symptom of the strain hospital services are under – they don’t tell us about the growing pressures faced by families and carers as deaths outside hospital continue to climb.”
Dr Layla McCay, director at the NHS Confederation, added: “Our members tell us that in many cases, their capacity is severely stretched, and this is only likely to deteriorate over time, as we see more Covid-19 patients needing hospital treatment, alongside those with the usual winter illnesses.
“Staff are doing all they can to keep up with Covid-19-related demand while bringing back other services, but we need realism about what can be achieved, and understanding from both the government and the public.”
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