Protecting NHS from Covid has created timebomb backlog for cancer treatment, medics fear

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 this year.

Separate studies point to the fact that many of these deaths are among those far younger than the lives that were cut short by Covid. 

One study, by Kings College London, suggests that on average, every death resulting from delays diagnosing cancer during 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 spare capacity. 

“When you look at international counterparts they didn’t seem to feel the need to go nuclear and stop it all. The problem was services were near capacity, the system was already incredibly stretched,” she says.

Ms Woolnough 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 they will be safe.

“It’s a problem that there has not been routine testing of asymptomatic staff,” she says.

“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, highlighting official 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.

“We know a lot of orthopaedic patients are really suffering, I know of people who have seen major deteriorations in mobility,” says Prof Neil Mortensen, president of the Royal College of Surgeons, citing the example of a patient who until recently used to enjoy fell running, 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 their previous levels by next month, and 90 per cent by October. 

But Prof Mortensen says the request is a “a tall order” without the creation of sufficient “Covid free” zones, and regular testing for all staff, whether or not they have symptoms.

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 can not only relieve misery and pain, 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, fears that “hysteria” about Covid could do more damage than the virus itself. 

The surgeon, now retired, says many of his former colleagues have been “out of service for months”.

“Surgeons were put on hold, left twidding their thumbs,” he says.  

“I can understand why the NHS embarked on the strategy [to stop routine surgery] but they should have changed tack sooner, to separate out Covid and non-Covid patients.

“Hospitals aren’t functioning properly because there is this paranoia about Covid, even though levels are actually low, and very few cases are being admitted to hospital.”

Chris Moulton, former vice president of the Royal College of Emergency Medicine, fears that policies which claim 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 risks,” he says.

In particular he raises concerns about trial schemes to encourage patients to “call first” before attending A&E, and about the use of GP consultations by video and phone in place of face-to-face appointments. 

“I worry that the actions intended to stop the spread of Covid are harming more people than they are helping,” he says.

“There is a national problem with access to care.”

Parts of the NHS ‘at a standstill’

In March, the head of the NHS instructed hospitals to empty more than 30,000 beds, in a bid to clear the decks for Covid patients. 

The action was to later prove controversial, as it came before the introduction of routine testing of patients being discharged to care homes.

Some believe the NHS had little choice, on the basis of forecasts suggesting health services could become overwhelmed. 

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 and treat those Covid-19 patients that required hospital care. Operating theatres had to be turned into critical care beds and anaesthetists, who are expert at managing ventilators, had to be redirected to treat the sickest Covid-19 patients. That inevitably meant stopping some routine surgery. 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 being treated for other conditions.”

While some parts of the NHS are scrambling to catch up, some medics are concerned that others remain “almost at a standstill”.

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

“There comes a point where we have to balance the risks of not being treated for a long time against the risk of Covid,” he says. 

“We’re caught in limbo, while more people suffer as their conditions worsen.”

An NHS spokesman said: “Actually, 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 over 60 per cent earlier this month, and is steadily increasing beyond that.” 

“As for emergency services, we agree with the new leadership of the Royal College of Emergency Medicine that Covid means safe alternatives are needed to A&E overcrowding.”

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