In July, Dr Peter Rabey, Guernsey’s Medical Director and Dr Gary Yarwood, Guernsey’s Medical Specialist Group (MSG) Chairman explained in detail to the media that we were emerging from a unprecedented lockdown period which severely restricted access to clinical facilities generally, and theatres specifically, and thus the ability to deliver normal levels of surgical procedures had been heavily impacted.
In fact, around 13 weeks of elective operations were unavoidably impacted in Guernsey at this time, though Guernsey’s Health & Social Care (HSC) delivered all Priority 1 and 2 procedures (emergency interventions) as required with no delay during this period.
This disruption reflected the pattern seen across mainland UK, who have seen the situation worsen in the months since, and far beyond the 13 weeks down time suffered by HSC. Drs Rabey and Yarwood explained in July that the lost time has had a material impact and because the HSC theatres had been running pre-pandemic at capacity, the additional backlog created by the pandemic would take a long time to recover.
Following the exit from lockdown, and in line with ensuring guidance and directives to safeguard patients and staff were followed at all times, HSC restored services across acute, adult, children’s and mental health services extremely quickly. In respect of elective activity, a dedicated team has met each month to drive recovery in this area including Drs Rabey and Yarwood. The initial focus of this work has been to build theatre throughput back up to pre- pandemic levels as quickly as possible, and that target was achieved by the end of September following a huge effort by all staff and partners across HSC and MSG.
What this means in terms of activity is that in January (pre pandemic), HSC delivered approximately 750 theatre procedures each month and this activity level has, during October, been restored. During August and September when the team were building up to full activity levels, theatre throughput stood at approximately 700 procedures each month, meaning HSC and MSG have worked hard to restore capacity extremely quickly since the lockdown in this operational area.
In terms of numbers of patients waiting for an elective procedure, the numbers reported in July were 1,400 overall, of which 600 awaited an orthopaedic intervention. Since this date, patients have again been able to see their GP and thus many more people have been able to receive a referral into secondary healthcare, which in turn has added to the waiting lists at a time when capacity was being restored. Despite this pressure, and through an ongoing focussed effort to manage this demand, the equivalent waiting list numbers to the 1,400 (overall) and 600 (orthopaedic) in July of this year are: 1,443 (overall) and 640 (orthopaedic) as at the end of October.
HSC and MSG say they will continue to maximise all available theatre capacity and work hard to deliver as many operations as possible. MSG staff will continue to explain the situation to patients awaiting surgery as it stands across the different specialisms.
Orthopaedic work continues to have the longest waiting times for surgery, the majority of which is restricted to the ‘ultra clean’ theatre. There is no current ability for HSC to commission work from mainland providers including the NHS who are suffering extremely long periods of disruption from the ongoing pandemic and thus have their own considerable issues as regards surgical backlog. Even if such capacity were available, the mainland has ongoing issues with restrictions in place as a result of the pandemic which in turn severely restricts the ability to arrange travel and the overall safety of patients more generally.
HSC and MSG recognise the upset and frustration that waiting for an operation can cause and asks for further understanding from the public at this unprecedented time. All staff are working to full capacity on island to support patients but it will take a significant period of time to work through the disruption the pandemic has created.