Fears rise for UK’s non-coronavirus patients as backlog grows
Patients with non-urgent ailments are staying home but what impact could this have on individuals and the health system?
London, United Kingdom – For the last three years, 40-year-old Shamir Khan has received treatment at Moorfields Eye Hospital in east London for diabetic retinopathy, a complication of diabetes that damages the back of the eye.
Every few months, he receives routine laser surgery, a minor operation which takes between 20 and 40 minutes.
“They [the hospital] just zap the blood vessels and they do that fairly regularly, depending on how it’s developing,” he told Al Jazeera. “These types of illnesses in and of themselves aren’t big deals, but they lead to bigger things if left alone.”
Recently, Khan became partially blind after his retina detached from the back of his eye and is worried his sight might worsen further.
The hospital postponed his routine operation, which was meant to take place on April 9, and he is still waiting for a new date to be scheduled.
“I can’t see out of my left eye. I think I have 20 to 30 percent vision left,” he said.
“The problem is, the hospital can’t do the check because they obviously don’t want to have people in the hospital. They said they would let me know [and] rearrange my appointment in April. But it’s already close to the end of the month.
“The fear if this extends over a long period of time, if I do get worse, that it will have a similar effect on my other eye, because I only have one eye to depend on.”
Responding to Al Jazeera’s request for comment over Khan’s concerns, a spokesperson for Moorfields Eye Hospital said: “We continue to provide a full range of urgent and emergency eye care services around the clock for anyone concerned about their sight. All changes to appointments are being made on the basis of a thorough medical assessment; our doctors and nurses have reviewed each person’s case to ensure they are not being put at risk.”
Last month, amid growing concerns over the coronavirus epidemic, NHS England said millions of non-urgent elective operations would be cancelled for a minimum of three months from April 15, to relieve pressure on the health system and aid the transfer of staff to the front lines of the pandemic.
There's nothing in place, as far as I know, for after the coronavirus that's going to keep up with the demand that's going to be there.
Every month across the country, 700,000 elective general and acute admissions are made.
In a letter addressed to GPs and hospital leaders in March, chief executive of the NHS, Simon Stevens, said emergency surgery and cancer operations would continue “unaffected”.
But non-urgent operations, such as hip and knee replacements and cataract operations, would be cancelled under the new measures to free up 30,000 hospital beds for COVID-19 patients.
However, it is not just routine non-urgent operations that have been impacted.
Hospitals are widely believed to breeding grounds for coronavirus and according to Cancer Research UK, 2,300 people a week with symptoms of suspected cancer are being left undiagnosed as patients avoid hospitals and as some doctors are reluctant to make hospital referrals.
Now that around 200,000 people per week are no longer being screened for bowel, breast and cervical cancer with screening services paused across the UK, there are concerns that more treatable early cancers could be left undetected.
Dr Amir Khan, a GP at The Ridge Medical Practice in Bradford, West Yorkshire, which oversees the care of 25,000 patients, said he was concerned.
“Before coronavirus, we were seeing about 30 patients a week with symptoms that aroused suspicion of a cancer, so we would then refer them via the two-week urgent referral pathway,” he said.
“They get seen by specialists, sorted, tested, diagnosed, or told that they don’t have cancer within two weeks.
“Since the coronavirus pandemic, we’re now averaging two to three cancer referrals a week, which really spooked me. I was thinking ‘God, where are all these people gone?’ Do they not want to burden us with what they might think are minor problems? Or are they worried of getting the virus if they leave the house?”
The British Heart Foundation has recorded a 50 percent drop in the number of people attending emergency departments in hospitals across England with symptoms of a suspected heart attack prior to COVID-19, from around 300 a day at the beginning of March, to 150 per day by the end of the month.
“There are a group of people with potentially worrying symptoms who are just sitting there, waiting for the pandemic to pass … then they come to us, and it may well be too late for any treatment to be effective,” Dr Khan said.
While he understands why routine procedures have been cancelled, Dr Khan has fears about a backlog of three to four months when the crisis eases.
“There’s nothing in place, as far as I know, for after the coronavirus that’s going to keep up with the demand that’s going to be there. They’re [the government] are not going to increase hospital capacity for routine works, and GP capacity for people who have been sitting on their ailments for a couple of months.
“Seeing more patients is not feasible. As it stands, 10 minutes per patient anyway is never long enough. GP numbers are already in crisis so we can’t employ more. Nobody knows what’s going to happen after this pandemic.”