Restarting Elective Surgery

By Steve Dechan

The COVID-19 pandemic has had a particularly detrimental impact on elective surgery rates in the UK. However, while the elective surgery rates of many medical areas are beginning to improve, those of orthopaedics are still among the lowest. 

According to the British Orthopaedic Association (BOA), this reflects the low level of prioritisation afforded to orthopaedic surgery and the treatment of chronic pain conditions compared to the surgical treatment of other diseases by the NHS. This is a perspective they are campaigning for change on and a viewpoint I agree with entirely.

During the first phase of the pandemic, due to uncertainties and risk of infection, the NHS stopped non-urgent care and prioritised their low-surgical capacity for life and limb saving surgery. Essentially, all trauma and orthopaedic treatments for chronic disorders were postponed. In the second phase of the pandemic, from May to August, while NHS England set 70 percent restart targets for elective surgery, data shows that NHS England was well below that capacity, with only five out of 19 specialty areas achieving this. 

Throughout recent months, while operating capacity has remained low, surgery has continued to be prioritised in the same way as during the pandemic’s first phase, with low priority for long-term musculoskeletal conditions. 

The result of these failed attempts to return to normality is critical. The continuing delays to surgery have had wide ranging impacts on the mental and physical health of patients, with both deteriorating as the prospect of surgery appears more and more unlikely. Whether due to the impact of their injuries on their everyday lives, or the uncertainty of not having a date, the BOA has been extremely vocal on the damages of further postponements to patients, and from this, what has to be done to ensure it does not continue.

Today’s figures report the situation at the end of August and reveal that for trauma and orthopaedics, that over 24,000 people had been waiting over 1 year and 302,426 had been on the waiting list for over 18 weeks.

Alongside the BOA, I urge the NHS to look at orthopaedic surgery rates and make a concerted effort to reverse the chronic pain crisis in the UK including by use of innovative benefits for our healthcare workers.

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