Huge backlog of operations mounting up

28 million elective operations cancelled worldwide

Patients know that they have to wait patiently before they are likely to be seen and that their condition is likely to only get worse in the meantime. GPs are getting increasingly creative around trying to ensure that the most critical of their patients will get to the top of the list to see a specialist as soon as theatres return to normal. However, many surgeons are forecasting a massive backlog for most routine operations. According to the British Journal of Surgery article on elective surgery cancellations, all told over twenty eight million elective operations could be cancelled as a result of the pandemic.

The study was led by CovidSurg Collaborative members based in the United Kingdom, Benin, Ghana, India, Italy, Mexico, Nigeria, Rwanda, Spain, South Africa, and the United States.

The CovidSurg Collaborative has projected that, based on a 12-week period of peak disruption to hospital services due to COVID-19, 28.4 million elective surgeries worldwide will cancelled or postponed in 2020. Each additional week of disruption to hospital services will be associated with a further 2.4 million cancellations.

Huge waiting lists

Led by researchers at the University of Birmingham, researchers collected detailed information from surgeons across 359 hospitals and 71 countries on plans for cancellation of elective surgery. This data was then statistically modelled to estimate totals for cancelled surgery across 190 countries.

The researchers project that worldwide 72.3% of planned surgeries would be cancelled through the peak period of COVID-19 related disruption. Most cancelled surgeries will be for non-cancer conditions. Orthopaedic procedures will be cancelled most frequently, with 6.3 million orthopaedic surgeries cancelled worldwide over a 12-week period. It is also projected that globally 2.3 million cancer surgeries will be cancelled or postponed.

Half a million cancelled operations in the UK

In the United Kingdom, the National Health Service advised hospitals to cancel most elective surgeries for 12 weeks. It is estimated that this will result in 516,000 cancelled surgeries, including 36,000 cancer procedures. These cancellations will create a backlog that will need to be cleared after the COVID-19 disruption ends.

If, after the disruption ends, the NHS increases the number of surgeries performed each week by 20% compared to pre-pandemic activity, it will take 11 months to clear the backlog. However, each additional week of disruption will lead to the cancellation of an extra 43,300 surgeries, significantly extending the period it will take to clear the backlog.

Mr Aneel Bhangu, BirminghamMr. Aneel Bhangu (pictured), consultant surgeon at the NIHR Global Health Research Unit on Global Surgery at the University of Birmingham says:

“During the COVID-19 pandemics elective surgeries have been cancelled to reduce the risk of patients being exposed to COVID-19 in hospital, and to support the wider hospital response, for example by converting operating theatres in to intensive care units".

He goes on to say:

“Patients' conditions may deteriorate, worsening their quality of life as they wait for rescheduled surgery. In some cases, for example cancer, delayed surgeries may lead to a number of unnecessary deaths.”

His colleague, Dr. Dmitri Nepogodiev, Research Fellow at the NIHR Global Health Research Unit said: 

“Each additional week of disruption to hospital services results in an additional 43,300 surgeries being cancelled, so it is important that hospitals regularly assess the situation so that elective surgery can be resumed at the earliest opportunity.

“Clearing the backlog of elective surgeries created by COVID-19 will cost the National Health Service at least £2 billion. The Government must ensure that the NHS is provided with additional funding and resources to ramp up elective surgery to clear the backlog.”

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