The expensive conflict around post-pandemic surgery backlogs.
The crisis after Covid-19
At present, Covid-19 is a part of everyone's daily life. Wearing face masks, keeping distance and working from home have quickly become the new standard. Healthcare providers especially have been in the centre of the crisis since the outbreak. Hospitals must care for incoming Covid-19 patients, in addition to meeting a new challenge: Ensuring that patients receive much needed surgery.
Due to the pandemic, 5 million people in England alone are waiting for hospital care. Although the health service constitution promises that treatment will be provided within 18 weeks, there is a record high number of patients who have been waiting for surgery for over 1 year already.
Why is there such a huge surgery backlog?
During the first wave of Covid-19 in 2020, hospitals were forced to close their operation rooms and outpatient clinics. The surgical staff and nursing personnel were needed to treat patients with Covid-19 and to cover the extra beds. Furthermore, additional healthcare workers were required in order to replace personnel that had to self-isolate due to Covid-19 infection.
In addition to limited human resources in healthcare institutions, hospitals implemented guidelines and regulations for staff, patients and visitors with the goal to protect and keep everyone safe. However, implementation of these measures prolonged existing processes within hospitals. Unlike before, the preoperative phase for a patient preparing for surgery now includes Covid-19 testing and additional paperwork screening for potential exposure. Although less face-2-face meetings with the care personnel are happening, the workload overall has increased. Additionally, the patient potentially has to be isolated prior to the surgery, adding increased preoperative anxiety as an extra burden for the patient. Moreover, delays or errors in the patient preparation and patient testing for Covid-19 causes cancellations of scheduled procedures, leading to an empty operating room, and even still, more patients on the waiting list.
A recent study conducted by the COVIDSurg Collaborative - research group, led by the University of Birmingham, showed that patients waiting for elective surgery benefit from receiving the Covid-19 vaccination prior to the surgery as it reduces the risk of postoperative deaths caused by the virus. It is not recommended to receive the vaccination, however, and have surgery in the same week. This adds a layer of complexity to the preoperative period and imposes an additional challenge on the clinic and the patient.
Now that it is clear what is happening on the side of the clinics, why surgery backlogs have reached such enormous proportions, and why they continue to grow - let’s explore what is happening from the patient’s perspective.
What does surgical backlogging mean for patients?
Independent from the Covid-19 outbreak, patients suffering from illnesses or diseases that require surgical treatment are dealing with worries concerning their health and are having to find ways to cope with their daily life. The surgical backlog caused by Covid-19 has forced patients into even longer waiting periods for their much needed procedures. Patients do not receive treatment in a reasonable time, but are placed on surgical wait lists with hundreds, if not even thousands of other patients. For many, seeking treatment means having to live with pain and fear about their health. This can be an agonizing experience.
Let’s consider patients with severe osteoarthritis, for example who suffers from chronic pain, due to severely inflamed, often immobile joints, and who have difficulties overcoming daily challenges and participating in activities of daily living (ADLs). This kind of chronic pain has been shown to often lead to substance abuse and impaired psychological well-being. An orthopaedic joint replacement surgery relieves these patients of pain. For these patients, long surgical waiting times mean an extended time of suffering and living with pain.
When patients do not receive surgical treatment for their condition, they may experience worsening of their health, which may complicate their treatment further down the road. Patients are exposed to the risk of developing more serious illnesses and permanent disabilities caused by the unmet need for treatment.
In regards to cancer patients, the surgery backlog leads to patients not getting surgery quickly and the tumour is not removed in an early stage. Potentially the cancer may continue growing, and endanger the patient's life, while the surgery could simply solve the problem and provide relief. As a result of the long surgical waiting lists, cancer patients are fearing for their health and their lives.
In addition, the surgery backlog impacts the patient’s possibility of having a say in the treatment and the circumstances of the surgery. Many patients have to accept compromises as of having little choice of who is going to perform the surgery and where the surgery is completed. In consequence patients are more anxious and nervous before their procedure, and have to organize how to get to and from the clinic, which adds to their stress.
With the best interest of patients in mind, hospitals face a great challenge.
Recognition of the problem's magnitude.
As of now there is no end in sight to Covid-19. Different variants of the virus continue spreading. Frequently, patients with symptoms are in need of treatment in hospitals. The nursing staff and doctors are continuously exposed to stress and exhaustion. It is to see if another wave of Covid-19 forces hospitals to close their operating rooms and surgery departments again.
Hence, overcoming the record high number of patients on surgical waiting lists is going to take many years. Estimates from the UK say clearing the surgery backlog is going to take 3-5 years in the United Kingdom, and could cost up to £40 billion.
At this point of time, the current hospital processes will not be sufficient to deal with the enormous backlog of surgery.
Digital tools as solution to mitigate the crisis
Hospitals and clinics must start overthinking their current processes and available tools to create strategies responding to the long surgical waiting lists. The implementation and usage of digital tools, such as the BuddyCare solution, can fasten up the hospital processes via remote & automated patient data exchange, leading to shorter waiting times for patients and decreasing surgery backlog. Digital tools enable hospitals to provide their patients with the procedures they need in a timely manner.
Not only can patients be faster prepared for surgery but establishing a communication channel and providing reliable information to the patient helps to address the patient's concerns and misconceptions about the risks of infections and catching Covid-19. Patients want information easily accessible, transparent, and understandable. Better educated patients tend to be more compliant and move smoother through their care path. And more importantly, being properly informed reduces patients’ self-inflicted complications’ risks, which likely stem from inadvertent, self-injuring acts.
The BuddyCare platform is a solution supporting hospitals and clinics to digitally and remotely handle the care coordination of surgery patients. The existing hospital processes are improved and streamlined. The solution allows pre-op nurses and schedulers to provide patients with all necessary information and instructions remotely while collecting the patients’ data digitally. BuddyCare enables a Covid-19-free surgical pathway.
If you want to hear more about how the BuddyCare solution can support your hospital in solving the surgery backlog, please contact us and let’s schedule a meeting.