Covid-19 Elective Guidance Issue 1: April 16th 2020

Management of Elective Patients

The national situation created by the Covid-19 virus has been a huge challenge for our healthcare system. The effective cessation of treating elective patients was originally thought to be a temporary solution to allow elective capacity to be repurposed to treat Covid-19 patients.

Increasingly, as time passes more proactive leaders are turning their thinking to what happens to these patients that have been delayed or cancelled whilst remaining on a national waiting list of over 4.5m. Royal Colleges have issued guidance for clinically reviewing urgent conditions and regions are beginning to think about a plan for the treatment of urgent Cancer patients.

However, it is important to realise that we are many months away from stable treatment levels of elective patients. Cancers and other high-risk conditions such as Stroke and Cardiac cases will need to be prioritised. Staff who have been working round the clock on Covid-19 will need to take time off to rest. Action is therefore needed now to manage elective patients during this prolonged period.

Most hospitals have seen their activity plans change with the removal of elective cases. There are undoubtedly significant numbers of clinical and administrative staff not dealing with Covid- 19 directly. We need to be talking about how we can use these staff to manage the risk of elective patients deteriorating.

We have set out some of the specific actions to take now, which will manage the risk and ensure that patients are safe and available for treatment when elective activity resumes.

Practical Steps to Follow

We believe there are 5 high-priority areas that need to be implemented now. Further steps may be needed as the situation develops.

MBI have been helping hospitals manage the risk on their waiting lists and have set out the 5 areas all hospitals should be implementing now along with specific actions to take in relation to each area.

These actions will allow patients to be managed as safely as possible, but also allow hospitals to come out of the crisis in the best possible manner with regard to its elective patients - representing the vast majority of the patients hospitals treat.

Although this is a situation that has not been faced before, it is imperative that standard processes are agreed and put in place as soon as possible. We have witnessed huge variation in the ways the clinical and operational teams are contacting, updating and tracking patient information.

Underpinning these processes with technology that makes it easy to track all of these virtual contacts in one place is critical.

Whilst trying to do the right thing by contacting patients, there is a risk that a lack of a standard way to update records and track these contacts could potentially make the situation worse and provide unnecessary worry to patients.

Practical steps to take now to manage elective patients