Top surgeon warns of time bomb as more operations are cancelled

Mark Taylor, a consultant surgeon who works in the Royal Victoria Hospital in Belfast, has warned in an interview with the News Letter that the redeployment of staff to critical care beds and covid wards will only exacerbate the long waits endured by patients for surgery — already the worst waiting times in the UK.

Mr Taylor, the Northern Ireland director of the Royal College of Surgeons and a member of the expert panel which in 2016 submitted radical proposals to reform the health service, also suggested the health service has been “overwhelmed” with those waiting for planned treatment missing out.

“A real casualty in all of this, and I have no doubt you and I will be talking about this in the next quarter when the waiting time statistics are made available, are the people with the hernias, the people that need a hip, the people with arthritis, the people with a back problem requiring surgery on their spine, the people with the lump on their breast that’s benign,” he said.

“Whatever surgery they are waiting for on those horrendous waiting lists — they are going to be waiting longer.”

A series of procedures have already been cancelled this week by the Southern Trust at Craigavon Area hospital so that intensive care capacity can be increased, while the Belfast Trust was earlier forced to postpone procedures for more than 100 cancer patients.

Health Trusts have now started putting into place ‘surge plans’ to deal with the influx of coronavirus patients.

Mr Taylor explained: “Surge planning is essentially saying what we do when the number reaches a certain amount in terms of critical care. What’s the action?

“One of the actions this week was to ask the system to come up with 120 critical care beds. What does that mean in a practical sense?

“Trusts throughout Northern Ireland were asked to come up with additional beds in critical care, and the Nightingale was upscaled. There is a major workforce issue there.

“The people that are going in to staff those beds are coming from the operating theatres. Our theatre nurses are being redeployed. Our ward nurses are being redeployed. Our junior doctors are being redeployed.

“That automatically cancels surgery.

“If you think back to the first wave we were managing covid but there wasn’t a lot of operative activity.

“We’ve absolutely seen the impact of that on the waiting lists.”

Asked if that situation is happening again, he said: “Absolutely.” He continued: “What happens in any health system is that the sickest patients get the treatment.

Asked if the health service is already at the point of being overwhelmed, Mr Taylor said: “In essence, if you look at the health service as being the service dealing with covid, the service dealing with urgent and emergency care, and the planned service, then the system is overwhelmed at the moment.”

WAITING TIMES IN CRISIS ALREADY

Northern Ireland’s waiting lists were already the worst in the UK even before the coronavirus pandemic.

In January, Health Minister Robin Swann described the situation as an “emergency” with 305,017 waiting for their first appointment with a consultant.

Of those, 108,582 were waiting over a year.

In February, leaked NHS data showed that rheumatology patients were being forced to wait more than five years.

After the first wave of the pandemic, the number of patients waiting more than a year had grown to 136,666 by June 30 — 40% of the total number of patients on the waiting list by that time.

During the three months leading up to June 30, the number of consultant-led outpatient appointments carried out was 41,500 — less than half the total from the year before.

‘Covid-light’ centres could offer a solution

Surgical centres kept apart from the hospital areas where coronavirus patients are treated could offer a possible solution to the waiting list crisis, Royal College of Surgeons Northern Ireland director Mark Taylor has said.

But the top surgeon has also warned that it could be weeks before health staff are available to work in them due to the severity of the situation in the hospitals at present.

Mr Taylor had called for the establishment of so-called covid-light centres several months ago, as plans were being put in place to deal with a second wave of cornavirus.

But he has said the pressures on staffing are now so severe there is a “snowball’s chance” of that happening any time soon.

Back in August, Mr Taylor said: “We must prioritise setting up Covid-light sites so that surgery can continue through any further spike.”

Speaking to the News Letter this week, he said “The elective care centres, or the covid-light centres — these sites could be working seven-days a week and able to continue doing the work no matter what is happening, rain, hail sleet or snow.

“I have made a call about the need for covid-centres and the Minister has accepted that. But given the numbers that are there at the moment there is a snowball’s chance of that getting up and running. That is fanciful thinking.”

He continued: “But if it [the situation with coronavirus] has plateaued, and the numbers continue to fall and the lag period is accounted for, then staff will be redeployed back out of those covid environments.

“While it’s fanciful as we sit today, if there is less of a burden on the health service, it could be explored in four, five, or however many weeks.

“It needs to be really explored after this when there is that time of recovery.”

Mr Taylor, also issued an appeal to the public to “batten down the hatches” and regain the communinty spirit from the first wave of the pandemic.

“What’s different about this second wave — well, we’re all tired,” he said.

“The added component, this time, is that the healthcare staff are really tired, they’re really worn ou.

“Basically, we know the messages on public health so let’s just batten down the hatches.”

He continued: “The Colleges are really worried about the pressure on the system and that could get worse.

“Every action should be taken that can mitigate Covid coming into the hospitals to allow some chance of getting through the winter, and trying to continue time-dependent surgery.”

A message from the Editor:

Thank you for reading this story on our website. While I have your attention, I also have an important request to make of you.

With the coronavirus lockdown having a major impact on many of our advertisers - and consequently the revenue we receive - we are more reliant than ever on you taking out a digital subscription.

Subscribe to newsletter.co.uk and enjoy unlimited access to the best Northern Ireland and UK news and information online and on our app. With a digital subscription, you can read more than 5 articles, see fewer ads, enjoy faster load times, and get access to exclusive newsletters and content. Visit https://www.newsletter.co.uk/subscriptions now to sign up.

Our journalism costs money and we rely on advertising, print and digital revenues to help to support them. By supporting us, we are able to support you in providing trusted, fact-checked content for this website.

Alistair Bushe

Editor