One of the NHS’s biggest hospitals has had to cancel urgent cancer surgery this week because so many of its intensive care beds are occupied by Covid-19 patients.
King’s College hospital in south London called off all “priority two” cancer operations it was due to perform on Monday and Tuesday. They are procedures that cancer specialists have judged to be urgent and need to be done within 28 days of the decision to undertake them.
The postponement has raised concerns among staff at the hospital, who fear that some of the patients affected may see their cancer spread or become inoperable as a result.
Staff and patients were told over the weekend about the delay, which has been forced on the hospital because so many of the beds in its intensive care unit are occupied by people seriously ill with Covid. Some cancer patients need to spend time in ICU after their surgery, and operations cannot go ahead unless the hospital has enough beds for that.
When told the news, patients were upset and concerned about how the cancellations may affect their health, as were their families, sources said. Some were “distraught”, they added. King’s is under such strain, with Covid hospitalisations in London rising rapidly, that it is unable to give patients a definite date in the future for their rescheduled surgery.
One member of staff said: “It’s important to do these cancer cases within four weeks because they’re urgent. If you put cancer surgery off for more than four weeks, that cancer can spread. [The delay can mean that] surgery may become inappropriate, because surgery can no longer get rid of the cancer, and thus the patient’s outcome may be worse.”
Some patients may be given chemotherapy as a temporary measure, to try to stop the tumour from growing before they have their rearranged surgery.
King’s College hospital confirmed it had cancelled priority two cancer operations. A spokesperson said: “Due to the large increase in patients being admitted with Covid-19, including those requiring intensive care, we have taken the difficult decision to postpone all elective procedures, with the exception of cases where a delay would cause immediate harm.
“A small number of cancer patients due to be operated on this week have had their surgery postponed, with patients being kept under close review by senior doctors.”
King’s is thought to be the first NHS hospital to cancel priority two operations as a result of the intense pressures on hospitals during the fast-deepening second wave of the pandemic. The Observer reported on Sunday that hospitals in the capital are so overwhelmed with Covid cases that NHS London bosses are poised to tell them to cancel cancer operations in order to concentrate resources on victims of the pandemic. Sir David Sloman, the boss of NHS London, said: “Urgent cancer surgery is not being cancelled in London.”
Sources at King’s said it was “unlikely” to be able to perform urgent cancer surgery on Wednesday, Thursday or Friday.
Cases
Many hospitals in England have cancelled surgery since the second wave began in September. But until now these have been elective – non-urgent – operations that usually involve less time-critical surgery such as cataract removals and hip and knee replacements, procedures that the NHS seeks to undertake inside 18 weeks.
Sara Bainbridge, a policy chief at Macmillan Cancer Support, said: “We still must make sure that cancer doesn’t become ‘the forgotten C’ during this time and it is imperative that people expecting tests and treatment face minimal disruption.
“However, if disruption is unavoidable to keep people safe, then cancer patients expecting to undergo surgery this week will be understandably concerned. This decision would represent one of the toughest choices that clinicians will ever make and is a grim indication of how overwhelmed many hospitals are becoming with Covid admissions.”
In another sign of the pressures on King’s, it has cancelled all leave that staff had booked for this week, blaming severe “operational pressures” due to its surge in Covid admissions.
Even staff who are booked to be on agreed leave this week as “compensation” for working over Christmas and new year are being asked if “they are able to postpone their leave and return to site”. The trust also runs the Princess Royal University hospital in Orpington, Kent.
It told staff that the situation it is facing may mean it has to cancel staff leave not just this week, but for all of January.
London, the south-east and east of England are the areas worst affected by the recent surge in Covid infections, which is being driven by the new variant.
The latest NHS England figures show the number of people in hospital in the capital with Covid reached a new peak of 5,524 on 30 December, even higher than the previous record of 5,201 recorded on 9 April, at the peak of the first wave.
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