Covid-19 has had a major impact on planned care services across West Yorkshire and Harrogate. During the first peak of the pandemic, health services had to take the difficult decision to temporarily stop carrying out most planned care procedures. This was done to keep both patients and staff safe whilst services focussed on treating patients who had contracted the virus.
Things are far from being how they were before Covid-19 but planned care services that were temporarily stopped have restarted gradually and in the safest possible way for patients and staff. The following information gives an update on the current situation with planned care in West Yorkshire and Harrogate.
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Planned care is also known as ‘elective’ care. It is treatment that people decide to have to help manage a health problem, rather than emergency treatment for an urgent medical condition, or following a serious accident for example. People are usually referred for planned care by their GP or another healthcare professional.
Planned care covers many different medical procedures including joint replacements and cataract surgery. It also includes diagnostics which are tests that are carried out to detect diseases such as cancer and other serious medical conditions.
Most planned care procedures are done as day cases, where patients leave hospital on the day of the procedure. Sometimes patients have to stay in hospital overnight or a bit longer if necessary.
During the first peak of the Covid-19 pandemic, health services had to take the difficult decision to temporarily stop carrying out most planned care procedures. This was done to keep both patients and staff safe whilst services focussed on treating patients who had contracted the virus.
However, some planned care services did not stop at all throughout the initial outbreak. Our six hospital trusts in West Yorkshire and Harrogate prioritised demand for tests to diagnose conditions that required urgent treatment, including cancer.
Cancer care and treatment in hospital has been happening throughout the pandemic and will continue to take place as long as it is still safe to do so.
Our local health services have worked incredibly hard to respond to the pandemic since the beginning of 2020 and the public’s support for the NHS and colleagues has been outstanding. Planned care services that were temporarily stopped have restarted gradually and in the safest possible way for patients and staff.
The aim is to carry out as many necessary and appropriate planned care procedures (treatments and tests) as possible between now and winter when additional viruses, such as the winter vomiting bug (norovirus) and flu may occur. High numbers of such cases could affect the ability of health services to carry out planned care procedures.
If you’re due to have a planned care procedure but it’s been delayed, we know how distressing this can be, not only for yourself but for your family or carers. We are doing all we can to balance the need to carry out planned care procedures with the ongoing need to keep patients and healthcare staff safe from Covid-19.
Safety for patients and staff is essential so services cannot simply go back to how things were done before the pandemic.
Social distancing and additional infection prevention measures mean that fewer people can be treated in hospital theatres or seen in outpatient departments each day. Staff availability is also a factor. Many healthcare professionals have gone from planned care services to look after patients who have the virus. In addition, some staff members are off work due to sickness or shielding which also reduces the capacity to treat planned care patients.
All these factors, along with the approaching flu season and the impact of local and national restrictions, are affecting planned care services. This is why it’s so important that we use services wisely and make sure that all planned care procedures meet people’s needs and are appropriate for each person.
To be able to carry out as many necessary and appropriate planned care procedures as possible, we are making the best possible use of the resources we have. This includes facilities and staff in NHS hospitals and in the private hospitals of the independent sector.
The reality is that capacity for planned care procedures is limited and will be for the foreseeable future. We continue to be focussed on delivering the best care possible with the resources we have to make sure care is available for those in need.
It’s important to note that most planned care is managed locally in our six places across West Yorkshire and Harrogate which are: Bradford District and Craven; Calderdale; Harrogate; Kirklees; Leeds; and Wakefield. For all six places, the main priorities at this time are to treat Covid-19 patients and to carry out diagnostic tests and treatments for cancer and other urgent conditions that cannot wait.
If you’re waiting for a planned care procedure, your case will be prioritised based on clinical urgency, not on how long you’ve been waiting. For example, if you need a test for cancer, or if delaying surgery would cause you harm then you’ll be prioritised ahead of less clinically urgent but longer waiting patient.
If you’re offered an appointment for a planned care procedure, you’ll have your case reviewed before going ahead to see if your needs have changed. For example:
If you have to wait longer, you should be reassured that you will get a planned care procedure at some point, if it’s clinically appropriate and the right thing for you. If you decide that you still want to have a procedure, then you will be supported while you wait.
Hospitals are continually reviewing the case of every patient who is on a waiting list for planned care. This is to make sure that patients in greatest clinical need are treated first. Once your review has taken place, you’ll be contacted by the hospital. This could be by letter or telephone call.
You may have already been contacted but if you haven’t, please bear in mind that reviewing the case of every patient is a huge process so for most patients, it will take some time. When you are contacted, you’ll be told if your case has been assessed as clinically urgent, or if you will need to wait longer for your planned care procedure.
If you are assessed as clinically urgent, you’ll be given details of any appointments you need to attend (on the phone or in person) along with any other relevant information you may need. You’ll also be given details of any Covid-19 testing requirements, to make sure that you don’t have the virus so that your treatment in hospital can go ahead.
If you’re told that you’ll need to wait longer for your planned care, you’ll also be told how you’ll be looked after until you can have your procedure. You’ll be given details of who to contact if your condition gets worse or improves whilst you’re waiting, or if you’re experiencing any other health condition that may affect your suitability to have the procedure.
A few weeks before you’re due to go into hospital, your GP or the healthcare professional who will carry out the treatment will talk to you about the procedure.
This consultation may take place over the phone or online rather than in-person to limit the number of non-essential visits to hospital. If a physical examination or test is required, you may be asked to go to hospital where all precautions are in place to keep you safe.
Your healthcare professional will ask you what health improvements you want, or expect to get, from having the procedure. They’ll explain any advantages and disadvantages of having the treatment and any risks associated with delaying treatment, if relevant.
This stage in the planned care process is known as ‘shared decision-making’ because it allows you and your healthcare professional to decide together if the procedure is the best option for you. It’s really important that you’re prepared for this shared decision-making discussion, so you don’t end the conversation feeling confused or unsure. If you need to make a decision about your care, it’s a really good idea to ask your healthcare professional these three simple questions:
Once you have all the information you need, you’ll be able to make the decision with the support of your healthcare professional. You may decide to go ahead with the procedure as planned or postpone it for now. It could be that postponing the procedure is safer for you, or that it’s more likely you’ll have a better outcome from having the procedure at a later date.
If you do decide to go ahead with the procedure, you may be asked to self-isolate at home for a period of time before going into hospital. You should self-isolate if you’re at greater risk of getting Covid-19, or of having a poorer outcome from the procedure if you do get the virus. Anyone who lives with you may also need to self-isolate, to help protect you in the run up to your procedure.
If you’re in one of the following groups, you may be at a higher risk of getting the virus and of it having a negative impact on the outcome of your planned care procedure. As part of the shared decision-making process, your healthcare professional will also discuss such risk factors with you, if relevant.
You may be offered a Covid-19 swab test a few days before you go into hospital to make sure that you’re not carrying the virus. If you are suspected or confirmed to have the virus, your planned care procedure will only go ahead if it’s urgent and only with your consent.
If you’re about to undergo a planned care procedure, the following links offer really good advice to help you get ready for your surgery:
At this time, the risk of getting Covid-19 from anywhere cannot be totally eliminated but if you do need to go to hospital, you should not worry. Hospitals are taking all necessary precautions to manage the risk from Covid-19. Patients are tested for the virus and those who test positive, or who have symptoms, are treated in separate units or areas.
When you go into hospital, you may be asked to wear a face mask or other type of personal protective equipment. Most staff will be wearing some type of protective equipment too which could be a mask, a visor or goggles, a plastic apron or full coveralls.
Extra infection prevention measures are in place throughout hospitals and these measures include regular deep cleaning of all areas. More time between procedures in an operating theatre allows for sufficient air changes to avoid infection between patients. Social distancing measures are also in place so there will be more space between you and other patients while you recover. These measures are all essential to help minimise risk but having them in place does mean that the number of people that can be treated each day is reduced.
If you’re going into hospital, you’ll be asked to go alone as long as you don’t need support from a relative or carer. Most inpatients, those staying in hospital overnight or longer, want to have visitors but it’s unlikely that this would be possible. Any visitors allowed, in exceptional circumstances, would need to wear face coverings and follow social distancing guidelines to help keep other patients and hospital staff safe.
Before Covid-19, most patients had different options for where they could go to have their planned care procedure. The continuing need to treat patients who have the virus means that there isn’t the same hospital capacity as before which means that patient choice is limited at this time.
We know that people usually want to be treated as close to their home as possible. Health services will do all they can to make sure that is the case but you may be given the option to have your procedure elsewhere within the West Yorkshire and Harrogate area. This could mean that you’re treated sooner than if you had to wait until capacity was available at your nearest or chosen hospital.
If travelling further from home is a problem, Yorkshire Ambulance Service (YAS) may be able to take you to and from hospital if you have no other option. If you have a medical condition or mobility issue that is so limited, it could stop you from getting to your hospital appointment by any other means, then you would be eligible to access this service.
More information about transport options and how to book a journey can be found on the Patient Transport section of the YAS website. Or you can book patient transport by calling: 0300 330 2000
Further outbreaks of Covid-19 or a surge in winter illnesses could result in high numbers of people requiring hospital admission and impact once again on planned care. It is for this reason that services cannot be specific about how much longer individuals will have to wait for their treatment.
If you’re not assessed as being in urgent clinical need of a planned care procedure, because treatment can wait without causing harm, you may need to wait longer than expected but you will be kept up-to-date throughout your wait.
If this is the case for you, your hospital trust will give you details about how you’ll be looked after whilst you’re waiting, and any other relevant information you may need. You’ll also be given details of who to contact if your clinical circumstances change. For example, your condition could get worse whilst waiting in which case you’d need to be reassessed. Or you may see an improvement in your condition as time goes on and decide, along with your healthcare professional, to cancel having the procedure. This would free up capacity for someone in greater need to have a procedure.
We know how difficult it can be to have to wait even longer for treatment but there are safe and effective alternatives to hospital care that can help you manage your condition from home. Your healthcare professional will be able to discuss these alternatives with you.
Personalised care is all about what matters most to people and their individual circumstances. We know from talking to patients that a ‘one size fits all’ approach does not work well and that most patients welcome the opportunity to have more control over their own health and wellbeing.
If you have to wait longer for a planned care procedure, there will be a self-care approach that works for you – a way of managing your health condition that temporarily meets your needs and fits in with your lifestyle. The information and advice you’re given to help you manage your condition at home will help you look after your physical and mental health while you wait for treatment.
This section 'Support for people who are waiting for a planned care procedure' looks at the practical steps and the support available to help you manage your health condition while you wait for a planned care procedure.
The guidance can also help you to prepare yourself for having that procedure.
Page 19 of our Coronavirus engagement report for stabilisation and reset details a poll carried out by the Health Foundation which asked about people’s experiences of using healthcare services during the initial national lockdown. The majority of people who took part in this poll said they had decided not to use healthcare services because of concerns about being exposed to Covid-19 but some felt that their condition ‘wasn’t serious enough’ to seek medical help.
On 9 October, NHS England and NHS Improvement, together with Public Health England, launched its latest phase of
‘Help Us, Help You’. This campaign aims to reassure patients that the NHS is still here to help and has adapted services in order to see people safely. We’re supporting this campaign and have produced two short films to help reassure you that essential health and care services are still available should you need them.
In this video, Dr James Thomas details the types of urgent symptoms people should be aware of and how to get those checked out as soon as possible.
In this video, Dr Bryan Gill reminds people that the NHS is still here for serious illnesses and injuries and provides reassurance that Covid-19 safety measures are in place in all GP practices and hospitals.
Suspected cancer
Although the NHS treated around 85,000 people for cancer during the initial national lockdown, one in ten people said they wouldn’t seek medical help even if they thought something was wrong.
If you have a symptom that could be cancer such as a new mole, unexplained blood that doesn’t come from an obvious injury, an unexplained lump, weight loss which feels significant to you, or an unexplained pain that doesn’t go away, you should contact your GP as soon as you can.
If your GP thinks that cancer is a possibility, they will refer you to hospital for further investigation and it’s so important that you attend, to get the tests you need.
You should not worry about attending hospital to be tested. All Covid-19 measures are in place to make sure that tests are carried out safely. Finding cancer early makes it more treatable so if it does turn out to be cancer, treatment can be planned to give you the best chance of a good outcome.
Other health conditions
At this time, it can be hard for people to know what to do if they're unwell but it’s very important to seek medical help if you need it. This applies to everyone, not just those who are waiting for a planned care procedure.
We’ve provided this information about the different healthcare services available to help people who suddenly fall ill, get injured or have a pregnancy concern to use the most appropriate service for them.
We want to hear about your experiences, your thoughts and any questionsMany organisations have been listening to people’s experiences of services during the pandemic. We have collated some of them here.
We want to continue to hear what you think about planned care services, and the information you might need to help you stay healthy and know how to access a service when you need to.
Please share any experiences of planned care services you may have. We’d like to hear your thoughts around planned care services restarting and we’d be happy to answer any questions. Your feedback will help us review planned care services as we go forward.
You can contact the planned care team via email to: wyhhcp.
If you ring us, your details will be taken by one of our call handlers so that your comments or enquiry can be forwarded to the most appropriate person. That person will then ring you back at a time to suit you - if you’re happy for them to do so.
If you do get in touch with us, by any method, please be reassured that your personal details, questions, comments or stories will be treated in total confidence and nothing will be shared or published without your consent.
We look forward to hearing from you.