Coronavirus: Weekend surgery as hospital backlog blows out

Hospitals are facing the prospect of scheduling operations in the evenings and on weekends as waiting lists blow out.

Hospitals are facing the prospect of scheduling operations in the evenings and on weekends as waiting lists blow out as a result of elective surgery suspensions.

Australian researchers who contributed to an international collaborative that examined surgery blowouts because of COVID-19 have estimated that more than 67,000 elective operations were postponed in the six weeks that all non-urgent surgery was suspended in Australia.

The COVIDSurg Collaborative said hospitals would need to increase operations following the resumption of surgery — not possible for many hospitals without taking extraordinary measures to clear the backlog.

Surgeon Peter Pockney, a member of the organising committee for the COVIDSurg project, said Australian hospitals may have to follow the approach of the NHS in Britain between 2000 and 2010 to clear waiting lists.

“Between 2000 and 2010 the NHS was putting a great deal of ­effort into reducing waiting lists. Lists were really quite bad at the beginning of that period, and they were very, very good at the end of that period,” Dr Pockney said.

“The NHS was commissioning work on weekends in its own hospitals, paying people overtime and using time in the operating theatres when they would not ordinarily be used.

“It was commissioning surgery in the private sector, and the NHS was also building prefabricated operating theatres, the sort of things the army uses.

 

“That’s how you’re going to have to go about clearing these waiting lists in Australia. Evenings and weekends will have to be utilised, the physical space used outside of hours and staff asked to do more. But all of that will have to be resourced.”

The federal government gave the green light late last week for all elective surgery to resume in Australia, after suspending non-­urgent cases six weeks ago to free up space in hospitals and preserve personal protective equipment. South Australia has now resumed all elective surgery, Western Australia and Victoria will allow 50 per cent of operations to resume, and other states are planning to ramp up surgeries in coming weeks.

But with many cases still to be suspended in several states for several weeks to come, waiting lists are continuing to grow.

Even before COVID-19 hit, public hospitals in Australia were overstretched, with the number of people added to waiting lists for elective surgery each year outstripping the number of operations performed.

According to the latest figures from the Australian Institute of Health and Welfare, 890,000 ­patients were added to public ­hospital elective surgery waiting lists nationally during 2018-19, while only 760,000 people were admitted for surgery during that period.

The number of patients in surgery has increased from 698,000 five years ago. Half of all patients waited at least 41 days for ­admission in 2018-19, up from 35 per cent five years earlier.

Dr Pockney said orthopaedic surgery was one of the areas of elective surgery hardest hit by the COVID-19 suspensions.

“I think in specialities which are essentially mostly elective, like ­orthopaedics, the backlogs are very significant,” he said.

“They’ve lost a couple of months of work and it will take them a few weeks to even get back up to normal volumes of work.

“So more people will be on the waiting list, more people will be postponed and that work will still need to be done.”