Cancer operations hit at major hospital trust amid 'catastrophic' risk of being overwhelmed by COVID

Emily Cleary
·4-min read
An ambulance outside an entrance to Southend University hospital in Essex. Hospitals in the county have declared a major incident and local authorities, concerned about the number of Covid-19 cases, have asked for military help to increase hospital capacity, with fears over critical care, bed capacity and staff sickness. (Photo by Joe Giddens/PA Images via Getty Images)
Mid and South Essex Foundation Trust has rated the “cancellation of cancer elective activity” at its highest risk level of 25 – which based on their own risk-scoring key is “catastrophic” (Joe Giddens/PA Images via Getty Images)

A hospital trust has warned the rapid rise of COVID cases in the area has put its ability to deliver a safe service to patients at “catastrophic” risk.

Minutes from a board meeting of the Mid and South Essex Foundation Trust, first reported by the Health Service Journal, say the risk due to the impact of coronavirus “has increased due to the rapid rise in community prevalence”.

The trust, which runs three major hospitals across Essex and serves a population of more than a million people, warned in its “January update” on Thursday that it is struggling to cope with the number of staff absence due to sickness and self-isolation.

Two of its hospitals have even had to suspend life-saving cancer operations in the past month, according to the HSJ.

It also warned COVID-19 patients occupy more than 50% of beds – and that the proportion is rising daily.

In the minutes, the board says the risk posed by COVID-19 has risen to its highest possible level – 25 – which has impacted non-emergency treatments including the “cancelation of cancer elective activity”.

A score of 25 means the likelihood of a “catastrophic” impact is almost certain (see the chart below).

A catastrophic impact can lead to permanent disability or death; serious irreversible health effects; or an inability to return to work.

Mid and South Essex's risk-scoring key ranks level 25 as  a 'catastrophic' risk to the lives of patients (MSEFT)
Mid and South Essex's risk-scoring key ranks level 25 as a 'catastrophic' risk to the lives of patients (MSEFT)

The minutes reveal that at Southend Hospital, a “huge surge in COVID positive admissions” resulted in cancer surgery ceasing on 24 December, although the system now has access to independent sector hospitals to deliver some cancer surgery.

At Mid Essex Hospital, a sudden influx of cases just before Christmas resulted in the cancelling of some cancer surgeries. The minutes also reveal that “elective work” was “dramatically impacted” with a “short period of life and limb only carried out on site”.

At the end of December hospitals in Essex declared a major incident due to COVID-19 and local authorities, concerned about the number of COVID-19 cases, asked for military help to increase hospital capacity.

The minutes recognise a “failure to deliver a high quality, safe service for our patients due to the outbreak of COVID-19 and failure to protect our staff from infectious disease transmission”.

“The risk due to the impact of COVID-19 on our healthcare provision has increased due to the rapid rise in community prevalence,” it said.

SOUTHEND-ON-SEA, ENGLAND - MAY 28: Medical staff attend the clap for carers at the Southend University Hospital on May 28, 2020. For 10 weeks, the public have applauded NHS staff and other key workers from their homes at 8pm every Thursday as part of "Clap for Our Carers". Annemarie Plas, the founder of the campaign, has now called for an end to the new tradition, suggesting that an annual clap should take its place. (Photo by John Keeble/Getty Images)
Southend University Hospital has been hit by staff shortages as workers are off sick or having to self-isolate (John Keeble/Getty Images)

“The number of COVID-19 admissions has increased markedly over the last month despite the mitigating actions being taken by the Trust and system partners and the support from Region.

“COVID-19 patients occupy more than 50% of our bed-base and the proportion is rising daily.

“Our ICU capacity has been increased but this expansion will ultimately be limited by the maximum oxygen supply and the availability of staff.

“We are struggling to maintain staffing levels despite use of bank, agency and redeployment.

“The number of staff absent due to sickness or self-isolation has increased. Non-emergency activity has been postponed and backlogs of patients waiting for care will inevitably develop.”

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In December the Mid Essex hospital agreed “legal undertakings” with NHS England for breaches against its provider licence in five areas. Two of these include “delayed diagnosis and treatment of cancer patients” and “growth in elective backlog”.

Each individual hospital site, which operated as separate trusts until they merged into one single trust in April 2020, have had a history of poor performance in both these areas.

Clare Panniker, Chief Executive of Mid and South Essex NHS Foundation Trust, told Yahoo News UK: “Coronavirus has clearly put significant pressure on NHS services, but any patients whose cancer treatment is urgent have received that care, and many patients – including 125 people this week – are getting their treatment through the independent sector instead, while those who have had their treatment postponed will get it the coming weeks and are being supported by clinicians.”.

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