Hospital trust becomes first in UK to cancel all routine cancer surgery amid coronavirus outbreak

Barking, Havering and Redbridge NHS Trust says decision made because of increase in number of seriously ill patients with virus

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An NHS hospital trust has become the first in the country to announce the postponement of all routine cancer surgery and chemotherapy due to a surge in coronavirus patients.

In a statement, Barking, Havering and Redbridge NHS Trust said "an increase in the number of seriously ill patients" diagnosed with Covid-19 meant planned cancer treatments would be delayed for at least two weeks.

Only the most "urgent" operations will be carried out, with endoscopy appointments also cancelled or delayed, a spokesman said.

It comes after NHS hospitals were advised to ration cancer services to patients with the highest chance of survival in the event of a major coronavirus outbreak.

Hospitals across the country have since begun telling individual cancer sufferers that their planned surgery or chemotherapy appointments have been cancelled until further notice.

Only two weeks ago, NHS England insisted cancer treatment would not be affected when it announced plans to suspend non-urgent procedures including knee, hip and cataract operations.

So far, three patients diagnosed with coronavirus have died at the two hospitals run by Barking, Havering and Redbridge NHS Trust.

In a statement on the Trust's website on Monday, a spokesman said: "We have made some further significant changes to keep our patients safe as we deal with Covid-19. This is because we are now seeing an increase in the number of seriously ill patients [who have tested positive for Covid-19] at our hospitals, which is only going to increase in the days and weeks ahead.

"Therefore, from today we are postponing all routine, planned surgery (including day cases and cancer operations) and stopping all outpatient appointments (including endoscopy and chemotherapy). This includes both face-to-face and telephone appointments.

"These measures will help us to protect our patients, including those with Covid-19, and those with other conditions. We will keep these changes under review. They will remain in place for at least the next two weeks. During this time, we will only carry out the most urgent operations."

Trusts across the UK are beginning to cancel cancer treatments for "a number of important and rational reasons", a senior NHS source told The Telegraph.

Health bosses are facing a lack of capacity, with intensive care wards requiring ventilators and other equipment to keep coronavirus patients alive. Meanwhile, cancer specialists are being re-trained in respiratory techniques so that coronavirus patients can be properly cared for.

There is also concern that cancer patients – and particularly those undergoing chemotherapy – are at substantially increased risk from the virus due to their weakened immune systems. 

People with underlying health conditions including specific cancers have already been urged by the government to stay at home "at all times" to avoid contracting the disease.

Cancer patients, however, spoke of fears that delays or cancellations to their treatment could put their lives at risk.

Claire Elliott, 51, from Worcestershire, said the proposed cancellations made her "feel like my life is not worth anything". Diagnosed with uterine cancer in 2016, she was given less than a year to live in 2018 but was told she had beaten the disease 10 months later.

The cancer has since returned and Mrs Elliott has been undergoing palliative chemotherapy, but the coronavirus pandemic is now set to interrupt her treatment. "It's a bit numbing, to be honest," she said. "I've been expecting it, but I'm a bit tearful. It makes me feel like my life is not worth anything."

Mrs Elliott said her consultant told her last week that a cancellation was possible. Her friends have been raising money via GoFundMe for her to have potentially life-saving treatment in Cyprus, but travel has been complicated by the pandemic.

"The chemo I have now is to shrink the tumour and stop it pressing on my abdomen," she said. "I was in pain, so that will recur at some point and the cancer will spread."

Earlier this month, NHS England told doctors to prepare for disruption due to staff sickness and shortages of drugs and equipment, although the guidance claimed disruption of cancer services remained an "unlikely scenario".

Hospitals were advised to group patients into "priority levels", according to how effective any planned treatment was likely to be. "If services are disrupted, patients can be prioritised for treatment accordingly,” the document says.

It warned that the frequency of treatments such as immunotherapy could be halved and long-term follow-up postponed indefinitely as staff are diverted to fight Covid-19.

Published by NHS England, the document also predicted that access to CT scanners – crucial for some cancer diagnoses – could be limited because of their use by coronavirus patients.

Clive Peedell, an NHS consultant clinical oncologist at South Tees Hospitals NHS FOundation Trust, said: "The issue is patient safety. Cancer patients are generally older and in the highest risk group for Covid-19. We need to balance risks of treatment versus outcomes very carefully."