In March 2020 NHS England asked all trusts to postpone all non-urgent elective operations from 15/04/20, this was to free up all inpatient and critical care capacity for coronavirus patients. It was especially important to cancel all patients in the ‘vulnerable’ category as we needed to protect them from contracting the virus. Sadly, women having breast reconstruction fell into the non-urgent/elective group. It was decided that all breast reconstructions surgeries would be put on hold because the length of surgery/anaesthetic/recovery had an increased risk during the pandemic for the patient contracting COVID and/or needing an ITU bed after surgery (of which there was a major shortage). Women with breast cancer were to proceed with their cancer treatment only (wide local excision/lumpectomy/lymph node surgery/mastectomy).
As QVH is a stand-alone specialist unit with limited ITU beds, it was decided that QVH would become a ‘cancer hub’ for the South East. As such, we remained ‘COVID protected’. All patients coming to us for oncology surgery isolated pre-op and had COVID swabs. We accommodated 8 breast units from across the South East from Apr-Oct 2020 to enable them to operate on their breast, skin and head & neck oncology patients. We utilised the private hospital on our site McIndoe for trauma patients to ensure the possibility for patients/staff contracting COVID was minimised as much as possible.
QVH were able to start again with immediate reconstructions in July 2020, followed by ladies in the next priority groups such as removal of painful implants/delayed reconstruction etc. from August 2020. Sadly, due to the second wave we became a cancer hub once more in Jan 2021 and many of our operating lists were utilised by the visiting 9 breast units for their oncology surgery. Delayed reconstruction was put on hold again, but we were able to continue with some immediate reconstruction and risk-reducing surgery.
We hope to be able to restart our delayed reconstruction waiting list in April 2021, but it will very much depend on the ever changing COVID pandemic and how long visiting breast units need to utilise our theatre capacity for.
Pam & Rebecca x
Macmillan Breast Reconstruction Nurse Specialists
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