Re-starting elective orthopaedic services in NHS Tayside during the COVID-19 pandemic

Peter S. E. Davies; Robert J. H. Sinnerton; Alasdair MacInnes; Alastair C. Faulkner; Peter D. Hutchison; Thomas S. W. Greensmith; Louise Roberts; Benedict Clift

doi:10.1016/j.surge.2020.10.002

Re-starting elective orthopaedic services in NHS Tayside during the COVID-19 pandemic

Peter S. E. Davies (Lead / Corresponding author), Robert J. H. Sinnerton, Alasdair MacInnes, Alastair C. Faulkner, Peter D. Hutchison, Thomas S. W. Greensmith, Louise Roberts, Benedict Clift

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

Abstract

Background: Elective orthopaedic operations were suspended at the start of the COVID-19 lockdown. Three pathways were created to allow patients to undergo urgent elective operations in NHS Tayside as soon as it was deemed safe to do so.

Methods: We examined elective orthopaedic activity in NHS Tayside during and immediately after the Scottish lockdown. Elective operations performed between 27 March 2020 and 10 August 2020 were included and compared with cases performed between 27 March and 10 August in both 2018 and 2019. Primary outcomes were 30-day mortality, 30-day complications, and nosocomial infection rates of COVID-19.

Findings: Fewer elective operations were performed in 2020 (258) compared with 2019 (1196) and 2018 (1261). The rate of nosocomial infection in the 2020 cohort was 0%. The 30-day mortality rate was 0%. Over 98% of patients agreed to undergo surgery after a detailed consenting process.

Interpretation: We were able to re-start a safe elective orthopaedic service in the early stages of recovery from the COVID-19 pandemic, compatible with the guidelines set by the Royal College of Surgery of England and the British Orthopaedic Association. Our findings will serve to reassure regions with sufficient resources that it is acceptable to restart elective surgery for urgent priority cases. They may provide a template for planned surgical care in the event of further pandemics.

Original language	English
Pages (from-to)	e230-e236
Number of pages	7
Journal	Surgeon
Volume	19
Issue number	5
Early online date	19 Nov 2020
DOIs	https://doi.org/10.1016/j.surge.2020.10.002
Publication status	Published - Oct 2021

Keywords

COVID-19
Elective
Orthopaedics
Pathway
SARS CoV 2

ASJC Scopus subject areas

Surgery

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10.1016/j.surge.2020.10.002

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title = "Re-starting elective orthopaedic services in NHS Tayside during the COVID-19 pandemic",

abstract = "Background: Elective orthopaedic operations were suspended at the start of the COVID-19 lockdown. Three pathways were created to allow patients to undergo urgent elective operations in NHS Tayside as soon as it was deemed safe to do so.Methods: We examined elective orthopaedic activity in NHS Tayside during and immediately after the Scottish lockdown. Elective operations performed between 27 March 2020 and 10 August 2020 were included and compared with cases performed between 27 March and 10 August in both 2018 and 2019. Primary outcomes were 30-day mortality, 30-day complications, and nosocomial infection rates of COVID-19.Findings: Fewer elective operations were performed in 2020 (258) compared with 2019 (1196) and 2018 (1261). The rate of nosocomial infection in the 2020 cohort was 0%. The 30-day mortality rate was 0%. Over 98% of patients agreed to undergo surgery after a detailed consenting process.Interpretation: We were able to re-start a safe elective orthopaedic service in the early stages of recovery from the COVID-19 pandemic, compatible with the guidelines set by the Royal College of Surgery of England and the British Orthopaedic Association. Our findings will serve to reassure regions with sufficient resources that it is acceptable to restart elective surgery for urgent priority cases. They may provide a template for planned surgical care in the event of further pandemics.",

keywords = "COVID-19, Elective, Orthopaedics, Pathway, SARS CoV 2",

author = "Davies, {Peter S. E.} and Sinnerton, {Robert J. H.} and Alasdair MacInnes and Faulkner, {Alastair C.} and Hutchison, {Peter D.} and Greensmith, {Thomas S. W.} and Louise Roberts and Benedict Clift",

note = "Funding Information: Stephanie A Davies ? Proof reading for spelling and grammar; Linda Johnston, Clinical Audit Manager ? Verification of data; Dave Ridley, Systems Developer ? Verification of data; Lorna O'Donnell, Clinical Audit and Research Nurse ? Verification of data; Sarah Keogh, Clinical Audit and Research Nurse ? Verification of data; Jennifer Scott, Clinical Audit and Research Nurse ? Verification of data. Publisher Copyright: {\textcopyright} 2020 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland Copyright: Copyright 2020 Elsevier B.V., All rights reserved.",

year = "2021",

month = oct,

doi = "10.1016/j.surge.2020.10.002",

language = "English",

volume = "19",

pages = "e230--e236",

journal = "Surgeon",

issn = "1479-666X",

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T1 - Re-starting elective orthopaedic services in NHS Tayside during the COVID-19 pandemic

AU - Davies, Peter S. E.

AU - Sinnerton, Robert J. H.

AU - MacInnes, Alasdair

AU - Faulkner, Alastair C.

AU - Hutchison, Peter D.

AU - Greensmith, Thomas S. W.

AU - Roberts, Louise

AU - Clift, Benedict

N1 - Funding Information: Stephanie A Davies ? Proof reading for spelling and grammar; Linda Johnston, Clinical Audit Manager ? Verification of data; Dave Ridley, Systems Developer ? Verification of data; Lorna O'Donnell, Clinical Audit and Research Nurse ? Verification of data; Sarah Keogh, Clinical Audit and Research Nurse ? Verification of data; Jennifer Scott, Clinical Audit and Research Nurse ? Verification of data. Publisher Copyright: © 2020 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

PY - 2021/10

Y1 - 2021/10

N2 - Background: Elective orthopaedic operations were suspended at the start of the COVID-19 lockdown. Three pathways were created to allow patients to undergo urgent elective operations in NHS Tayside as soon as it was deemed safe to do so.Methods: We examined elective orthopaedic activity in NHS Tayside during and immediately after the Scottish lockdown. Elective operations performed between 27 March 2020 and 10 August 2020 were included and compared with cases performed between 27 March and 10 August in both 2018 and 2019. Primary outcomes were 30-day mortality, 30-day complications, and nosocomial infection rates of COVID-19.Findings: Fewer elective operations were performed in 2020 (258) compared with 2019 (1196) and 2018 (1261). The rate of nosocomial infection in the 2020 cohort was 0%. The 30-day mortality rate was 0%. Over 98% of patients agreed to undergo surgery after a detailed consenting process.Interpretation: We were able to re-start a safe elective orthopaedic service in the early stages of recovery from the COVID-19 pandemic, compatible with the guidelines set by the Royal College of Surgery of England and the British Orthopaedic Association. Our findings will serve to reassure regions with sufficient resources that it is acceptable to restart elective surgery for urgent priority cases. They may provide a template for planned surgical care in the event of further pandemics.

AB - Background: Elective orthopaedic operations were suspended at the start of the COVID-19 lockdown. Three pathways were created to allow patients to undergo urgent elective operations in NHS Tayside as soon as it was deemed safe to do so.Methods: We examined elective orthopaedic activity in NHS Tayside during and immediately after the Scottish lockdown. Elective operations performed between 27 March 2020 and 10 August 2020 were included and compared with cases performed between 27 March and 10 August in both 2018 and 2019. Primary outcomes were 30-day mortality, 30-day complications, and nosocomial infection rates of COVID-19.Findings: Fewer elective operations were performed in 2020 (258) compared with 2019 (1196) and 2018 (1261). The rate of nosocomial infection in the 2020 cohort was 0%. The 30-day mortality rate was 0%. Over 98% of patients agreed to undergo surgery after a detailed consenting process.Interpretation: We were able to re-start a safe elective orthopaedic service in the early stages of recovery from the COVID-19 pandemic, compatible with the guidelines set by the Royal College of Surgery of England and the British Orthopaedic Association. Our findings will serve to reassure regions with sufficient resources that it is acceptable to restart elective surgery for urgent priority cases. They may provide a template for planned surgical care in the event of further pandemics.

KW - COVID-19

KW - Elective

KW - Orthopaedics

KW - Pathway

KW - SARS CoV 2

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DO - 10.1016/j.surge.2020.10.002

M3 - Article

C2 - 33308925

AN - SCOPUS:85097462494

SN - 1479-666X

VL - 19

SP - e230-e236

JO - Surgeon

JF - Surgeon

IS - 5

ER -

Re-starting elective orthopaedic services in NHS Tayside during the COVID-19 pandemic

Abstract

Keywords

ASJC Scopus subject areas

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