NHS roadmap to safely bring back routine operations

Health leaders have today set out a series of measures to help local hospitals plan to increase routine operations and treatment, while keeping the necessary capacity and capability to treat future coronavirus patients.

Over the coming weeks patients who need important planned procedures – including surgery – will begin to be scheduled for that care, with specialists prioritising those with the most urgent clinical need.

But, in line with measures currently in place to protect staff and patients who have been receiving urgent treatment during the pandemic, they will be required to isolate themselves for 14 days and be clear of any symptoms before being admitted.

Testing will also be increasingly offered to those waiting to be admitted to provide further certainty for patients and staff that they are COVID-free.

This approach will help to protect patients from potentially catching the virus in hospital, and help staff to ensure they are using the correct infection control measures and protective equipment.

Those requiring urgent and emergency care will continue to be tested on arrival and streamed accordingly, with services split to make the risk of picking up the virus in hospital as low as possible.

Those attending emergency departments and other ‘walk-in’ services will be required to maintain social distancing, with trusts expected to make any adjustments necessary to allow this.

As well as the requirements for those needing operations, as many outpatient appointments as possible will be conducted remotely, and those who do need a face to face consultation will be asked not to attend if they have COVID symptoms.

Those requiring a long hospital stay will be continuously monitored for symptoms and re-tested between 5 and 7 days after admission, and those who are due to be discharged to a care home will be tested up to 48 hours before they are due to leave.

NHS national medical director, Professor Stephen Powis, said: “The number one priority for NHS staff over the last three months has been ensuring that all those who need urgent care, not just those with coronavirus, have been able to get it when they need it – and we have achieved that.

“Combined with the need to avoid unnecessary contact to reduce the spread of the virus, this has meant that it has been the right thing clinically for some non-urgent appointments and surgeries to be postponed.

“Now that we are confident that we have passed the first peak of coronavirus, it is important that we bring back those services where we can, but only where that can be done safely – the virus is still circulating and we don’t want to put our patients, the public or our staff at greater risk.

“So our message to any member of the public who might have been putting off seeing their GP about treatment they might need is: the NHS is open and is working to deliver safe services, so please help us help you, and come forward for care when you need it.”

Over the last three months the NHS has created an unprecedented level of surge capacity, including critical care, which has allowed staff to treat and care for a peak of more than 19,000 patients a day with confirmed COVID-19 infection.

With the number of people requiring hospital care currently coming down to around half that level, the NHS is turning its focus to maintaining enough capacity to provide high quality services for patients with COVID-19, including in the event of any second peak, while cautiously increasing other urgent clinical services, important routine tests and planned surgery.

The guidance published today sets out a national framework to support local NHS teams to do this in the safest way possible for both patients and staff, falling into five principles:

  1. Careful planning, scheduling and organisation of clinical activity
  2. Scientifically-guided approach to testing staff and patients
  3. Excellence in infection prevention and control
  4. Rigorous monitoring and surveillance, and
  5. Focus on continuous improvement

In line with current guidance all staff or members of their household who are symptomatic should continue to be tested, with additional available capacity used to routinely and strategically test asymptomatic frontline staff as part of infection prevention and control measures.