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The Covid pandemic is casting a wide shadow over the nation’s health, according to new data revealing a dramatic drop in urgent referrals for suspected cancers in England, and a plummeting quality of life among patients awaiting hip and knee surgery in the UK.
The crisis has caused huge disruption to healthcare services: in November NHS England revealed that the number of people waiting more than a year for surgery had reached its highest level since 2008, while patients have reported that their procedures, from cancer surgery to hip replacements, have been repeatedly cancelled.
It has also been linked to a fall in MRI and CT scans, while among other consequences breast screening programmes were paused last year. Experts have warned the pandemic may also have led to people avoiding GPs and hospitals, meaning they may have missed out on crucial care.
Now an analysis of NHS England data by Cancer Research UK has found that the number of people urgently referred for suspected lung cancer fell by 34% between March 2020 and January 2021 compared with the same time period in 2019/2020 – adjusted for working days. That, they say, equates to about 20,300 fewer people being urgently referred.
Declines were also found for other suspected cancers including urological cancer and gynaecological cancer, with about 51,000 fewer patients urgently referred for the former, a 25% drop, and 19,800 fewer patients urgently referred for the latter, a 10% drop, compared with the year before.
The charity added there was a 9% drop in people starting treatment for lung cancer between April 2020 and January 2021 compared with the same period the year before – about 2,600 fewer patients.
Cancer Research UK said the findings were of concern as cancer was more treatable when spotted at an early stage.
According to an online survey of 1,000 regionally representative GPs in the UK, carried out for the charity between 5 and 26 February, just 2% said the pandemic had not led to delays in lung cancer diagnoses.
Of the remaining respondents, 91% said a key driver was patients hesitating to go to hospitals for tests, with more than three-quarters citing patients not seeking primary care.
More than two-thirds said difficulties in spotting symptoms of lung cancer by remote consultations were a factor, while turnaround times for Covid tests and diagnostic tests for lung cancer were also considered to be contributing to the problem.
The analysis follows concerns raised by charities last year that the similarity of symptoms between Covid and lung cancer, together with worries about seeking help, may be delaying diagnoses.
Dr Neil Smith, Cancer Research UK’s GP adviser, said Covid-19 had created a “perfect storm” of problems, and urged patients with lung cancer symptoms – such as a long-lasting cough – to contact their GP and go for tests.
The analysis comes as a new study shows that tens of thousands of people in the UK waiting for a new hip or knee have a quality of life rated “worse than death” because they cannot get an operation.
A third of those awaiting a hip replacement and more than a fifth of those due to have a new knee fitted have such pain, immobility and loss of function that they are in that category, researchers found.
Bob Handley, the president of the British Orthopaedic Association, said the findings underlined the “misery and despair” faced by people with severe arthritis who were forced to wait for a new joint.
A total of 843 patients from 10 surgical centres across the UK were assessed using an established quality-of-life survey which asked them about pain and their ability to undertake normal life.
Overall, 35% of the hip patients and 22% of the knee patients recorded a minus score, which the researchers said meant that those patients considered that they could not bear to survive in their current state of health. Before the pandemic began last March, 19% and 12% of those groups of patients said the same thing.
Chloe Scott, a consultant hip and knee surgeon and a lecturer at Edinburgh University, said: “These patients are suffering. Because of the pandemic, elective surgery such as hip and knee replacements has all but stopped.”
Meanwhile, the NHS Confederation will warn on Wednesday that thousands of NHS staff could quit if they are not given enough time off to “decompress” after the rigours of the pandemic and are pushed into starting to help clear the massive backlog of surgery that has built up because the NHS suspended so much normal care.
Dr Richard Vautrey, chair of the British Medical Association’s GPs committee, also called for greater support for the NHS.
“Despite the best efforts of GPs and indeed all NHS staff working throughout the pandemic, the exceptional demands of Covid-19 have caused severe disruption to services, meaning a growing number of patients are now having to wait longer for vital treatment, such as cancer care or surgery,” he said.
“GPs have been very clear that patients who are concerned they may have cancer symptoms or any other serious health concerns should absolutely come forward to see their GP immediately.
“With the largest backlog of care ever to contend with in the NHS, it is now crucial that the government takes steps to support primary care and ensure that hospitals have adequate staff and resources to resume care for those patients who desperately need it.”
Source: The Guardian
Keyword: NHS hit by Covid disruption as cancer referrals plunge | NHS