Guidance for adult patients having an operation during COVID-19
Some surgical services which stopped to help hospitals cope with the COVID-19 pandemic have restarted
CPOC has produced a series of Frequently Asked Questions to address some of the concerns that you may have about going to hospital during the pandemic and to offer some advice on how you can best prepare for your operation
The NHS is working to continue to provide safe surgical services throughout the COVID-19 pandemic.
Hospitals are contacting patients on the waiting lists, especially those with urgent cases to see if surgery is still required for their problem and is still what each patient wants.
This series of FAQs aims to address some of the concerns that you may have about going to hospital during the pandemic and to offer some advice on how you can best prepare for your operation.
Click the link below to download the FAQs in full as a leaflet, or scroll down to open each individual adult FAQ.
In conjunction with the FSSA, Association, RCSEng and the RCoA, CPOC has published guidance on the COVID-19 and timing of elective surgery. A multidisciplinary consensus statement on the significant number of patients who have previously been infected with SARS-CoV-2 requiring surgery and the multisystem consideration required for safe surgery can be found here.
Download the patient information on the consensus statement below.
Frequently Asked Questions
NHS staff throughout the UK have worked hard to plan and prepare for how their hospitals can most safely offer surgery during the pandemic. The approaches may vary at different hospitals, but all staff will be doing everything possible to ensure that the risk of you getting an infection is as low as possible, for example by:
- testing all patients coming to hospital for coronavirus
- caring for those patients who are suspected to have, or who have tested positive for, coronavirus in separate areas
- ensuring that staff are well trained in how to limit the spread of infection in hospitals
- ensuring that staff have and use appropriate personal protective equipment (PPE)
- ensuring that the right levels of staffing and equipment are in place so that surgery can take place safely
- regularly testing NHS staff (including those without symptoms)
- minimising visitors into the hospital
Local NHS hospitals will also use different strategies to support patients with COVID-19 separately. Separating patients who have COVID-19 and those who do not may involve using different wards or parts of a hospital or using private hospitals to minimise the risk of spreading infection.
If your surgery is urgent (for example for a cancer that may get worse if there is a delay in treatment), it is likely that going ahead with your surgery will be the most beneficial option for you. However, you may wish to talk to those involved in your care (your GP, surgeon or oncologist) who can help you to consider your options. You may also want to discuss your choices with your family.
If your surgery is less urgent you may wish to talk to those involved in your care about whether it is the right option for you at that moment. Some conditions, like joint and back pain, can be improved with exercises and physiotherapy to the point that surgery can be avoided.
You may consider asking your doctors the following questions before any test, treatment or procedure, to help you make an informed decision:
- What are the Benefits?
- What are the Risks?
- What are the Alternatives?
- What if I do Nothing ?
BRAN is a discussion tool used in shared decision making. You can find out more about BRAN and shared decision making here.
To maintain social distancing and reduce travelling to hospitals, you may be offered online consultations with the surgeon and the preoperative assessment clinic, rather than being asked to attend appointments in person.
Developing COVID-19 around the time of an operation is more dangerous than at other times. Therefore, you should minimise contact with others and follow strict social distancing and hand washing advice. You may also wish to self-isolate for 14 days before the operation to reduce the risk of catching the virus at this time even further.
The hospital will ask you to take a swab test for COVID-19 a few days before admission and to self-isolate from this time. Your surgery may need to be postponed if you test positive for the virus. If you stay in hospital for several days you may need a repeat swab.
Before coming in, you will be asked about symptoms that might indicate COVID-19 infection such as cough or temperature.
When you are in hospital, staff will be wearing some protective equipment – this may be a surgical mask or may also include a plastic apron and gloves or may be ‘full’ PPE depending on the area. Full PPE can look alarming as much of the person’s face is covered by a mask and a visor or goggles. Please do not be intimidated by it and continue to speak to staff and ask questions as you normally would.
If you have hearing difficulties and particularly if you rely on lip reading, please make staff aware of this so that they can make changes to how they communicate with you. In some hospitals the staff may use flashcards to communicate with patients.
Yes. It is important to contact the hospital so that further details can be taken. A decision can then be made based on the urgency of your planned procedure. Even though this may cause a delay in your surgery, in most cases it will be much safer to rule out coronavirus, than to go ahead when you may have it.
Patients who have COVID-19 around the time of surgery are at higher risk of developing a severe form of the disease, of breathing difficulties and of death. For this reason, if you have symptoms of coronavirus, you must let your healthcare team know immediately. If you have,or are thought to have coronavirus, your operation will only take place if it is a very urgent or emergency procedure and you consent to it, after discussing the risks with the healthcare team. Extra care will be taken to support you through this period.
If you have any underlying medical conditions, you should tell the surgeon or anaesthetist, for example at the preoperative assessment clinic (which may be online or on the telephone), so that they can take this into account in planning your care and assessing your risk. It is important that you control any medical conditions, remain active and take your medications regularly.
Hospitals are stopping or limiting visitors to patients in hospital in order to reduce the risk of spreading coronavirus. You should follow the local advice and guidance. Whether you can receive visitors or not will depend on your circumstances and that of your hospital at the time. Very often, if visitors are allowed, they will be asked to wear extra protection.
Many hospitals are now using video and phone apps to allow patients to stay in touch with their families and loved ones, if they cannot have visitors.
This will depend largely on the type of procedure you have, any known medical problems and the surgical care plan that the staff have agreed with you. Some patients can recover on a normal ward, while some may need a stay in the Intensive Care Unit or the High Dependency Unit.
If you have been tested positive for coronavirus you will be cared for in a separate area of the hospital.
For some procedures, and if all goes to plan, you will be able to leave hospital on the same day of the operation
You will not be discharged from hospital until you are well enough to leave. This would normally be to your own home or usual place of residence (for example a care home). If you are returning to a care setting (such as a care home) you will need a further swab test to ensure you do not have the virus before leaving.
You should always follow all the instructions given to you on your discharge letter. Communication between the hospital and the community is continuing as usual during the pandemic. Your GP should be aware of any ongoing issues that you may need help with and any additional nursing you require will be organised prior to you leaving hospital. However, it is important that you discuss any concerns at an early stage to allow early treatment if needed. Booking in any planned appointments early, like wound cleaning and dressing, can help surgeries plan their workload during the pandemic.
You may be able to get help with practical issues such as shopping or arranging for someone to check in on you or call you on the phone, if you are isolated. This can be arranged through your Local Authority’s Covid support service networks or your GP surgery may have a ‘social prescribing link worker.’
GPs are seeing fewer patients face to face, but you can still speak with them online or over the phone. The GP will consider doctor or district nurse home visits if appropriate. Anyone visiting you in your home will wear appropriate PPE.
Your hospital should let you know what to do if you develop symptoms of coronavirus soon after your operation – please ask if you are not given this information before you leave.
What can I do to prepare for my operation and minimise risk?
If your procedure is not an emergency, you may find that you need to wait a while until the day of your operation. However, you can use this to your advantage. There is much you can do during the waiting time to prepare yourself for surgery and improve your health. Evidence shows that fitter patients recover quicker from surgery and experience fewer complications. What we understand about the virus also shows that those people in better health usually develop milder symptoms and recover quicker from COVID-19.
If you are as fit as possible ahead of the procedure, the healthcare team may allow your surgery to be treated as a ‘day case’. This means that you will be able to leave the hospital the same day of the operation and minimise risk even further. Please note that some operations always require you to remain overnight in hospital after the surgery.
Below are some steps you can take to improve your physical and mental health ahead of the operation and to increase your ability to fight coronavirus:
Would you like to download the guidance for young people 'My Operation and Coronavirus'?
Click below to access the above FAQs as a leaflet.