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
With the restart of some NHS surgical services after they had been stopped to help hospitals cope with the COVID-19 pandemic, hospitals will start contacting patients on the waiting lists, especially urgent cases, about their delayed operations to arrange a date for the surgery.
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.
Frequently Asked Questions
NHS staff throughout the UK have been working hard to plan and prepare for how their hospitals can safely restart surgery during the pandemic.
How this will be done will vary from hospital to hospital. All providers will plan their services so that the care of patients requiring surgery under anaesthetic is as safe as possible at this time.
Your hospital will be doing everything possible to ensure that the risk of you getting an infection is as low as possible, for example by:
- ensuring that staff are well trained in how to limit the spread of infection in hospitals
- arranging for all patients coming to hospital to be tested for coronavirus, and for those who have tested positive to be cared for in separate areas
- carrying out regular deep cleaning of wards, operating theatres and equipment
- ensuring that staff use necessary personal protective equipment (PPE) where there is a significant risk of infection and that there are adequate stocks of PPE
- ensuring that the right levels of staffing and equipment are in place so that surgery can take place safely
- ensuring that as many NHS staff as possible are tested for COVID-19.
Local NHS hospitals will also use different strategies to treat patients with COVID-19 separately. This may include treating COVID-19 patients at the temporary Nightingale hospitals (where available), setting up COVID protected cancer hubs or using private hospitals to minimise the risk of infection.
Unfortunately, it is not possible to completely remove the risk of contracting coronavirus while in hospital. It is also not possible to give patients an estimate of how likely they are to contract it – that information is just not available at the moment.
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.
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. Some types of surgery, for example cardiac, carry considerable additional risks for patients with coronavirus.
If you have any underlying medical conditions, you should tell the surgeon or anaesthetist, for example at the preoperative assessment clinic, 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 and take your medications regularly.
Many hospitals are now discouraging 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). Occasionally you may be offered further time to recuperate at another care facility prior to going home.
Before leaving hospital you may be asked to repeat the swab test to check whether you have coronoavirus, even if you have no symptoms.
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.’
Because of coronavirus, surgeries are seeing fewer patients face to face, but you can still speak with GPs online or over the phone. Home visits may be arranged if needed. Many practice nurses are working in the community during the pandemic, so more are available for home visits. Anyone visiting you in your home will wear appropriate PPE.
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.
What can you do?
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.