Abstract
Between October 2020 and January 2021, we conducted three national surveys to track anaesthetic, surgical and critical care activity during the second COVID-19 pandemic wave in the UK. We surveyed all NHS hospitals where surgery is undertaken. Response rates, by round, were 64%, 56% and 51%. Despite important regional variations, the surveys showed increasing systemic pressure on anaesthetic and peri-operative services due to the need to support critical care pandemic demands. During Rounds 1 and 2, approximately one in eight anaesthetic staff were not available for anaesthetic work. Approximately one in five operating theatres were closed and activity fell in those that were open. Some mitigation was achieved by relocation of surgical activity to other locations. Approximately one-quarter of all surgical activity was lost, with paediatric and non-cancer surgery most impacted. During January 2021, the system was largely overwhelmed. Almost one-third of anaesthesia staff were unavailable, 42% of operating theatres were closed, national surgical activity reduced to less than half, including reduced cancer and emergency surgery. Redeployed anaesthesia staff increased the critical care workforce by 125%. Three-quarters of critical care units were so expanded that planned surgery could not be safely resumed. At all times, the greatest resource limitation was staff. Due to lower response rates from the most pressed regions and hospitals, these results may underestimate the true impact. These findings have important implications for understanding what has happened during the COVID-19 pandemic, planning recovery and building a system that will better respond to future waves or new epidemics.
| Original language | English |
|---|---|
| Pages (from-to) | 1167-1175 |
| Number of pages | 9 |
| Journal | Anaesthesia |
| Volume | 76 |
| Issue number | 9 |
| Early online date | 18 May 2021 |
| DOIs | |
| Publication status | Published - Sept 2021 |
Bibliographical note
Funding Information:We thank the NAP7 local co-ordinators and other clinicians who have completed any round of the ACCC-track surveys. Those who have responded and expressed interest in being included in publication have been listed as contributors in the Supporting Information Appendix?S2. We thank the NAP7 Steering Panel?and the HSRC/RCoA research team including K. Williams (Audit Coordinator), J. Lourtie (Head of Research), S. Drake (Director of Clinical Quality and Research) and I. Moppett (Deputy Director) for supporting and collaborating on the project. The project was supported by the Health Service Research Centre at the Royal College of Anaesthetists who also partially fund the salary of J. Soar and T.M. Cook. No competing interests declared.
Funding Information:
We thank the NAP7 local co‐ordinators and other clinicians who have completed any round of the ACCC‐track surveys. Those who have responded and expressed interest in being included in publication have been listed as contributors in the Supporting Information Appendix S2 . We thank the NAP7 Steering Panel and the HSRC/RCoA research team including K. Williams (Audit Coordinator), J. Lourtie (Head of Research), S. Drake (Director of Clinical Quality and Research) and I. Moppett (Deputy Director) for supporting and collaborating on the project. The project was supported by the Health Service Research Centre at the Royal College of Anaesthetists who also partially fund the salary of J. Soar and T.M. Cook. No competing interests declared.
Publisher Copyright:
© 2021 Association of Anaesthetists.
Structured keywords
- Covid19
