Waiting for an appointment? Here are some questions you might have

Waiting for a hospital appointment? COVID-19 has had a major effect on our services and we’re trying to keep you in the picture as best we can.

Here’s some answers to some questions you may have.

My GP’s referred me for treatment but I’ve just received a letter telling me it’s been ‘paused’ – why?

To put it simply – coronavirus or COVID-19.

All hospitals, including Hull Royal Infirmary and Castle Hill Hospital, were instructed by NHS England to cancel outpatient appointments and routine surgery in March so they were not overwhelmed by the virus.

We reconfigured every part of our hospitals, freeing up beds, changing wards and redeploying clinicians, nurses, admin and support staff to help as COVID-19 became our focus. More recently, we’ve had to adapt those plans again as we’ll be dealing with the virus for most, if not all, of this year and perhaps even beyond.

Was it just surgery or outpatient appointments that were paused?

It was both. We were only able to keep performing life-saving, emergency surgery and cancer treatment.

What about me? I was on the waiting list before the COVID-19 outbreak

If you were on a waiting list before the COVID-19 outbreak, you will still be on our waiting list unless we have written to you to advise you differently.  However, unfortunately, you will be waiting longer to be seen and we are really sorry about that.  Our clinicians are regularly reviewing our waiting lists and prioritising patients to be treated.  Since the lockdown, GPs have continued to refer patients to us and they are also on our waiting list.

How many patients are affected?

We’re very sorry to tell you the numbers are huge. COVID-19’s impact on the UK will last for years and affect millions waiting for hospital treatment all over the country.

These figures will help you understand why.

In 2018/19, we had 1,047,501 contacts with patients as outpatients, inpatients and follow-ups after procedures and treatment. Losing even a single day, let alone two months, can have a big impact. And that’s just at our NHS trust. There are another 222 just like us in the country, running more than 1,000 hospitals.

We have sent 12,296 letters to those waiting for their first outpatient appointment before the COVID-19 outbreak. There were another 10,612 waiting for a date for either day surgery or surgery involving a hospital stay and we’ve contacted them too.

We expect to see around 60,000 people for outpatient appointments every month but, in April, we saw just over half that number, 2,400 day cases compared to our normal 6,000 and 305 inpatients compared to 1,300.

In June, we’re expecting to see 32,000 outpatients, almost half of the number we saw in the same month last year, 3,100 day cases compared to 6,000 last year and 400 inpatients, less than a third of the number we saw in June 2019. Working at half our capacity means waiting lists in almost every area are increasing every month.

What are you doing to sort this?

Everything we can. But it’s not easy. We can’t just pick up where we left off because COVID-19 has changed everything.

If it’s suitable, we’re introducing video and telephone consultations. But you’ll appreciate that, in a hospital setting, that isn’t always suitable.

With so much of our hospitals taken up with COVID-19, we’re also working with the independent hospital sector to send some of our patients there for appointments and procedures. So, your appointment letter may ask you to attend the Spire Hospital in Anlaby.

When it’s not, we’re trying to bring back services but we have to take account of supplies of Personal Protective Equipment (PPE), staff availability and bed space.

Why is COVID-19 having such a massive impact when Hull escaped the worst of the pandemic?

It’s right to say that, so far, our hospitals haven’t seen the surge in admissions experienced by hospitals in larger cities like London or Birmingham. That might still happen and we check  admissions closely so we’re ready to respond to any change.

But the pandemic isn’t over, not by a long way. We’re still looking after around 100 patients with confirmed or suspected COVID-19 every day and that’s been the case for two months. We’ve had 150 deaths and we’ve discharged more than 300 patients.

All patients admitted to hospital as urgent or emergency cases who are expected to stay with us for more than one night are being tested as well as those coming for screening ahead of surgery requiring a hospital admission.

We’re also swabbing those attending hospitals for procedures such as endoscopies and we’re testing every patient before they are discharged to a care home or their own home with a package of support.

So, that’s a huge amount of additional work on top of our everyday activities.

Surely it’s easy just to restart everything?

Let’s remind ourselves about the virus. COVID-19 is highly infectious and is spread by droplets caused by coughing, sneezing, talking and – here’s the important part – anything releasing those  droplets in the air. These are called aerosol-generating procedures (AGPs) and we do lots in hospital – everything surgery to CPR.

Remember, these droplets can linger on surfaces for up to three days.

In a hospital setting, just as you do at home, we have to take precautions to keep our patients and staff safe. Our theatre teams, for example, have to wear special PPE. They need to change and the air in theatres has to “settle” between patients. It’s time-consuming. Say in a normal day we’d see 15 patients, we can only see half of those now. That means fewer operations each day so more patients waiting for treatment.

We have to make sure we’ve got enough PPE to keep our staff and patients safe. The supply issues caused by the global demand are well-known. We will not reintroduce a service unless we have the PPE to keep our teams and our patients as safe as possible.

Some of our wards are treating COVID-19 so we’ve got fewer beds. That means we can’t call you in for your procedure or surgery if we’ve got no bed for you to begin your recovery.

We’ve also got a significant proportion of our staff self-isolating or off with COVID-19. This includes pregnant staff and those with their own underlying health conditions. Fewer staff means we can’t look after as many patients as before or hold as many clinics.

I understand all this. But how long will I have to wait?

It’s really hard to say. Our clinicians are going through our waiting lists very carefully and patients will be seen depending on the state of their health. In reality, that means those with the greatest need will be seen first. The lists will be reviewed regularly as we know some people’s conditions will deteriorate so whereas they might not have been a priority to start, that could change as the weeks and months go by.

I’ve been asked to shield and stay at home because I’m high risk. But I’ve been asked to come to hospital for an appointment. What should I do?

We are aiming to hold appointments by telephone or video-conferencing where possible to help with social distancing and so people don’t need to travel to hospital. However, some patients will need to have face-to-face appointments to give blood, for example, or so we can assess clinical issues. If you need to come here, we’ll try to make sure you’re seen in a part of the hospital where there are no known COVID-19 cases. If that’s not possible, we’ll attempt to give you an appointment either at the start or the end of a clinic to minimise your contact with other people. Be assured that our staff will be wearing the appropriate PPE to keep you as safe as possible. Remember, if you’re got any concerns about coming to hospital, you can call the number on your appointment letter.

What if I become unwell or my condition deteriorates?

If you feel that you are seriously unwell, please call 111 or, in an emergency, call 999. If you think your condition is deteriorating or you’re experiencing increasing pain, contact your GP who can request advice from one of our clinicians if necessary.

When will I hear from the service again?

From the outset, we want to say how sorry we are to everyone who is having to wait far too long for treatment. We know this is far from ideal. We know it’s frustrating for so many. Our staff come to work in the NHS to help people, not to keep them waiting, often in pain and discomfort. But we are coping with a situation beyond our control but in the best way we can.

We’re trying to keep everyone informed and we really appreciate your patience and understanding.

With so many people to help, it’s a massive task in itself just to get in touch with everyone.

We’ll be keeping people informed of important changes and general updates through our Facebook and Twitter pages and our website and we’ll be asking the media to help us relay important changes as we go along.

When it’s time for you to come for your appointment or procedure, we’ll get in touch with you. If you’ve got specific queries, you can contact our Appointments Centre on (01482) 604444 Monday to Friday 8am to 8pm and Saturday 8am to 12 noon.  Please remember they’re really busy so only get in touch if you have no alternative.