• Reference Number: HEY1141/2020
• Departments: Coronavirus - COVID-19, Gynaecology
• Last Updated: 6 August 2020

Introduction

We understand that this is a challenging time for everyone and that you will have questions regarding your operation. The COVID-19 pandemic is placing huge demands on the NHS and is changing the way we work. ­­­­­­­­­

Understanding the risks and benefits during COVID-19

There may be delays in your operation

It is likely that your planned operation will be delayed, possibly by several months. During the pandemic there has been a major reorganisation of our hospitals, wards, intensive care units and emergency departments and this means we have been unable to undertake routine operations for a period of time. The amount of operations we can do in a day has also been reduced due to the increased precautions at this time. This means our waiting list is now much longer.

We are prioritising theatre lists so that if you need an operation as an emergency to save your life or prevent serious harm to your health this will not be delayed.

Understanding the risks

You will already have had a discussion with your surgical team about the risks and benefits of your operation, but it is important to understand that there are specific risks during this time and that the risk of undergoing procedures during the COVID-19 pandemic has increased.

Coming into hospital will increase your risk of contracting COVID-19 as you may come into contact with members of staff and / or patients who could be unknowingly carrying the virus.  It is also possible that you already have the infection but are not yet showing symptoms. The Trust is following government guidance and have strict policies and procedures in place to minimise the risk and protect hospital visitors and staff as far as possible.

The chance of contracting COVID-19 around the time of surgery is unknown but probably quite low and is likely to decrease over time. However, if you do become infected with COVID-19 around the time of surgery or up to 30 days after, you have a much higher chance of serious complications and may have approximately a 20% (1 in 5) chance of death. Some patient groups have a higher and some a lower risk but current evidence shows this is the average risk for all groups.

We will arrange for you to be tested for COVID-19 prior to your surgery but no current testing for COVID-19 will pick up all cases. Up to 30% of people who test negative for COVID-19 may still have the virus. This is a rapidly changing situation and our advice is based on the current available evidence, we will continue to gather evidence and improve our understanding of the risks.

Precautions we are taking

Following advice given through all of the NHS, we are now asking patients having planned surgery to follow comprehensive social distancing and hand hygiene for 14 days prior to surgery.

Please see the link below for further details on what this means: https://coronavirusresources.phe.gov.uk/stay-alert-to-stay-safe-/overview/

We are also aiming to reduce the risks with the following measures:

• Reducing the number of people in our hospital – our wards are restricting the numbers of visitors to help prevent the spread to vulnerable patients
• Our staff are provided with PPE (Personal Protective Equipment) to prevent the infection moving from person to person
• You will be provided with masks to wear during your time in hospital
• All of our patients admitted as emergencies are tested and we have created safe environments for patients admitted with COVID-19
• We have introduced social distancing in areas where we can
• All our practice follows the current national guidance

Self-isolation

Before your procedure you must self-isolate in your home after having your Covid-19 swab until the date of surgery.  This period of pre-operative isolation is one of the most important things you can do to protect yourself and others prior to surgery.

If you are at high risk of complications of Covid-19 your clinician may advise to self-isolate for 14 days prior to surgery.

To further minimise the risks of complications due to Covid-19 you may wish to minimise contact with others and may want to self-isolate for 14 days.

Preparing for your procedure

Before your operation

Wherever possible, your pre-operative communications will take place by telephone or letter.

We will also arrange for you to have a COVID-19 swab taken prior to surgery. This will be a nose and throat swab. If your swab tests positive or you are unwell prior to surgery, then your surgery will need to be postponed. It is important that you understand, as mentioned above, that a negative swab cannot completely rule out infection with the virus. Up to 30% of people with a negative swab may still have infection.

In hospital

If you need to stay in hospital following your surgery, this is likely to be on Cedar Ward in Women’s and Children’s Hospital but this may change before or during your stay.

Wards have been reorganised to provide areas that are as COVID-19 free as possible. Staff will be wearing masks and a variety of other protective equipment such as gloves, aprons, visors, theatre clothing and / or boiler suits, depending on their area and type of work, to provide added protection from the virus to patients, themselves and other members of staff.

You will meet your surgeon on the day of your operation. This may not be the same person you met previously in clinic but they will be experienced and trained to perform your operation.

It is unlikely your friends and family will be able to visit you in hospital, as we are minimising the amount of people coming into hospital to try and reduce the risk of COVID-19 to our patients and staff. If this changes we will let you know as soon as possible.

After your operation

We will discharge you as soon as it is safe to do so and before you leave we will give you information on who to contact if you have questions or concerns following your surgery.

If you need any follow up consultations following your surgery this is likely to be over the telephone.

Your choice

Individual decision making about your surgery

Undergoing an elective procedure is your choice and always carries both risks and benefits. We recognise that, knowing these additional risks, you may not want to proceed with your operation at this time.

If you decide to delay your treatment, your consultant will inform you any risks of not proceeding at this time and any alternative treatments that they may be able to offer you. If you decide not to proceed at this time, but still want your operation at a later date, we will note this in our records.

If you decide to continue with your operation, we would like you to take the additional precautions mentioned above.

Contact information

If you have a non-urgent question regarding your care please contact your consultant’s secretary through the hospital switchboard on (01482) 875875

If you are unwell please contact your doctor or out of hours contact NHS 111 either on the telephone or online. In an emergency please attend the Emergency Department at Hull Royal Infirmary.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.