Managing surgical demand when needs outstrip resource: qualitative investigation of colorectal cancer surgery provision in the first wave of the COVID-19 pandemic

• DOI: 10.1093/bjs/znac371
• Publication Date: 2022-11-07T02:58:21Z
• Authors: Carmel Conefrey; Cynthia Ochieng; Christin Hoffmann; Daisy Elliott; Kerry Avery; Joanne Bennett; Natalie Blencowe; Sarah Duff; James Kinross; Angus McNair; David Messenger; Anne Pullyblank; Baljit Singh; Anni King; Sarah E Squire; Jane Blazeby; Barry Main; Leila Rooshenas
• Keywords: Pandemic

At the onset of COVID-19 pandemic, elective surgical provision was severely affected by need for hospital reorganization to care critically ill patients. In response, National Health Service (NHS) England issued national guidance proposing acceptable time intervals postponing different types procedure. This study reports healthcare professionals' private accounts strategies adopted manage imbalance demand and resource, using colorectal cancer surgery as a case study.Twenty-seven semistructured interviews were conducted with professionals between June November 2020. A key informant sampling approach used, followed snowballing achieve maximum regional variation across UK. Data analysed thematically constant comparison approach.In context considerable resource constraint, teams overcame challenges continue provision. They achieved this pursuing combination strategies: relocating services; prioritizing patients within specialties; adapting patient treatment plans; introducing changes team working practices. Despite guidance, prioritization decisions framed complex, most challenging implement, both practically emotionally.There is better support surgeons tasked when capacity exceeds demand.