Impact of Multiple COVID-19 Waves on Gynaecological Cancer Services in the UK

Samuel Oxley; Ashwin Kalra; Michail Sideris; Nicole Itzkowitz; Olivia Evans; Emma Christine Atakpa; Adam R Brentnall; Nina Dworschak; Faiza Gaba; Rhian Gabe; Sudha Sundar; Nick Wood; Shibani Nicum; Alexandra Taylor; Stephen Dobbs; W Glenn McCluggage; Andy Nordin; Rosa Legood; Sean Kehoe; Sadaf Ghaem-Maghami; Ranjit Manchanda

doi:10.3390/cancers15041273

Impact of Multiple COVID-19 Waves on Gynaecological Cancer Services in the UK

Samuel Oxley, Ashwin Kalra, Michail Sideris, Nicole Itzkowitz, Olivia Evans, Emma Christine Atakpa, Adam R Brentnall, Nina Dworschak, Faiza Gaba, Rhian Gabe, Sudha Sundar, Nick Wood, Shibani Nicum, Alexandra Taylor, Stephen Dobbs, W Glenn McCluggage, Andy Nordin, Rosa Legood, Sean Kehoe, Sadaf Ghaem-MaghamiRanjit Manchanda^* (Corresponding Author)

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: This study aimed to assess the impact of multiple COVID-19 waves on UK gynaecological-oncology services.

METHODS: An online survey was distributed to all UK-British-Gynaecological-Cancer-Society members during three COVID-19 waves from 2020 to2022.

RESULTS: In total, 51 hospitals (including 32 cancer centres) responded to Survey 1, 42 hospitals (29 centres) to Survey 2, and 39 hospitals (30 centres) to Survey 3. During the first wave, urgent referrals reportedly fell by a median of 50% (IQR = 25-70%). In total, 49% hospitals reported reduced staffing, and the greatest was noted for trainee doctors, by a median of 40%. Theatre capacity was reduced by a median of 40%. A median of 30% of planned operations was postponed. Multidisciplinary meetings were completely virtual in 39% and mixed in 65% of the total. A median of 75% of outpatient consultations were remote. By the second wave, fewer hospitals reported staffing reductions, and there was a return to pre-pandemic urgent referrals and multidisciplinary workloads. Theatre capacity was reduced by a median of 10%, with 5% of operations postponed. The third wave demonstrated worsening staff reductions similar to Wave 1, primarily from sickness. Pre-pandemic levels of urgent referrals/workload continued, with little reduction in surgical capacity.

CONCLUSION: COVID-19 led to a significant disruption of gynaecological-cancer care across the UK, including reduced staffing, urgent referrals, theatre capacity, and working practice changes. Whilst disruption eased and referrals/workloads returned to normal, significant staff shortages remained in 2022, highlighting persistent capacity constraints.

Original language	English
Article number	1273
Number of pages	13
Journal	Cancers
Volume	15
Issue number	4
Early online date	16 Feb 2023
DOIs	https://doi.org/10.3390/cancers15041273
Publication status	Published - 16 Feb 2023

Keywords

COVID-19
multidisciplinary team
gynaecological cancer

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).
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Oxley, S., Kalra, A., Sideris, M., Itzkowitz, N., Evans, O., Atakpa, E. C., Brentnall, A. R., Dworschak, N., Gaba, F., Gabe, R., Sundar, S., Wood, N., Nicum, S., Taylor, A., Dobbs, S., McCluggage, W. G., Nordin, A., Legood, R., Kehoe, S., ... Manchanda, R. (2023). Impact of Multiple COVID-19 Waves on Gynaecological Cancer Services in the UK. Cancers, 15(4), [1273]. https://doi.org/10.3390/cancers15041273

Oxley, S, Kalra, A, Sideris, M, Itzkowitz, N, Evans, O, Atakpa, EC, Brentnall, AR, Dworschak, N, Gaba, F, Gabe, R, Sundar, S, Wood, N, Nicum, S, Taylor, A, Dobbs, S, McCluggage, WG, Nordin, A, Legood, R, Kehoe, S, Ghaem-Maghami, S & Manchanda, R 2023, 'Impact of Multiple COVID-19 Waves on Gynaecological Cancer Services in the UK', Cancers, vol. 15, no. 4, 1273. https://doi.org/10.3390/cancers15041273

@article{d25bd5bf24364d5c9b97c8eab84eef3d,

title = "Impact of Multiple COVID-19 Waves on Gynaecological Cancer Services in the UK",

abstract = "BACKGROUND: This study aimed to assess the impact of multiple COVID-19 waves on UK gynaecological-oncology services.METHODS: An online survey was distributed to all UK-British-Gynaecological-Cancer-Society members during three COVID-19 waves from 2020 to2022.RESULTS: In total, 51 hospitals (including 32 cancer centres) responded to Survey 1, 42 hospitals (29 centres) to Survey 2, and 39 hospitals (30 centres) to Survey 3. During the first wave, urgent referrals reportedly fell by a median of 50% (IQR = 25-70%). In total, 49% hospitals reported reduced staffing, and the greatest was noted for trainee doctors, by a median of 40%. Theatre capacity was reduced by a median of 40%. A median of 30% of planned operations was postponed. Multidisciplinary meetings were completely virtual in 39% and mixed in 65% of the total. A median of 75% of outpatient consultations were remote. By the second wave, fewer hospitals reported staffing reductions, and there was a return to pre-pandemic urgent referrals and multidisciplinary workloads. Theatre capacity was reduced by a median of 10%, with 5% of operations postponed. The third wave demonstrated worsening staff reductions similar to Wave 1, primarily from sickness. Pre-pandemic levels of urgent referrals/workload continued, with little reduction in surgical capacity.CONCLUSION: COVID-19 led to a significant disruption of gynaecological-cancer care across the UK, including reduced staffing, urgent referrals, theatre capacity, and working practice changes. Whilst disruption eased and referrals/workloads returned to normal, significant staff shortages remained in 2022, highlighting persistent capacity constraints.",

keywords = "COVID-19, multidisciplinary team, gynaecological cancer",

author = "Samuel Oxley and Ashwin Kalra and Michail Sideris and Nicole Itzkowitz and Olivia Evans and Atakpa, {Emma Christine} and Brentnall, {Adam R} and Nina Dworschak and Faiza Gaba and Rhian Gabe and Sudha Sundar and Nick Wood and Shibani Nicum and Alexandra Taylor and Stephen Dobbs and McCluggage, {W Glenn} and Andy Nordin and Rosa Legood and Sean Kehoe and Sadaf Ghaem-Maghami and Ranjit Manchanda",

note = "Funding: This research was funded by the British Gynaecological Cancer Society (EMSG1L5R) and Ovacome charity. It is supported by the National Cancer Research Institute Gynaecological Cancer Clinical Studies Group and the British Association of Gynaecological Pathologists. The funding bodies had no role in the study design, data collection, analysis, interpretation or writing of the report, or decision to submit for publication. The research team was independent of funders. Acknowledgments: The study is supported by researchers at the Barts Cancer Research United Kingdom Centre for Excellence, Queen Mary University of London (C16420/A18066). We are grateful for the endorsement and support from charities and patient support groups such as Ovacome, The Eve Appeal, Target Ovarian Cancer, Ovarian Cancer Action, Jo{\textquoteright}s Cervical Cancer Trust, and GO Girls. We are grateful for the support received from the Royal College of Obstetricians and Gynaecologists, the National Cancer Research Institute Gynaecological Cancer Clinical Studies Group, and the British Association of Gynaecological Pathologists.",

year = "2023",

month = feb,

day = "16",

doi = "10.3390/cancers15041273",

language = "English",

volume = "15",

journal = "Cancers",

issn = "2072-6694",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

number = "4",

}

TY - JOUR

T1 - Impact of Multiple COVID-19 Waves on Gynaecological Cancer Services in the UK

AU - Oxley, Samuel

AU - Kalra, Ashwin

AU - Sideris, Michail

AU - Itzkowitz, Nicole

AU - Evans, Olivia

AU - Atakpa, Emma Christine

AU - Brentnall, Adam R

AU - Dworschak, Nina

AU - Gaba, Faiza

AU - Gabe, Rhian

AU - Sundar, Sudha

AU - Wood, Nick

AU - Nicum, Shibani

AU - Taylor, Alexandra

AU - Dobbs, Stephen

AU - McCluggage, W Glenn

AU - Nordin, Andy

AU - Legood, Rosa

AU - Kehoe, Sean

AU - Ghaem-Maghami, Sadaf

AU - Manchanda, Ranjit

N1 - Funding: This research was funded by the British Gynaecological Cancer Society (EMSG1L5R) and Ovacome charity. It is supported by the National Cancer Research Institute Gynaecological Cancer Clinical Studies Group and the British Association of Gynaecological Pathologists. The funding bodies had no role in the study design, data collection, analysis, interpretation or writing of the report, or decision to submit for publication. The research team was independent of funders. Acknowledgments: The study is supported by researchers at the Barts Cancer Research United Kingdom Centre for Excellence, Queen Mary University of London (C16420/A18066). We are grateful for the endorsement and support from charities and patient support groups such as Ovacome, The Eve Appeal, Target Ovarian Cancer, Ovarian Cancer Action, Jo’s Cervical Cancer Trust, and GO Girls. We are grateful for the support received from the Royal College of Obstetricians and Gynaecologists, the National Cancer Research Institute Gynaecological Cancer Clinical Studies Group, and the British Association of Gynaecological Pathologists.

PY - 2023/2/16

Y1 - 2023/2/16

N2 - BACKGROUND: This study aimed to assess the impact of multiple COVID-19 waves on UK gynaecological-oncology services.METHODS: An online survey was distributed to all UK-British-Gynaecological-Cancer-Society members during three COVID-19 waves from 2020 to2022.RESULTS: In total, 51 hospitals (including 32 cancer centres) responded to Survey 1, 42 hospitals (29 centres) to Survey 2, and 39 hospitals (30 centres) to Survey 3. During the first wave, urgent referrals reportedly fell by a median of 50% (IQR = 25-70%). In total, 49% hospitals reported reduced staffing, and the greatest was noted for trainee doctors, by a median of 40%. Theatre capacity was reduced by a median of 40%. A median of 30% of planned operations was postponed. Multidisciplinary meetings were completely virtual in 39% and mixed in 65% of the total. A median of 75% of outpatient consultations were remote. By the second wave, fewer hospitals reported staffing reductions, and there was a return to pre-pandemic urgent referrals and multidisciplinary workloads. Theatre capacity was reduced by a median of 10%, with 5% of operations postponed. The third wave demonstrated worsening staff reductions similar to Wave 1, primarily from sickness. Pre-pandemic levels of urgent referrals/workload continued, with little reduction in surgical capacity.CONCLUSION: COVID-19 led to a significant disruption of gynaecological-cancer care across the UK, including reduced staffing, urgent referrals, theatre capacity, and working practice changes. Whilst disruption eased and referrals/workloads returned to normal, significant staff shortages remained in 2022, highlighting persistent capacity constraints.

AB - BACKGROUND: This study aimed to assess the impact of multiple COVID-19 waves on UK gynaecological-oncology services.METHODS: An online survey was distributed to all UK-British-Gynaecological-Cancer-Society members during three COVID-19 waves from 2020 to2022.RESULTS: In total, 51 hospitals (including 32 cancer centres) responded to Survey 1, 42 hospitals (29 centres) to Survey 2, and 39 hospitals (30 centres) to Survey 3. During the first wave, urgent referrals reportedly fell by a median of 50% (IQR = 25-70%). In total, 49% hospitals reported reduced staffing, and the greatest was noted for trainee doctors, by a median of 40%. Theatre capacity was reduced by a median of 40%. A median of 30% of planned operations was postponed. Multidisciplinary meetings were completely virtual in 39% and mixed in 65% of the total. A median of 75% of outpatient consultations were remote. By the second wave, fewer hospitals reported staffing reductions, and there was a return to pre-pandemic urgent referrals and multidisciplinary workloads. Theatre capacity was reduced by a median of 10%, with 5% of operations postponed. The third wave demonstrated worsening staff reductions similar to Wave 1, primarily from sickness. Pre-pandemic levels of urgent referrals/workload continued, with little reduction in surgical capacity.CONCLUSION: COVID-19 led to a significant disruption of gynaecological-cancer care across the UK, including reduced staffing, urgent referrals, theatre capacity, and working practice changes. Whilst disruption eased and referrals/workloads returned to normal, significant staff shortages remained in 2022, highlighting persistent capacity constraints.

KW - COVID-19

KW - multidisciplinary team

KW - gynaecological cancer

U2 - 10.3390/cancers15041273

DO - 10.3390/cancers15041273

M3 - Article

C2 - 36831615

VL - 15

JO - Cancers

JF - Cancers

SN - 2072-6694

IS - 4

M1 - 1273

ER -

Impact of Multiple COVID-19 Waves on Gynaecological Cancer Services in the UK

Abstract

Keywords

UN SDGs

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