This link sets out the latest guidance issued by NICE for people who are waiting for diagnostic tests / investigations or treatment (available here).
Much depends on a patient's own risk factors, but the recommendations are for 14 days of social distancing and hand hygiene before planned procedures requiring general or local anaesthetic or sedation. Three days before the procedure the patient should have a COVID-19 test and from then until admission be socially isolated. Some patients who may be especially vulnerable may still need to self-isolate for 14 days. Your specialist will confirm this with you if this is required.
Guidance for the precautions prior to treatments (other than surgery) or diagnostic tests/investigations are more flexible, and decisions are made by hospital trusts after risk assessments of individual patients and specific treatments.
Patients should phone their treatment teams if they are not clear about the measures they should be taking. Information and recommendations may change depending on the local number of COVID-19 cases in your area.
All screening programmes, except for bowel scope, have restarted in accordance with the ‘Full Restoration of Services’ letter from Simon Stevens (NHS CEO); we expect a recommendation around whether bowel scope restarts or an alternative test – known as FIT- starts in September. Simon Stevens has asked for all screening services to resume full activities and for people to be encouraged to attend screening when invited. If you think you have missed a screening appointment, then contact your GP for more information.
There are currently no shortages of anaesthetic drugs. Any issues that existed during the height of COVID-19 have now all been resolved.
All carers are encouraged to phone the hospital ward and ask to speak to the nurse and / or doctor who is primarily caring for your relative. Your relative will have to give permission for information about them to be passed on.
Cancer hubs are aligned with your local hospital. They will have been established in clean COVID-19 free areas (Green areas) of the hospital or the associated local private hospital (which is being used as an extension of your local hospital), your treatment team will direct you.
Patients with suspected cancer and who are referred on the ‘two week wait’ pathway are investigated urgently. If following these investigations a cancer has been diagnosed then the treatment that is required will be explained by your clinician (surgeon or oncologist). They should be in a position to explain to you how soon treatment can be expected. For some cancers it is clear that when surgery is required, it does not need to be done immediately. For other cancers there is some urgency. You can expect this to be explained to you when you see your specialist following the multi-disciplinary discussion of your case.
If your own, local hospital is unable to offer you the treatment that you need you will be offered treatment in another, appropriate hospital. Your specialist will be able to explain this. Please be reassured that if you are offered the opportunity to be treated in another hospital, all the information about your condition will be communicated to team members involved in your care.
This is not currently known but the expectation is that all the most vulnerable people (which might include some people with cancer and those undergoing some types of cancer treatment) will be prioritized for a Coronavirus vaccine if and when this arrives.
With the exception of some private home care services, intravenous chemotherapy is not given at home. In the East of England some trusts are able to give chemotherapy or supportive care that is delivered by a subcutaneous injection at home. (Subcutaneous is an injection that is given just under the skin, not into a vein or into muscle). Oral chemotherapy is, of course, taken at home. The decision to have medications at home is based on the type of treatment and a risk assessment for the patient.
If care is transferred to another hospital, the relevant clinical information will be made available to them so that the new treating team members can still ensure that you get the best possible care. This usually means sending information electronically but sometimes by letter too.
Hospitals are returning to ‘face to face’ appointments as and when necessary. There are situations where it is important for clinicians to examine or see their patients face to face. This is especially the case for patients with breast, head and neck, and skin cancers.
Virtual appointments will be retained where appropriate. Often a patient will be contacted by phone or by online video initially to gather more information so that the next steps can be planned in a way that avoids unnecessary hospital appointments.
We are very aware that not all patients have access to or feel comfortable to use video-consultations when available. If this is offered and you prefer the telephone please discuss this with your specialist’s secretary as this can almost certainly be accommodated.
Not all specialists however are able to offer video-consultations. If a face to face consultation is preferred (e.g. you struggle on the telephone) please be sure to discuss this again with the specialist’s secretary.
The situation now is that once a diagnosis has been reached then a plan for treatment will follow swiftly. In some cases there will be less urgency for the treatment to get underway. Your specialist will be able to explain if this is applicable to you and why.
Some of these can be found on hospital websites already. Hospitals are encouraged to provide as much information as possible about local services.
Some written information is available in a range of languages if English is not your first language. Hospitals can use easily accessible telephone-based interpreter services when you are having face to face consultations. The Macmillan website is also a good source of information in many different languages and is easily accessed.