The persistent challenges faced by vascular surgery services during the UK coronavirus pandemic: a snapshot qualitative survey

Abstract

Introduction The coronavirus (COVID-19) pandemic continues to affect the NHS. The Vascular and Endovascular Research Network (VERN) COvid Vascular sERvice (COVER) study has prospectively shown the significant global impact of the COVID-19 pandemic on vascular surgery. The aim of this study is to investigate the way in which this second wave has affected surgeons’ ability to treat patients with urgent vascular conditions, using contemporaneous snapshot data from 30 UK vascular centres. Methods This is a contemporary (18–28 January 2021) re-run of the Tier 1 COVER survey. This used closed and open questions, related to centres’ provision of common vascular services, threshold for treatment, imaging, screening, staff and theatre availability, multidisciplinary team input, clinics, personal protective equipment, vaccination policies and case-backlogs. The survey was disseminated to clinicians via email. A service reduction score was calculated. Results Forty-two complete responses were received from 30 vascular centres (England, Northern Ireland, Scotland and Wales). Overall, 56.7% of units are performing only urgent procedures. The threshold for abdominal aortic aneurysm (AAA) repair has increased in the majority of UK centres (60%). One in six AAA screening programmes have stopped all screening activity: 30% having a significantly reduced programme and only half running as normal. Waiting lists are increasing for AAA, lower limb revascularisation and venous disease. Conclusion Overall, these data suggest that vascular care in the NHS is facing unprecedented pressures due to COVID-19. Vascular stakeholders will have to urgently address these issues in the coming months. Study registration number ISRCTN 80453162 (registered prospectively).

Lasting Impact of COVID-19 on Bariatric Surgery Delivery in North America: A Retrospective International Cohort Study of 349,209 Patients in 902 Centers

“…Although data on the persistent effect from COVID-19 are not well described in bariatric surgery, growing evidence from other surgical specialties continues to demonstrate a persistent COVID-19 effect on waiting lists, patient selection, and operative technique utilization [7]. Vascular surgery in the United Kingdom continues to report long waiting lists, a reduction in aneurysm screening, and an increase in aneurysm size thresholds for intervention [8]. Similarly, massive case-load backlogs have persisted across most, if not all, surgical specialties, forcing surgeons to triage patients accordingly [9,10].…”