Elective procedures postponed at Cavan General over Covid fears

Elective in-patient procedures at Cavan General Hospital have been cancelled for the rest of the week, as the local health facility looks to curb any inward spread of Covid following a rise in community transmissions locally.

As of last weekend, Cavan General had been caring for several patients infected with the novel coronavirus.

It's understood those admitted are all in a stable condition, none are in the Intensive Care Unit (ICU), nor have they been in receipt of emergency critical care.

There are also a number of staff currently off work.

They are all now understood to be self-isolating, with extensive contract tracing taking place among those who have tested positive.

Such absenteeism has risen across a multiple of disciplines at the hospital, including nursing and administration, with the number off work believed to be in the low teens.

Preparedness

The decision to cancel elective procedures comes as senior management Cavan General continue to “review activities” at the hospital to best manage any potential influx of Covid infections.

In recent months Cavan General has ramped up preparations for the Winter flu season, while with one eye also on dealing with any potential rise in Covid presentations.

Those levels of preparedness were stepped up further in September.

Safe and direct pathways of care have been established for patients displaying symptoms of Covid sickness, and visiting arrangements at the hospital have now been severely curtailed.

Restrictions

A strict “no visiting” rule is currently in place, with people seeking to visit critically ill, or end of life patients advised to contact the ward manager directly.

Visiting at Maternity, Antenatal or Paediatrics, is now on a case-by-case basis, and visitors are being reminded about hand hygiene and mask wearing. Temperature checks are also taking place.

The cancellation and rescheduling of elective procedures, including endoscopy, could extend beyond this week.

It's understood that local GPs and other community-based health staff have been written to by the hospital notifying them of the decision to cancel procedures for this week.

Delays

It comes as a major blow especially as the number of people waiting for inpatient care at Cavan General Hospital has more than doubled due to services being scaled back through Covid restrictions.

According to the latest information available from the National Treatment Purchase Fund, valid as of the end of July last, there are 755 people waiting for inpatient care at Cavan General at present.

In January, the corresponding figure was just 340.

Of the 340 figure, 322 were adults, and 18 children.

However, the vast majority of the backlog locally has only arisen in the past nine months.

The 755 on the hospital's waiting list as of the end of July includes 721 adults, and 34 children, with five of those in the bracket as having had their treatment delayed by between nine and 12 months.

Treatment

According to the report, 230 (32%) patients have been waiting up to three months for treatment at CGH, 276 (36%) between three and six months, and 224 (30%) between six and nine months.

Only 25 patients have been waiting between nine and 12 months to be seen by a consultant doctor.

Cavan General is the only hospital nationally which has zero patients waiting longer than between a year and 15 months for treatment.

However, the extent of the impact of Covid is clear when comparing the waiting list figures from July with the start of the year and subsequent months, several of which were spent in lockdown.

Back in January 2020, the longest waiting period facing a patient in Cavan was just six months (46), with zero patients waiting longer than that.

The remaining 294 (86%) had been on the list no more than three months.

The numbers waiting for treatment crept slight upwards in February to 349 (+ 19%), but effect of delaying procedures really began to manifest by March, when 494 (+ 41.5%) were then on the list.

By that stage the cumulative delay caused by inpatient services being cancelled saw 12 cases pushed out as having waited six to nine months; and by April there were appearances of delayed cases right across the board, with 628 (+ 27%) cases waiting in total.

In May there were 686 patients on the waiting list, up 9%; and in June 692 (>1%).

There are meanwhile, according to the NTPF figures for July, 1,322 patients at Cavan General presently awaiting GI Endoscopy.

That figure too has increased since the start of the year, when there were just 589, with all but one of those cases waiting no longer than three months to be seen.

July's figures now show more than half (699) waiting up to three months; 481 (36%) up to six months; and 139 (10.5%) up to nine months. There are three cases waiting between nine and 12 months.

Hospital services had started back gradually across the country, with many like Cavan General developing new ways of working to continue to reduce the risk of coronavirus.

Many hospitals are using virtual clinics to continue delivering care to patients, while some other patient’s hospital appointments have changed because of the coronavirus (COVID-19) outbreak.

Monaghan

Meanwhile, the prospect of sharing more services with Monaghan Hospital to alleviate pressure on the Cavan site has been examined

The Celt has learned of plans to increase outpatient services at Monaghan Hospital, after endoscopy services were extended earlier this year.

The prospect of adding a second scoping room and some radiology services are also currently under consideration.