Preparing for future pandemic
In order to develop our healthcare service, it is vital that we learn from this experience to improve our preparedness for future pandemic situations. The lessons main learned are those surrounding management of resources in order to appropriately manage the pandemic situation, whilst maintaining sufficient services to allow the management of other patients with time-critical illness. Firstly, organisation of staffing and preparing for staff sickness and absence is vital in order to maintain the service. To achieve this, prompt cessation of elective theatre and clinics should be instated to enable staff to be redeployed to areas of greatest need and unavoidable surgery needs to be prioritised appropriately to limit patient throughflow. Any required meetings should be performed virtually to reduce risk of transmission. Patients should be manged through virtual clinics where possible and if patient attendance is absolutely necessary, all investigations should be performed during the same visit and treatment commenced where possible to limit patient appointments. Routine screening should be postponed until after the pandemic. Non-infective patients should be managed in a geographically distinct area from those with infection and surgery should be performed in a negative pressure environment to limit transmission. In addition, surgical procedures may need to be altered to reduce operating time, reduce post-operative recovery and its associated hospital admission. Alternatives to surgery should be explored where possible to reduce the number of patients requiring admission where they risk exposure to infection and occupy limited resources. Finally, planning needs to be commenced early regarding the reinstating of services in order to deal with the incurred backlog secondary to the pandemic to ensure patients are followed up appropriately to avoid excess morbidity and mortality.