Ensuring the delivery of time-critical cancer surgery and a rapid recovery during Covid-19

Published 15 June 2020


Ensuring the delivery of time-critical cancer surgery during the Covid-19 crisis, and supporting a rapid recovery of cancer services in London post-Covid-19


As Covid-19 spread quickly through London in March, there was a risk that capacity would be diverted from cancer services leading to delays in time-critical surgery. The Royal Marsden, with analytical support from Edge Health, led the London response by rapidly establishing the West London cancer hub that allowed essential surgery to be maintained during the crisis and is now supporting the delivery of the demand backlog.


Karl Munslow-Ong, Chief Operating Officer at The Royal Marsden Foundation Trust, commented:


"There was a very considerable risk that as the Covid-19 pandemic unfolded that the vast majority of cancer elective work would be stopped. The work that the Royal Marsden and RMP Cancer Alliance undertook with Edge Health and academic partners demonstrated the vital importance of maintaining time critical surgery for the most clinically urgent patients. The modelling ultimately helped inform the development of the Cancer Hubs both in London and its roll out nationally.”


Ensuring the delivery of time-critical cancer surgery


The West London cancer hub, which involved a collaboration between the NHS and independent sector, was set up within a matter of days. This hub was established after the potential impact of Covid-19 on the NHS became apparent, and it was necessary to protect surgical capacity for time-critical cancer.


"The work that the Royal Marsden and RMP Cancer Alliance undertook with Edge Health and academic partners demonstrated the vital importance of maintaining time critical surgery"

To ensure that this hub had enough capacity to meet essential demands, Edge Health was commissioned to work in collaboration with the Royal Marsden team to estimate the requirements – specifically operating theatres. To do this, Edge worked closely with world-leading experts to seamlessly integrate demand and capacity modelling with expert understanding of essential demand and the impact that infection control would have on surgical throughput for cancer cases.


Since being established, the hub has ensured that nearly 1,000 patients have received time-critical cancer surgery.


Supporting the Covid-19 recovery


While demand for time-critical cancer surgery was met during the Covid-19 crisis, many cancer cases usually identified through Two Week Wait referrals from GPs dropped significantly – up to 80% during early April. Cumulatively this meant that up to 20,000 patients across West London did not have their cancer diagnosed in March and April because of the Covid-19 crisis.


"The modelling ultimately helped inform the development of the Cancer Hubs both in London and its roll out nationally"

As the demand for cancer services starts to return, these undiagnosed cancer cases will be identified. So that capacity is available for the timely delivery of this backlog of activity, the Royal Marsden worked closely with Edge Health to develop an understanding of resources requirements going forward.


By combining the understanding of capacity requirements with the Royal Marsden's clinical and operational excellence, people with cancer will receive timely diagnosis and treatment despite the substantial disruption from Covid-19.





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