THE Scottish Government is under pressure to set out a timetable for when planned operations and delayed cancer treatments will resume as coronavirus-related hospital admissions continue to decline.
First Minister Nicola Sturgeon said the issue was "under active consideration" as she confirmed that the total number of people in hospital with confirmed or suspected Covid-19 had dropped to 1754, including 126 in intensive care - the lowest since admissions peaked at 221 on April 12.
All elective surgeries were put on hold for three months in March to help free up beds amid fears that the NHS could be overwhelmed with Covid patients, resulting in delays for thousands of people waiting for procedures such as heart bypasses, hip and knee replacements, and cataracts.
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Intensive care capacity has been increased from around 190 to 600 beds, with 3000 acute hospital beds also ring-fenced to treat coronavirus.
The Scottish Exhibition Centre in Glasgow has also been converted into the NHS Louisa Jordan field hospital which can provide critical care to 300 patients, with potential to accommodate 1000, but currently lies empty.
The majority of outpatient clinics were also paused and some cancer care, including surgery and chemotherapy, postponed due to the risk of potentially deadly complications if patients contracted the virus.
The Royal College of Surgeons Edinburgh (RCSEd) said 87 per cent of its members in cancer surgery across the UK had stopped operating altogether or significantly reduced it due to the danger.
On Monday, UK Health Secretary Matt Hancock said the "most urgent" non-Covid NHS services including cancer care and mental health support would begin being reinstated in England this week.
Asked about the plans for NHS Scotland, Ms Sturgeon said it was "an issue we’re looking at closely and carefully right now".
She added: “It’s something that is under consideration and we will set out more details on that when we’ve taken particular decisions.
“There’s a number of factors we have to weigh up: obviously hospital and ICU capacity is one of them, but also making certain we are protecting patients who are perhaps returning to hospital for non-Covid procedures from being infected with the virus.
"All of that is under active consideration right now.”
It came as new figures showed that a record number of people were diagnosed with cancer in Scotland in 2018.
Macmillan's director of policy Steven McIntosh said: "The jump in the number of people diagnosed with cancer is a timely reminder the illness remains one of the biggest public health issues in Scotland, particularly for those living in deprived communities.
“In light of the announcement cancer care is restarting in England, we urge the Scottish Government to outline their plans urgently.
"Having cancer at any time is tough, but the added uncertainty people are facing now is leading to increased worry and anxiety.
“While we know the NHS is under unprecedented pressure, people with cancer must still receive the best possible care.
“Restoring cancer care will require urgently catching up on treatment and tests that have been affected by the response to coronavirus.
"To get back on track, cancer care teams must be supported with protective equipment and Coronavirus testing to keep staff and patients safe.”
Marion O’Neill, Cancer Research UK’s head of external affairs in Scotland, said diagnostic tests and treatment for cancer patients should take place "in an environment that’s Covid-free".
"A widespread Covid-19 testing programme for patients and healthcare staff should be at the heart of this,” she said.
READ MORE: Third of cancer surgeons stop operating over virus fears
Professor Mike Griffin, a cancer surgeon and president of RCSEd, said NHS bosses must urgentlh focus on creating 'Covid-lite' spaces for the riskiest procedures such as cancer and open heart surgery.
He said this could be set up within designated areas of acute hospitals, using the private sector, or restructuring non-emergency hospitals for cancer surgery.
He said: "In Glasgow I think breast cancer surgery has gone to one of the private hospitals. There are some plans for the more major stuff to go to the Golden Jubilee.
"In Edinburgh breast cancer surgery is going to the private hospital, but the more major cancer surgery was still being done at the ERI in a theatre ring-fenced as 'Covid-lite'.
"That's what's happening at the moment but it needs to be more structured.
"What everyone needs to realise is if you devise these Covid-lite areas within hospitals [also treating Covid patients] there's got to be absolutely rigid testing.
"If a patient is coming in for a planned cancer operation they must be tested the day before. They'll also need a CT scan of the chest to check for signs of Covid pneumonia, and will have been self-isolating at home for 14 days at home prior. You do not want to operate on someone who is Covid positive.
"And equally, you've got to do that testing for the staff. You've got to test, test, test so that you know you're doing everything to minimise the risk of having coronavirus there."
Ms Sturgeon announced yesterday that all over-70s will now be tested for Covid-19 on admission to hospital, with check-up tests every four days, regardless of symptoms.
Professor Andrew Elder, president of the Royal College of Physicians of Edinburgh, said: "The Covid-19 pandemic has created substantial but unavoidable and unforeseen delays in such activities, but, given the decline in Covid-19 hospital admissions, the College believes that we must now move swiftly but carefully towards restoration of deferred or delayed activity.
"Any return to such activity must be carefully considered based on the scientific and medical evidence available and respect and uphold all requirements relating to travel and social distancing when at all possible.
"It is vital that patients can feel secure that their risk of infection is as low as possible."
Prof Elder said virus testing for staff and patients, availability of protective gear, and redeploying staff back from Covid duties to their own specialist roles would be vital to resuming elective work safely.
"We understand that health boards in Scotland are already making plans for this to happen,” he added.
A spokesman for the Scottish Government said vital cancer treatments and emergency, maternity and urgent care was already continuing "where that is clinically agreed", including through the use of private hospitals.
He added: "We are continuously keeping the position under review and encourage patients to engage with the NHS when they consider that they need to seek treatment.
"Whilst the efforts and sacrifices of people across Scotland are now showing early promising results, we need to continue with the current situation whilst also giving consideration as to whether and – if so – when any reinstatement of currently 'paused' healthcare can be reinstated.”
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