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It is, therefore, vital to optimise the training opportunities that present themselves.Emergency and urgent colorectal surgery accounts for a large proportion of the general surgery on-call workload. However, it is high-risk surgery, with a high peri-operative morbidity and mortality. It is, therefore, important to ensure that, if this surgery is being performed by higher surgical trainees (HSTs), it is safe for them to do so. There is a gap in the literature regarding this aspect of surgical care. The aim of this study was to compare the outcomes of patients undergoing urgent colorectal surgery by consultants and HSTs. Patients and MethodsDetails of patients who underwent urgent colorectal surgery at a busy district general hospital in the West Midlands were retrospectively collected for a 5-year period (June 1998 to June 2003). Patients were identified, through the hospital coding department, by selecting patients who had had operations consistent with emergency and urgent colorectal surgery. The resulting list was then analysed for the coded diagnoses and appropriate notes selected for inclusion in the study. Based on codes for operation performed and diagnosis, 575 patients were identified who appeared to fit the intended population and 90.26% (519) of these notes were obtained. After initial screening, 157 patients were excluded due to incorrect coding or incomplete data.Data were collected regarding patient demographics, disease process, American Society of Anesthesiologists (ASA) score, indication for surgery, procedure performed, COLORECTAL CANCER

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Objectives The aim of this study was to evaluate the differences in surgical capacity for head and neck cancer in the UK between the first wave (March‐June 2020) and the current wave (Jan‐Feb 2021) of the COVID‐19 pandemic. Design REDcap online‐based survey of hospital capacity. Setting UK secondary and tertiary hospitals providing head and neck cancer surgery. Participants One representative per hospital was asked to report the capacity for head and neck cancer surgery in that institution. Main outcome measures The principal measures of interests were new patient referrals, capacity in outpatients, theatres and critical care; therapeutic compromises constituting delay to surgery, de‐escalated surgery and therapeutic migration to non‐surgical primary modality. Results Data were returned from approximately 95% of UK hospitals with a head and neck cancer surgery specialist service. 50% of UK head and neck cancer patients requiring surgery have significantly compromised treatments during the second wave: 28% delayed, 10% have received radiotherapy‐based treatment instead of surgery, and 12% have received de‐escalated surgery. Surgical capacity has been more severely constrained in the second wave (58% of pre‐pandemic level) compared with the first wave (62%) despite the time to prepare. Conclusions Some hospitals are overwhelmed by COVID‐19 and unable to offer essential cancer surgery, but all have neighbouring hospitals in their region retaining good (or even normal) capacity. It is noteworthy that very few patients have been appropriately redirected away from the hospitals most constrained by their burden of COVID‐19. The paucity of an effective central or regional strategic response to this evident mismatch between demand and surgical capacity is to the detriment of our head and neck cancer patients.