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.
receiving an oral treatment whereas only 33.5% would agree if the treatment was endovenous. In general, younger patients (<50 years old) feel more comfortable with virtual visits than older ones (>70 y) (77.4% vs 62%, p¼0.07). Only 20% of patients older than 50 believe that they can handle new technologies as opposed to 58.5% of younger ones (p¼0.001). 60.4% of the younger patients would like to have different technological tools to contact their oncologist whereas most patients (47.6%) older than 70 prefer only phone calls (p¼0.001). Regardless of the type of visit (treatment or follow-up) patients felt comfortable with virtual attendance (58.7% and 65.6% respectively, p¼0.2).Conclusions: As a whole, patients surveyed believed that telehealth could have a role following the COVID-19 pandemic. However, telemedicine is not applicable in all cases. Visits to older patients, to inform about radiological results and to patients recieving treatment should be assessed case by case.
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