RCSEd Urges Government to Increase 'COVID-Free Hubs' So Vital Cancer Surgeries Can Continue

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24 Apr 2020


87% of leading cancer surgeons surveyed say they have reduced operating


The Royal College of Surgeons of Edinburgh is calling on Government to increase the number of ‘COVID-free hubs’ available to patients, so life-saving cancer operations can go ahead. 

The College has issued the rallying cry after a survey* of its fellows showed that a third of those who carry out cancer operations have completely stopped performing these procedures in recent weeks as a result of COVID-19, and 87% have reduced cancer operations. 

The College, which represents 15,000 members across the United Kingdom, notes that while official guidance was published by Public Health England three weeks ago, encouraging surgical staff to operate in ‘COVID-free cancer hubs’ to minimise coronavirus transmission for patients and staff, this isn’t being carried out nationwide. 

In fact, 53% of those surveyed said their NHS Trust or health board had not yet set up such a space for major cancer operations to take place, leaving surgeons with no option but to delay vital procedures in many cases. 

Hubs can be private hospital spaces solely used for non-coronavirus purposes, or in certain cities which have more than one hospital, COVID patients could be housed in the acute facilities, with separate hospitals being used for performing operations related to cancer. 

Professor Michael Griffin OBE, President of the Royal College of Surgeons, said:

“Surgeons are facing an extremely difficult time right now when it comes to performing surgery in what we call COVID-rich environments.

“Major surgeries on certain cancer types have very significant risks attached to them, and performing them in an environment where coronavirus is present could potentially outweigh the risk of delaying surgery.

“Operating in a hospital where COVID-19 is present could pose a huge risk to patients who are already unwell, and major surgery would make them markedly immunocompromised and therefore at an even higher risk of developing complications should they contract coronavirus.

“In addition, there is a risk for the teams performing these operations and a need to ensure they are protected appropriately from transmission of the virus to ensure they can continue working safely in their vital roles.

“Surgeons are left facing an impossibly difficult question – should I be operating or not?  If you don’t, you could reduce the chances of curing a patient’s cancer, but if you go ahead, you could be increasing their chance of catching COVID postoperatively and risking their recovery.”


The statement comes after Matt Hancock admitted during Wednesday’s PMQs that he couldn’t guarantee all cancer operations will be able to go ahead during the pandemic despite adequate capacity within the NHS due to the prevalence of coronavirus and the associated risks it poses to patients. 

A significant drop in patients presenting with symptoms of suspected cancer over the past few weeks has also prompted concern over delays in diagnoses and a potentially significant backlog of operations over the coming year.  

Professor Griffin continued:

“The main issue is that there is no uniform approach across the country.  A cancer patient in one part of the country could receive a completely different course of treatment to someone in another region depending on whether there is a COVID-deficient environment available for them to operate in.   Where possible we must maintain consistency of treatment, and for this reason, we need more of these hubs where the presence of coronavirus is minimised. 

“The transmission rate of the virus is far greater within hospitals than in the community, because there are large numbers of COVID patients present.  It’s vital for healthcare staff to observe social distancing as much as possible during their down time. 

“Of course it’s not possible to socially distance all the time when working in a hospital environment, but by taking this into account and minimising contact in group meetings, medical staff can ensure they are creating as much of a COVID-deficient space as possible.  

“The reality is that despite the guidance, many Trusts and Health Boards are being left to their own devices and to make their own decisions, and this is resulting in a disparate approach to patients across the country.

“We need a unified approach to avoid a scenario where patients find themselves facing a postcode lottery, and the only way to achieve this is with more suitable spaces to carry out vital operations.”



*This survey was completed by 200 consultant surgeons who carry out cancer surgeries across 150 hospitals in the UK.

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