Abstract
BackgroundWe aim to investigate current head and neck outpatient practices across the United Kingdom during the COVID-19 pandemic.MethodA cross-sectional study comprising of an online 20-item survey was emailed to members of the British Association of Head and Neck Oncologists (BAHNO). Topics covered included safety measures, protective equipment used and protocols around the use of flexible nasendoscopy (FNE) in clinic.Results117 participants completed the survey covering 66 Trusts across the UK. There was a significant reduction in face-to-face clinic patients compared to pre-pandemic numbers. Room down-time after FNE ranged from 0-6 hours and there was a significant increase in allocated down-time after the patient had coughed or sneezed. Natural ventilation existed in 36% of clinics and the majority of responders didn’t know the calculated Air Change Per Hour (ACPH) of the room (77%). Where ACPH was known, it often did not match the allocated room down-time.ConclusionsAdaptations are being made across the UK to maintain staff and patient safety, but more can still be done by liaising with hospital infectious diseases and the hospital estates team to clarify outpatient protocols.Outpatient activity will likely remain limited and alternative strategies will need to develop to manage the backlog in face-to-face clinics.
Highlights
The COVID-19 pandemic caused by the SARS-CoV-2 coronavirus infection has resulted in an unprecedented challenge on healthcare systems worldwide [1, 2]
We explore safety measures for patients, protective equipment for healthcare staff and protocols around the use of flexible nasendoscopy (FNE) in the clinic
It was not known what proportion of the overall membership performed flexible nasendoscopy
Summary
The COVID-19 pandemic caused by the SARS-CoV-2 coronavirus infection has resulted in an unprecedented challenge on healthcare systems worldwide [1, 2]. As outpatient services adopt new strategies for the delivery of care, many face-to-face appointments have been cancelled, causing a significant backlog of surgical work. Evidence suggested that Head and Neck clinicians, for example, those in specialities such as Otolaryngology and Maxillofacial surgery, were at a high risk of contracting the disease [5]. This was attributed to the elevated viral load found in the nasopharynx [6], close proximity to the oral cavity and the frequency of aerosol-generating procedures [7]. Outpatient management of head and neck cancer extends beyond these two specialities with a broad range of multidisciplinary team members performing at risk procedures such as nasendoscopy, speech valve changes and tracheostomy care
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