Abstract
The COVID-19 crisis has undoubtedly taken a toll on the care of patients with colorectal disease. Elective services, be that face to face contact, endoscopy or operating all but ceased during the pandemic.
Highlights
The COVID-19 crisis has undoubtedly taken a toll on the care of patients with colorectal disease
Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland
A final point is that integration of services into regional pathways offers an opportunity to provide some redress for patient groups that, pre-COVID-19, have been commonly disenfranchised from hospital care, either in terms of access to, or wait for, specialist treatment
Summary
Our overarching aim is to improve care for patients. Any legacy from the COVID-19 crisis must clearly have patients’ interests ‘front and centre’ with other factors feeding into this central theme (Fig. 1). The ‘old’ paradigm involved invasive and expensive investigation of such patients with a near exclusive focus on the exclusion of cancer – to the extent that the primary reason the patient attended in the first place, namely management of their problem, was often neglected or forgotten This is a grossly inefficient way of working; it puts patients at unnecessary risk of investigation and has little benefit for those who need treatment for conditions other than bowel cancer. Obvious examples are modifications to the 2-week-wait and straight-to-test pathways Both are leading to an ever-increasing drain on limited endoscopy resources, a decreasing efficacy in identifying significant pathology as only cancer detection is prioritized and often inappropriate discharge of patients symptomatic from other pathologies.
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