Interview by Rohan Gujjuri.

Since December 2019, the coronavirus disease 2019 (COVID-19) pandemic has spread across the globe, causing an unprecedented health crisis. Countries have employed a variety of methods to contain and control the spread of COVID-19 and to limit the damage caused by the virus.

However, the efficacy of these strategies have varied, as has the resilience of global healthcare systems. A consequence of COVID-19 has therefore been a "second hit" of mental, social and healthcare morbidity that remains poorly defined, and which has been exacerbated by the economic consequences of this crisis. It is now imperative that we take the initiative and prepare ourselves to transition into the restoration phase of COVID-19; this will require innovative strategies for ensuring patients with colorectal disease remain safe and that they receive timely and high quality care .

There have been many initiatives created during this time to tackle the lack of data in providing guidance to healthcare professionals. James Kinross, a colorectal surgeon from Imperial College London gave a perspective on behalf of the PanSurg collaborative on what surgeons should anticipate as we move forward.

James said, "We are taking a systems approach when trying to model a return to normal service and we are considering four domains."

The PanSurg approach to post-COVID recovery covers:

  • Patient domain: Patient care has varied dramatically during this pandemic and there is a need to consider patient specific variables when planning on new services. How are different surgical patient groups affected by COVID-induced disruption? How can we look differently at surgical patients post-COVID?
  • Pathway domain: There is a need to consider post-pandemic services in addition to current care and this needs to account for both local and patient variation. Which pathways were affected most, and which are most able to resume? What role do non-surgical procedures play?
  • Place domain: There has been variation in the COVID response across the country, due to different prevalence in infection rates and differing levels of resilience in services. It is important to consider these factors when examining current and new networks of care to ensure these remain sustainable following the pandemic. How did different trusts respond to the COVID-19 pandemic, and how does this translate to equitable access to care across England?
  • Policy domain: There is a need for a policy to govern the immediate ongoing phase and to guide care going forward. Data is needed to help guide the creation of these policies. Are they new models of care which would help overcome the surgical backlog?

More information regarding the PanSurg collaborative can be found on their website.

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