Slated to recommence on 27 April, elective surgery bans have been eased and elective surgery will be reintroduced in a staged manner according to the federal health Minister Greg Hunt.
But it’s not an immediate return to business as usual.
Category 1 patients continue to be allowed and focus been turned to the reintroduction of surgery for category 2 and more urgent category 3 cases.
The Federal Health Minister has released the following information giving guidance to which added procedures can be considered.
“Reintroduction of elective surgery will be done using a staged and controlled process which balances the ongoing need for the capacity to treat COVID-19 patients, while allowing our hospitals to treat elective surgery patients.
The selection of patients to undergo elective surgery will ultimately be a clinical one, guided by the following principles, recommended by the Australian Health Protection Principal Committee (AHPPC) and endorsed by National Cabinet:
- Procedures representing low risk, high value care as determined by specialist societies
- Selection of patients who are at low risk of post-operative deterioration
- Children whose procedures have exceeded clinical wait times
- Assisted reproduction (IVF)
- Endoscopic procedures
- Screening programs
- Critical dental procedures.
This first stage of reinstating elective surgeries will require health administrators to monitor supplies of personal protective equipment (PPE), ICU and bed capacity, while preparing for the next phase.
On the advice of AHPPC, in addition to Category 1 elective surgeries, hospitals will initially recommence one in four closed operating lists, with a focus on Category 2 and some important Category 3.
In reintroducing elective surgery we acknowledge the safety of patients and healthcare workers is paramount. A thorough risk assessment of patients planned for elective surgery is essential, based on national guidelines.”
NASOG reminds all members to maintain vigilance and stick to recommendations both of the Federal Government and of local hospitals where procedures are undertaken.
In many cases, hospitals are requesting potential theatre cases be discussed with a colleague prior to scheduling, to ensure the proposed procedure is within the current recommendations.
We have been informed that some facilities are using more formal processes with the requirement that proposed theatre lists, with justifications, be submitted to medical advisory committees for approval prior to procedures being able to be booked.
How much elective surgery is performed will of course depend on individual hospitals’ continued availability of personal protective equipment. This is likely to vary both in region and individual institutions so liaison with your specific local hospital is essential.
Bear in mind that the categorisation of patients has been defined by the Office of the Prime Minister:
Category 1 – Needing treatment within 30 days. Has the potential to deteriorate quickly to the point where the patient’s situation may become an emergency
Category 2 – Needing treatment within 90 days. Their condition causes pain, dysfunction or disability. Unlikely to deteriorate quickly and unlikely to become an emergency
Category 3 – Needing treatment at some point in the next year. Their condition causes pain, dysfunction or disability. Unlikely to deteriorate quickly.
Obstetrics related theatre cases remain Category 1 and are not subject to any bans. NASOG strongly recommends that COVID-19 drills and simulations continue to be undertaken to ensure all staff maintain readiness and familiarity with processes needed to deal with a potentially infectious case.
This is a significant improvement in elective surgery situation and is important we continue to monitor how the rollback of restrictions is progressing. Please feel free to contact NASOG and let us know of any concern so we can continue to inform the appropriate authorities.
Finally, continue to look after yourselves and your colleagues to make sure health worker and patient safety remains the top priority.
A/Prof Gino Pecoraro
President