ABSTRACT
BACKGROUND: The coronavirus disease 2019 pandemic led to increased pressure on health services, which, combined with variable social restrictions, led to decreased referrals for head and neck cancer. This study assessed whether there were lasting changes to head and neck cancer referrals during different stages of the pandemic response in 2020 and 2021. METHODS: A retrospective review was conducted of all cases referred for suspected head and neck cancer to our institution in January 2020, April 2020, April 2021 and June 2021. RESULTS: There was a rebound 91 per cent increase in referrals between April 2020 and April 2021 following the 59 per cent decrease in referrals between January 2020 and April 2020. Males made up 47.1 per cent of referrals in January 2020, 40 per cent in April 2020 and 37.82 per cent in April 2021. CONCLUSION: Further research is recommended to investigate the reasons why there is a continued decline in male referrals and the effect this has on their outcomes.
Subject(s)
COVID-19 , Head and Neck Neoplasms , Humans , Male , Female , COVID-19/epidemiology , Head and Neck Neoplasms/therapy , Retrospective Studies , Referral and Consultation , United Kingdom/epidemiologyABSTRACT
Background: The onset of the COVID-19 pandemic in November 2019 has witnessed a reactive 'covidisation' of NHS care services. Training opportunities for junior doctors have suffered and psycho-social impacts are anticipated. This study will seek to assess these factors and their impact on doctors' career aspirations. Method: A five question survey was disseminated to 350 junior doctors in the Yorkshire and Humber deanery. 115 responses were gained;78 Foundation doctors (FY1-2), 24 Core/Early specialist trainees (CT 1-2/ ST1-2) and 13 Specialist Registrars. Results: Negative impacts on training include teaching commitments (61.7%) and work-based assessments (48%). A change in treatment protocols (67%) and acute referrals (58%) were also identified. Concerns regarding personal wellbeing were highlighted by 65%, with a greater willingness to consider taking time out of training (32%) or leave UK medical practice altogether (22%). Discussion: The number of doctors immediately progressing into specialist training has almost halved. COVID era practice has impacted on training opportunities, clinical experience, and the ability to meet ARCP requirements. It has also led to high levels of personal concern amongst junior doctors surveyed. These factors may stimulate a greater willingness to take time out of training (1/3) or leave UK based medical practice (1/4). Conclusions: It is evident that new and existing concerns amongst junior doctors have been heightened by COVID-19. This data provides a useful snapshot and may be utilised in ensuring the continued health and robustness of the UK's junior doctor workforce and its ability to meet the evolving challenges of global healthcare.
ABSTRACT
BACKGROUND: The coronavirus disease 2019 pandemic has necessitated almost exclusive National Health Service focus on emergency work and cancer care. There are concerns that increased hospital and community pressures will lead to decreased referrals and worse outcomes for head and neck cancer patients. METHOD: This is a retrospective review of all cases referred for suspected head and neck cancer to our institution in January and April 2020. RESULTS: There was a 55 per cent decrease in referrals but diagnostic yield rose from 2.9 per cent in January to 8.06 per cent in April. In both months, 100 per cent of patients met the 31- and 62-day targets, with similar 14-day wait time success (97.83 per cent for January vs 98.33 per cent for April). Referrals for laryngopharyngeal reflux rose from 27.5 per cent to 41.9 per cent. Referrals for those aged over 60 years fell from 42 per cent to 26 per cent. CONCLUSION: It is suggested that further research be conducted into the reasons why fewer patients were referred, particularly elderly patients, and why laryngopharyngeal reflux is so prevalent in fast-track referrals.