'No light at the end of the tunnel' says Northwick Park surgeon on operation backlogs

Dr Matt Bartlett on BBC Newsnight.

Dr Matt Bartlett on BBC Newsnight. - Credit: BBC/LNWH

A leading Northwick Park surgeon fears there’s “no light at the end of the tunnel” for NHS staff due to the backlog of work caused by the Covid crisis.

Dr Matt Bartlett, divisional clinical director of surgery at London North West University Healthcare NHS Trust, told of the “heartbreaking” decision to cancel operations for a second time last year, as the second wave took hold in December.

Between the first and second peaks of the pandemic, he found the trust’s hospitals did recover in treating people for non-coronavirus related problems, but by late December it was no longer safe to run surgery.

The 54-year-old said: “Before this last wave we pretty much had it back up to previous surgery levels, and were starting to make in-roads into waiting lists and getting people treated who’ve been waiting for an awfully long time.

“So perhaps to stop that all again is heartbreaking, but we’ve really got no choice.”

The orthopedic surgeon said that on January 14 two thirds of patients at the hospitals were suffering from coronavirus, with staff needing to prioritise running the intensive care unit (ICU) and nursing people on the wards.

By that date, Dr Bartlett was working his 25th day straight.

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The NHS boss said it became a case of “midnight decisions”.

“When it started we anticipated it by a few days, but it hit us very hard initially…and it’s gone all the way through the holiday period, so basically everyone’s just stayed in over the holidays to sort it out.

“Christmas was pretty much cancelled this year for Northwick Park, as it has been for most people.”

With the exception of emergency surgery such as trauma, Dr Bartlett said a lot of his day job has “disappeared”, and been replaced by keeping busy with shifts in ICU, or organising patient transfers to other hospitals with more ICU beds.

“[There’s] no job too big, no job too small really, it’s all the way up from the basic portering duties when they’re being overwhelmed, to discussions with chief executives and medical directors,” he said.

A typical day may start from 7am and end “anywhere between” 7pm to 10pm – and on occasion 1am.

But the new demanding duties have meant longer waiting times for some patients, and Dr Bartlett said it is “really humbling” how all his patients have been “incredibly understanding” about their treatments being postponed.

“Our great effort is to make sure we don’t lose the opportunity to treat people,  that we actually don’t permanently disadvantage people by not treating them,” he said.

Procedures for hip or knee arthritis will be among the first to be pushed back as their operation can still be done in six month’s time.

He said: “That’s dreadful, because it’s an awful thing to do, but we at least know we can still treat these people at the end of the day.

“The thing we want to avoid and we have gone to great pains to do, is to make sure we don’t have someone on the cancer pathway who misses any vital bit of their treatment, so we’re still carrying on with our most urgent work.”

Looking ahead, the doctor knows there will be a “serious impact” on waiting lists when staff will "work twice as hard" while "exhausted from having just tackled the pandemic”.

“So the problem for medical staff is, we’ve got no light at the end of the tunnel to look forward to, because we know that even when this is over, we’re going to have an even bigger problem of getting on top of that, so we just move on to the next problem really.”

Dr Bartlett feels it will be the vaccine and the public’s behaviour that will “finally crack this”, but that it’s “humbling” to see the commitment of NHS staff.

The medic believes hospitals are at a critical point now and cases are slowing, but that we’re in for “at least” another couple of months dealing with the aftermath such as rehabilitating people who spent a lot of time in ICU and starting up elective surgery again.

He added: "Everyone’s really looking forward to things being normal again, we’re not looking for any end of the rainbow or anything, we just want it to go back to normal life…

“I’d love to get back to my day job and start doing knees again, that would be delightful.”