Green light for staged return to elective surgery

The Australian Private Hospitals Association (APHA) has welcomed the phased reintroduction of elective surgery as efforts to control the spread of COVID-19 continue.

APHA CEO, Michael Roff, said patient safety and wellbeing was central to the staged return of elective surgery, agreed to by the National Cabinet.

“Private hospitals welcome the controlled return of elective surgery, which must be conducted so patients, health care workers and other hospital staff are as safe as possible,” he said.

“A phased reintroduction will allow hospitals to minimise risk to patients, monitor use of Personal Protective Equipment (PPE) and ensure we maintain capacity in the system to address the pandemic if it is required.

“We must acknowledge the great work already done in the health care system and by Australians in flattening the curve and putting governments in a position to allow the reintroduction of some elective procedures

“We agree with the National Cabinet’s approach and look forward to resuming surgeries that will have a dramatic effect on the quality of life for many Australians.”

Federal Health Minister, Greg Hunt, said the decision to allow some elective surgery to go ahead from April 27, had been helped by the efforts of all Australians.

“This (decision) is possible due to the strong collaboration across governments to build capacity and strengthen the health system to reduce the threat of COVID-19,” Mr Hunt said.

“Through our containment measures we have successfully suppressed the virus, closing our borders, testing, tracing, and in particular, the social distancing and the isolation.

“These continue to be our strongest weapons against the coronavirus.”

Reintroduction of elective surgery will be done using a staged process which balances the ongoing need for the capacity to treat COVID-19 patients, while allowing hospitals to treat elective surgery patients.

The selection of patients to undergo elective surgery will be a clinical one, guided by the following principles:

  • 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 will require health administrators to monitor supplies of PPE, as well as ICU and bed capacity.

Mr Roff stressed the importance of access to PPE to ensure safety of patients and health care workers and that the use of PPE was appropriate to the procedure in accordance with nationally developed guidelines.

“Access to PPE is going to be a critical issue for return to elective surgery and if normal supply chains are not restored soon, private hospitals will need to be given access either to government supply chains or to the national stockpile to ensure they can provide care safely,” he said.

“For a nationally consistent approach, surgical restrictions need to be eased across the private and public hospitals at the same rate.

“This is to ensure equity of access to available services for patients on public elective waiting lists, in addition to privately insured patients.

“We must work together, going forward to ensure Australians are able to get the care they need and our health workforce has the PPE needed to provide that care in a safe environment.”

Private Healthcare Australia (PHA) chief executive, Dr Rachel David, said the decision to resume elective surgery was good news for Australians who were living in pain and discomfort.

“Many patients who have spent the last month living in distress and uncertainty as a result of the temporary restrictions on elective surgery will now have clarity on when their surgery will take place,” Dr David said.

“Consumers can be assured that health funds will work closely with private hospitals and surgeons to safely and efficiently clear the backlog of elective procedures.

“Health fund members will have access to timely surgery, their doctor of choice and continuity of care.”

The Medical Technology Association of Australia (MTAA) CEO, Ian Burgess, said his organisation had been working closely with the government to secure the PPE supplies required.

“For a range of medical conditions, what is non-essential, very quickly becomes essential if left untreated and a measured and responsible return to elective surgery will ensure continuity of care for those who need it most,” Mr Burgess said.

“A gradual and responsible return to elective surgery with the safety of patients and medical personnel front and centre will enable thousands of Australians to access the treatments they need to keep them working, studying and spending more time with their families.”

In addition to Category 1 elective surgeries, hospitals will initially recommence one in four closed operating lists which a focus on Category 2 and some important Category 3.

An overall review for additional support will be undertaken at two weeks and again at four weeks, based on the number of positive cases – in both healthcare workers and patients – linked to increased activity; PPE use and availability; and the volume of procedures and hospital/system capacity.

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