NHS England has reported a significant drop in 2 week-wait referrals and has asked charities to emphasise the message that women should still contact their GPs when experiencing concerning symptoms. However, we know some people will be reluctant to visit or ‘bother’ their GP, and others will struggle to get through to their GP as they’re swamped. What specific information and advice can we give to people trying to make contact with their GP if they’re worried about symptoms and are finding it hard to get through?
Patients who have symptoms concerning cancer should still contact their GPs, even during the COVID-19 pandemic. Please don’t worry that you are ‘bothering’ us – we won’t think that.
GP practices may not be able to see you face-to-face; many are trying to keep patients and staff safe by doing telephone and video consultations. Ideally, if you have abnormal vaginal bleeding, you should still be examined in your GP practice prior to referral, although this may not be possible in all areas due to local services pressures. GP practices should still be able to perform blood tests, if this is required prior to referral, although alternative arrangements may need to be made depending on local pressures at the time. Please get these done as soon as you can as we will need the results to plan the next step of your care and cannot do some scans and tests without them.
Referral criteria remain the same as before the COVID-19 pandemic. Hospitals have been organising services so that we can still see you, if you need to. Please don’t sit on anything, if you are worried, GPs and hospitals are still ‘open for business’ and we are trying to keep those with known COVID-19 cared for separately from those without. Obviously, should you be unwell with symptoms of COVID-19 or self-isolating because someone in your household has symptoms, any appointments will be delayed until it is safe for you to be seen, as we have a responsibility to others in your community, including other patients and staff. A short delay is unlikely to cause any harm to you and any treatment is unlikely to be safe whilst you have COVID-19 – it is much safer to wait a couple of weeks in most cases.
Some existing cancer patients have open access to their gynae oncology service, normally via the CNS. If you have already had a gynae cancer diagnosis and have symptoms concerning for recurrence (vaginal bleeding, bloating, pain etc), please get in touch with your CNS via their usual contact details. Please be aware that many staff have been re-deployed to look after acutely unwell patients, so there may be a delay, or a CNS from another cancer team may be covering the gynae cancer team. Please be understanding with us, if this is the case, we will try our very hardest to look after you and get back to you as quickly as we can.
Sometimes you may be referred to another hospital in your area, if your normal hospital is very busy. We have been working together to help get you seen and treated as soon as we can. We are all one big NHS team, now more so than ever. Please bear with us and be understanding, if this is the case.
What can people expect to happen a) in terms of getting in touch (e.g. triage by phone) b) if their GP thinks there’s cause for concern? Essentially, what does the referral process look like right now?
Things are different everywhere as we try to find the safest way to look after you and processes may differ in different places over time, depending on local circumstances. This is just a guide for what might happen.
If you need to be referred to hospital with symptoms concerning for a new cancer, you may first get a telephone or video appointment, so that the Drs or specialist nurses can find out as much as they can, without needing to bring you to hospital too often. They are doing this to keep you safe. They may then arrange for you to have tests performed (blood tests and/or scans) or may want to see you in person for an examination and/or to take samples (biopsies).
If you go to a hospital it is likely that staff will be wearing face masks, aprons or gowns and gloves. This is to protect both you, other patients and the staff. It may be difficult to hear people properly and you won’t be able to see their faces. Be assured that they will be smiling and kind, even behind the masks (and a bit hot and itchy!). However, this can make it hard to hear people properly. If you need to lip-read, please let us know in advance so we can make plans to help you. If you can’t hear because speech is muffled, please let us know – we won’t mind.
You are also likely to be asked to come on your own into the hospital/clinic room. You could think about using a mobile phone on ’speaker phone’ or link remotely using an App. This means that if you want a friend or relative can be there for you and listen to what is said, even if they can’t be in the room. We will be there to hold your hand in their place.
We may get in touch with you about the results to save you a trip back to the hospital to reduce your risks from COVID-19. If we plan to call you with results, you may need to arrange this to be at a set time. This means you can have someone available to support you, if you would like, in case of good or bad news. This could be either as a video or telephone ‘conference’ that several people can join in with, if you are living alone. An alternative is to ask you to use the ’speaker phone’ function on your phone so that whomever you live with can hear and talk too. Talk to the team about how you would like to get the results and what we are able to offer.
Please bear with us. We are all working as hard as we can and adapting and learning along the way. Our only aim in this is to look after you as safely as we can. Some of this may not be as ideal as we would like, but we are being creative as to how we can support you and keep you, and the hospital team, as safe as we can.
For further information click here
Does taking PARP inhibitors affect a patient's risk of severe illness if they contract coronavirus?
PARP inhibitors can result in immunosuppression in particular at the beginning of the treatment course before the optimal dose can be established for an individual patient. Once stable and the dose has been adjusted the risk of immunosuppression is significantly lower however the risk of infection cannot be completely eliminated.
What advice and information can we give to patients concerned about delays to treatments and surgeries?
Please see the BGCS patient facing letter.