B.C. is gearing up to go under the knife as it unveils an “ambitious” plan to renew regular surgery capacity by mid-June in the province.
On Thursday, Health Minister Adrian Dix and provincial health officer Dr. Bonnie Henry announced a detailed plan that is expected to allow B.C. to resume its normal surgery capacity by June 15.
“British Columbians have stepped up to the challenge of COVID-19 by making sacrifices, including thousands of people who have waited for postponed elective surgeries. This has been very difficult for people and their families,” said Premier John Horgan. “But these sacrifices have helped flatten the curve in B.C., and now we can move forward, safely, getting people the surgeries they’ve been waiting for.”
Adrian Dix said this plan is extremely susceptible to change and can easily be affected by outside factors, like a second wave of COVID-19.
Not only is the province planning on getting surgery numbers back to normal, but the new plan includes steps to boost the number of surgeries performed to help catch up on those cancelled or postponed due to COVID-19.
From March 16 to May 18, an estimated 30,000 surgeries were lost – 14,000 patients saw a surgery postponement while an additional 16,000 cases that normally would have been scheduled, were passed over.
A glimpse into the lost surgeries as a result of COVID-19
“That’s 30,000 people who have been having to endure pain and other sufferings as we’ve worked together to address COVID-19,” said Horgan, “But because of those sacrifices we’ve been able to move forward.”
In addition to the estimated 30,000 surgeries lost, the province expects 24,000 more cases would have normally been put on the list from surgery referrals.
For the surgeries that were still being performed, health authorities reported a 30 per cent loss in productivity. This means for every 10 surgeries that would normally be completed, only seven were done as a result of fear instilled by COVID-19 and additional safety precautions.
B.C.’s health officials say without a significant increase in capacity along with program changes, it would be impossible to catch up with these needed surgeries.
According to the government, without any new changes, patients would wait much longer, non-urgent cases would become urgent and incoming urgent cases would exceed capacity.
That has spurred the provincial government to release a five-point plan to resume and exceed the normal surgery capacity in an effort to get back on track.
The five key steps being taken by the BC Government in an effort to get elective surgeries back on track
With this plan, the hope from the BC Government is that health authorities can clear the current backlog within a two-year span.
The first step in the surgery-renewal plan is to increase the number of surgeries by extending working hours and opening new facilities. This means daily operating hours will run longer, facilities will operate on weekends, staff vacations will be limited in the summer months to allow for ample on-hand personnel and new or unused operating rooms will be made available.
Meanwhile, private clinics are also being called upon to do outpatient procedures, such as cataracts.
In order to accommodate the increased volume of surgeries, the BC Government hopes to increase the number of staff and personnel available.
The province says the biggest change will be in how current front line workers are redeployed – turning part-time workers into full-time, hiring graduate students and reinstating nurses.
Recruitment efforts for more surgeons and anesthesiologists will continue accordingly, something B.C. has been doing for years, and 100 current staff will undergo medical device training.
With the right systems and workers in place for increased capacity, the focus will then shift to prioritizing patients.
Urgent patients, who need surgeries in less than four weeks will be put first, followed by those who have had their surgeries postponed. Then, officials will move on to the estimated 14,000 patients who have been waiting more than twice their clinical benchmarks.
Health authorities will start calling patients as early as Thursday, to start the pre-screening process.
More daytime surgeries will be undertaken as well to ensure more beds remain available for COVID-19 cases.
Step four will fall on sourcing adequate funding for the changes, as BC health officials are estimating the new surgical-renewal plan will cost $250 million.
Minister Dix said this new plan will actually accelerate the 5-year surgical strategy plan that was in place before COVID-19 struck.
The fifth and final part of the plan is to prepare monthly reports for the public on how the surgery capacity is coming along, in an effort to remain transparent.
The Ministry of Health is working closely with Michael Marchbank, former president and CEO of Fraser Health Authority, to monitor and provide oversight for the plan.
“This is going to be a huge undertaking and it really is something that I am anxious to assist with and help. So I’m happy to do that,” said Marchbank.
In Langford, on the same day as the surgery announcement, Debbie England was walking gingerly in her backyard.
Her left knee is wrapped in a brace and the knee is increasingly painful as her March 30 surgery to repair damaged ligaments was cancelled due to COVID-19.
CHEK first met England in early April, offering cars to health care workers from her lot. She was still able to walk, but a kickboxing injury had led to her injured knee. Her doctor now recommends she stay at home, and off her knee as much as possible to reduce the pain.
“It’s all the time. Night is the worst. Like I said there is not much I can do about it. Until I get the operation, there’s nothing I can do about it,” England said.
Knowledge that surgeries are back up is little comfort because of the uncertainty when hers will happen.
“I don’t know what their backlog is like. I don’t know how quickly I’ll hear from them,” she said.
The province has released a detailed timeline of how they expect and hope surgeries to proceed:
- May 7 – 15 – patient outreach, pre-operative screening, implementation planning;
- May 18 – surgical services begin, increasing capacity over four weeks to near normal pre-COVID levels;
- May 31 – all privately contracted facilities working at maximum available capacity
- June – begin recruitment and training of new staff;
- June 15 – all existing operating rooms running at full available capacity;
- June 15 – October 15 – incrementally bringing on additional capacity through extending daily hours of operation, adding Saturdays and Sundays to the schedule and opening new operating rooms where available
- July – Ministry of Health first monthly progress report on surgery renewal
- July – August – optimize capacity over the summer period.
In the outlined timeline, the province is estimating it will take about four weeks to ramp up elective surgeries, with full capacity in provincial hospitals expected by mid-June.
The actions taken under this outlined plan will ensure the health system can keep up with the demand for new surgeries and clear the existing COVID-19 backlog in the next 17 to 24 months, according to the BC Government.
The update on elective surgeries comes on the heels of the province unveiling plans for slowly reopening the British Columbian economy.
Rebecca Lawrence
Graham Cox
Mary Griffin
