scholarly journals P-BN45 The Impact of Covid-19 on Benign Upper GI Operations in England During 2020

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Laura Sandland-Taylor ◽  
Barbara Jenkins ◽  
Ian Beckingham
Keyword(s):  
Bile Duct ◽  
Elective Surgery ◽  
Demographic Data ◽  
National Level ◽  
Emergency Operations ◽  
Surgical Services ◽  
Upper Gi ◽  
Level Data ◽  
The Uk ◽  
The Impact

Abstract Background Since the cancellation of elective surgery in early 2020 due to the threat of Covid-19, surgical provisions in England have continued to be affected by the Covid-19 pandemic. Elective surgery makes up the majority of surgical procedures performed in England and therefore   cancelled operation lists and increased demand for ITU beds has had a significant impact upon the surgical services delivered to patients through out 2020. The following research looks at the impact of Covid-19 on benign upper GI surgery in England and reviews the relationship between Covid-19 deaths and operations performed throughout England and analyses the data at a regional level.  Methods Data relating to operation numbers was taken from The Surgical Workload Outcomes Audit (SWORD) database. The SWORD database was interrogated for the years 2017 – 2020. A mean number of operations was calculated using the 2017-2019 data and compared to data from 2020. Operations performed and other demographic data  was analysed regionally and compared to Covid-19 deaths throughout England. Covid-19 data was obtained from the national government dashboards.  Results The results show that there is a correlation with increasing Covid deaths and lower rates of elective surgery. Furthermore, elective surgery was worse hit than emergency surgery with a slower recovery overall. Cholecystectomies were reduced by a total of 20817 (31.4%) for the year 2020 with a greater reduction seen in elective operations (35.6%). However, similar reductions were seen in both laparoscopic (31.4%) and open (37.5%) Similarly, bile duct explorations and elective splenectomy were reduced by 34.4% and 23.4% respectively. Comparatively, both paraumbilical and inguinal hernias also saw reductions of greater than 40% in 2020 when compared to the mean of the previous 3 years. Regional variances were seen between operation numbers performed and Covid-19 rates, however the overall trend remained the same for national level data.  Conclusions Overall, the Covid-19 pandemic has had a significant impact on operations, particularly on those deemed as benign and ‘less urgent’. Whilst a global impact across all benign operations was seen, greater reductions were seen in elective operations compared to emergency operations. Hernia operations and bile duct exploration saw greater overall reductions compared to cholecystectomies and splenectomies, which suggests that whilst operation numbers were reduced, efforts were made to prioritise operations with greater clinical need throughout the pandemic. On analysis of the data in relation to Covid-19 rates and deaths, variation was seen across the regions in the UK, however overall the trend remained the same. Centres and regions worse hit by Covid-19 performed less operations during 2020. However, further qualitative research to investigate why certain centres maintained higher levels of performance during the pandemic would be beneficial for planning for future waves and future pandemics. 

scholarly journals P-OGC83 The Impact of Covid-19 on Malignant Upper GI Operations in England During 2020

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Laura Sandland-Taylor ◽  
Barbara Jenkins ◽  
Ian Beckingham
Keyword(s):  
Significant Variation ◽  
Malignant Disease ◽  
Demographic Data ◽  
Upper Gi ◽  
Care Services ◽  
Cancer Services ◽  
Life Saving ◽  
Number Of Patients ◽  
The Uk ◽  
The Impact

Abstract Background Due to the Covid-19 pandemic and the overwhelming number of patients requiring ITU due to serious Covid-19 infections, trusts throughout England reduced their operation numbers to reduce the burden on secondary care services. Whilst efforts were made to preserve cancer services in England, the Covid-19 burden still significantly impacted the provision of oesophagectomies and gastrectomies. The following research aims to look at the true impact of Covid-19 on operation numbers in England and compare these to the Covid-19 burden.  Methods Data relating to operation numbers was taken from The Surgical Workload Outcomes Audit (SWORD) database. The SWORD database was interrogated for the years 2017 – 2020. A mean number of operations was calculated using the 2017-2019 data and compared to data from 2020. Operations performed and other demographic data  was analysed regionally and compared to Covid-19 deaths throughout England. Covid-19 data was obtained from the national government dashboards.  Results Results showed that there was a significant reduction in the number of operations performed in 2020 due to the Covid-19 pandemic. This was closely correlated with Covid deaths throughout England. Variations between centres were present throughout the UK, however the overall trend reflected more than a 40% reduction in gastrectomies and more than a 30% reduction in oesophagectomies, which equated to 1018 less gastrectomies and 490 less oesophagectomies performed in 2020. There was significant variation between centres, the impact on individual centres and oesophagectomy rates ranged from -0.8% reduction to a 100% reduction in operations carried out in 2020. Gastrectomies was similarly affected, varying between a 2.7% and 89.5% reduction in operations carried out in 2020.  Conclusions Overall, despite efforts to preserve procedures, particularly for malignant disease, there was significant fall in operations performed throughout 2020. As a consequence of this, it is likely that patients requiring life saving or life extending operations did not receive their treatment. The data suggests that overall gastrectomies were worse hit than oesophagectomies across England. Variances in performance across the UK should be further analysed to allow better planning and resource allocation for future waves or future pandemics. 

scholarly journals The Impact of COVID-19 on Surgical Training: the Past, the Present and the Future

2021 ◽  
Author(s):  
Marina Yiasemidou
Keyword(s):  
Infection Control ◽  
Surgical Training ◽  
New Technologies ◽  
Negative Impact ◽  
Elective Surgery ◽  
Control Measures ◽  
Negative Consequences ◽  
Surgical Services ◽  
The World ◽  
The Impact

AbstractThe COVID-19 pandemic and infection control measures had an unavoidable impact on surgical services. During the first wave of the pandemic, elective surgery, endoscopy, and ‘face-to-face’ clinics were discontinued after recommendations from professional bodies. In addition, training courses, examinations, conferences, and training rotations were postponed or cancelled. Inadvertently, infection control and prevention measures, both within and outside hospitals, have caused a significant negative impact on training. At the same time, they have given space to new technologies, like telemedicine and platforms for webinars, to blossom. While the recovery phase is well underway in some parts of the world, most surgical services are not operating at full capacity. Unfortunately, some countries are still battling a second or third wave of the pandemic with severely negative consequences on surgical services. Several studies have looked into the impact of COVID-19 on surgical training. Here, an objective overview of studies from different parts of the world is presented. Also, evidence-based solutions are suggested for future surgical training interventions.

The EU as an “enforcement patchwork”: the impact of national enforcement for compliance with EU water law in Spain and Britain

2013 ◽  
Vol 34 (2) ◽  
pp. 331-353 ◽  
Author(s):  
Mónica García Quesada
Keyword(s):  
Waste Water Treatment ◽  
National Level ◽  
State Level ◽  
Detailed Examination ◽  
Deterrent Effect ◽  
Eu Law ◽  
Wide Range ◽  
The Uk ◽  
The Impact ◽  
The Eu

AbstractFailures of compliance with European Union (EU) directives have revealed the EU as a political system capable of enacting laws in a wide range of different policy areas, but facing difficulties to ensure their actual implementation. Although the EU relies on national enforcement agencies to ensure compliance with the EU legislation, there is scarce analysis of the differential deterrent effect of national enforcement in EU law compliance. This article examines the enforcement of an EU water directive, the Urban Waste Water Treatment Directive, in Spain and the UK. It focuses on the existing national sanctions for disciplining actors in charge of complying with EU requirements, and on the actual use of punitive sanctions. The analysis shows that a more comprehensive and active disciplinary regime at the national level contributes to explain a higher degree of compliance with EU law. The article calls for a detailed examination of the national administrative and criminal sanction system for a more comprehensive understanding of the incentives and disincentives to comply with EU law at the national state level.

Directing Equal Pay in the UK ICT Labour Market

2008 ◽  
pp. 3150-3157
Author(s):  
Claire Keogh ◽  
Angela Tattersall ◽  
Helen Richardson
Keyword(s):  
Labour Market ◽  
National Level ◽  
Equal Pay ◽  
Skills Shortage ◽  
Part Time ◽  
Underrepresentation Of Women ◽  
Equal Pay Act ◽  
Ict Industry ◽  
The Uk ◽  
The Impact

The UK labour market is dramatically changing, with rapid technological innovations alongside globalisation where organisations are required to place a premium on human and intellectual capital. The demand for labour is outstripping supply, and businesses are increasingly dependent on their ability to attract, invest in and develop their workforce (Kingsmill, 2003). However, a recent comparative report of the information technology (IT) workforce in Holland, Germany and the UK indicates that women are haemorrhaging out of the IT sector (Platman & Taylor, 2004). Given that presently there is an IT specialist’s skills shortage of 18.4% (IER/IFF, 2003), and female IT managers represent a mere 15% of ICT managers, 30% of IT operations technicians and 11% of IT strategy planning professionals (EOC, 2004a), this suggests that the ICT industry is not equipped for equality and diversity at work. Despite many years of egalitarian rhetoric and 3 decades after the UK Equal Pay Act (1970) was introduced, women still receive on average 18% less than that of their male counterparts working full-time and 41% less than men when working part-time hours. The ESF-funded DEPICT project seeks to identify pay discrimination experienced by women in ICT at a national level throughout England. An important aim is to highlight the impact of pay and reward discrimination has on the underrepresentation of women in the ICT labour market. From this study, we hope to more clearly understand the reasons for the gender pay gap, particularly in the ICT sector; and the impact this has on women’s entry and retention to occupations where they are already severely underrepresented. Equal pay is an issue for all; it’s unjust, unlawful and impacts on social justice, equality and economic performance (EOC, 2001b). Pay is a major factor affecting relationships at work; distribution and levels of pay and benefits affect efficiency of organisations, workforce morale and productivity. It is vital for organisations to develop pay systems that reward workers fairly for the work they perform (ACAS, 2005).

scholarly journals Disproportionate Impact of COVID-19 Pandemic on Racial and Ethnic Minorities

2020 ◽  
pp. 000313482097335
Author(s):  
Brad Boserup ◽  
Mark McKenney ◽  
Adel Elkbuli
Keyword(s):  
Ethnic Groups ◽  
Social Vulnerability ◽  
Negative Binomial ◽  
Demographic Data ◽  
National Level ◽  
The United States ◽  
Death Rates ◽  
Social Distancing ◽  
The Impact ◽  
Racial Ethnic

Background Health disparities are prevalent in many areas of medicine. We aimed to investigate the impact of the COVID-19 pandemic on racial/ethnic groups in the United States (US) and to assess the effects of social distancing, social vulnerability metrics, and medical disparities. Methods A cross-sectional study was conducted utilizing data from the COVID-19 Tracking Project and the Centers for Disease Control and Prevention (CDC). Demographic data were obtained from the US Census Bureau, social vulnerability data were obtained from the CDC, social distancing data were obtained from Unacast, and medical disparities data from the Center for Medicare and Medicaid Services. A comparison of proportions by Fisher’s exact test was used to evaluate differences between death rates stratified by age. Negative binomial regression analysis was used to predict COVID-19 deaths based on social distancing scores, social vulnerability metrics, and medical disparities. Results COVID-19 cumulative infection and death rates were higher among minority racial/ethnic groups than whites across many states. Older age was also associated with increased cumulative death rates across all racial/ethnic groups on a national level, and many minority racial/ethnic groups experienced significantly greater cumulative death rates than whites within age groups ≥ 35 years. All studied racial/ethnic groups experienced higher hospitalization rates than whites. Older persons (≥ 65 years) also experienced more COVID-19 deaths associated with comorbidities than younger individuals. Social distancing factors, several measures of social vulnerability, and select medical disparities were identified as being predictive of county-level COVID-19 deaths. Conclusion COVID-19 has disproportionately impacted many racial/ethnic minority communities across the country, warranting further research and intervention.

7. Elections and voting

UK Politics ◽  
2021 ◽  
pp. 145-169
Author(s):  
Andrew Blick
Keyword(s):  
Electoral Systems ◽  
National Level ◽  
Electoral System ◽  
Direct Role ◽  
Theoretical Perspectives ◽  
Different Types ◽  
General Elections ◽  
The Uk ◽  
The Impact

This chapter looks at how voting helps people to take a direct role in politics. The chapter discusses the rules by which the electoral system operates. It discusses the different types of electoral systems used in the UK. It connects General Elections and the formation of government at the national level. The chapter then offers a number of theoretical perspectives from which to consider voting in terms of fairness, mandates, and effectiveness. The chapter looks at the impact of the Fixed-Term Parliaments Act 2011 and how the integrity of elections is maintained. Finally, it looks at the plan to equalize the size and reduce the number of UK parliamentary constituencies.

scholarly journals The inequity of morbidity: Disparities in the prevalence of morbidity between ethnic groups in New Zealand

2020 ◽  
Vol 10 ◽  
pp. 2235042X2097116
Author(s):  
Jason Gurney ◽  
James Stanley ◽  
Diana Sarfati
Keyword(s):  
New Zealand ◽  
Ethnic Groups ◽  
Latin American ◽  
Middle Eastern ◽  
National Level ◽  
Morbidity Burden ◽  
Individual Level ◽  
Level Data ◽  
The Social ◽  
The Impact

Objective: The burden of chronic disease is not evenly shared within our society. In this manuscript, we use comprehensive national-level data to compare morbidity burden between ethnic groups in New Zealand. Methods: We investigated the prevalence of morbidity among all New Zealanders aged 18+ (n = 3,296,837), stratified by ethnic group (Māori, Pacific, Asian, Middle Eastern/Latin American/African, European/Other), using national-level hospitalisation and pharmaceutical data and two measures of morbidity (the M3 and P3 indices). Results and Conclusions: We observed substantial disparities for Māori and Pacific peoples compared to other ethnic groups for the vast majority of commonly-diagnosed morbidities. These disparities appeared strongest for the most-common conditions – meaning that Māori and Pacific peoples disproportionately shoulder an increased burden of these key conditions. We also observed that prevalence of these conditions emerged at earlier ages, meaning that Māori and Pacific peoples also experience a disproportionate impact of individual conditions on the quality and quantity of life. Finally, we observed strong disparities in the prevalence of conditions that may exacerbate the impact of COVID-19, such as chronic pulmonary, liver or renal disease. The substantial inequities we have presented here have been created and perpetuated by the social determinants of health, including institutionalised racism: thus solutions will require addressing these systemic issues as well as addressing inequities in individual-level care.

scholarly journals Awareness of Human Factors in the operating theatres during the COVID-19 pandemic

2020 ◽  
Vol 31 (1-2) ◽  
pp. 44-50
Author(s):  
Carolina Relvas Britton ◽  
Gareth Hayman ◽  
Nicola Stroud
Keyword(s):  
Human Factors ◽  
Basic Education ◽  
Team Leaders ◽  
Front Line ◽  
Second Nature ◽  
Surgical Services ◽  
Operating Theatres ◽  
Major Disruption ◽  
The Uk ◽  
The Impact

One of the priorities at our large Operating Theatres Department is to support awareness and basic education of the multi-disciplinary teams in clinical Human Factors, to help build competence and capacity in healthcare towards a resilient system. From May 2019 until February 2020, our Human Factors Champions embarked on a project called Observation of Non-technical Skills and Teamwork in the operating theatres (ONSeT), to monitor and evaluate the benefits of local Human Factors education. In September 2020, six months after the COVID-19 pandemic hit the UK and caused a major disruption of surgical services, we decided to investigate the usefulness of the project and the impact of COVID-19 in the operating theatres, looking through the eyes of the Human Factors Champions. Results pointed to a consensus about ONSeT having helped during the pandemic, with regards to how teams worked and in enabling team leaders to be more responsive. Human Factors Champions found that feedback on performance was received in a non-threatening way and observation of performance became ‘second nature’. As organisations need to develop critical thinking, we think that the ONSeT project has helped us build some capacity for this, from the front-line onwards.

scholarly journals Estimating the effect of the 2005 change in BCG policy in England: a retrospective cohort study, 2000 to 2015

2019 ◽  
Vol 24 (49) ◽  
Author(s):  
Sam Abbott ◽  
Hannah Christensen ◽  
Nicky J. Welton ◽  
Ellen Brooks-Pollock
Keyword(s):  
High Risk ◽  
Labour Force ◽  
Demographic Data ◽  
Credible Interval ◽  
Incidence Rates ◽  
School Age Children ◽  
School Age ◽  
Bcg Vaccination ◽  
The Uk ◽  
The Impact

Background In 2005 in England, universal Bacillus Calmette–Guérin (BCG) vaccination of school-age children was replaced by targeted BCG vaccination of high-risk neonates. Aim Estimate the impact of the 2005 change in BCG policy on tuberculosis (TB) incidence rates in England. Methods We conducted an observational study by combining notifications from the Enhanced Tuberculosis Surveillance system, with demographic data from the Labour Force Survey to construct retrospective cohorts relevant to both the universal and targeted vaccination between 1 January 2000 and 31 December 2010. We then estimated incidence rates over a 5-year follow-up period and used regression modelling to estimate the impact of the change in policy on TB. Results In the non-United Kingdom (UK) born, we found evidence for an association between a reduction in incidence rates and the change in BCG policy (school-age incidence rate ratio (IRR): 0.74; 95% credible interval (CrI): 0.61 to 0.88 and neonatal IRR: 0.62; 95%CrI: 0.44 to 0.88). We found some evidence that the change in policy was associated with an increase in incidence rates in the UK born school-age population (IRR: 1.08; 95%CrI: 0.97 to 1.19) and weaker evidence of an association with a reduction in incidence rates in UK born neonates (IRR: 0.96; 95%CrI: 0.82 to 1.14). Overall, we found that the change in policy was associated with directly preventing 385 (95%CrI: −105 to 881) cases. Conclusions Withdrawing universal vaccination at school age and targeting vaccination towards high-risk neonates was associated with reduced incidence of TB. This was largely driven by reductions in the non-UK born with cases increasing in the UK born.

Sign in / Sign up

Export Citation Format

Share Document