Abstract 1637P
Background
Cancer services had to adapt for social distancing to minimise risk of COVID spread between staff, persons with cancer attending and those supporting them. Prior to COVID patients attended a large combined outpatient clinic (OPC) once a week (12.30-7pm). This allowed optimal staffing of the day unit and inpatient service for the majority of the week. A separate outpatient facility at a removed location, though still on the Hospital campus, was created for OPC assessments with the intent of dispersing the large clinic across 4 days during COVID outbreak. An analysis of the impact on staff availability throughout the service as a consequence of an increased frequency / reduced patient volume OPC is outlined below.
Methods
The numbers of non-consultant hospital doctors (NCHDs), their assigned location (day unit or OPC), allowances for full staff and also allowing for vacation time were gathered for 1) pre-COVID clinic and 2) modified COVID clinics. Activity levels within the day unit treatment facility was also assessed using the hospital information system. The number of NCHDs multiplied by the hours available to the day unit were calculated per week for both clinic structures to produce the "available NCHD hours".
Results
From Jan. 2nd to Dec. 31st 2020 there were 11089 day oncology treatment unit by 1304 patients, alongside 4045 OPC visits. To adjust for COVID social distancing the large OPC (7 hours) was dispersed across 4 mornings (18 hours). This change resulted in the reduction of available NCHDs to the day oncology unit from 247 available NCHD hours to 158 available NCHD hours once vacation and study leave are factored into the equation. This represents a 36% reduction in available staff yet no planned reduction in patient activity.
Conclusions
While dividing clinical activity in the OPC over several days allowed patients attend with a family member, allowing better insight and support, it reduced the numbers of doctors available for a significant part of the day, placing more strain on those doctors trying to manage a similar number of patients in a safe and patient-focussed manner. Changes within the outpatient clinic setup adjusting to COVID restrictions has inadvertantly had knock -on effects on the "Oncology Ecosystem” and may impact on future service quality.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.