Our elective hand surgery service was suspended in March 2020 in order to free capacity for the treatment of patients with Covid-19. The hospital entered the ‘restart’ phase in August 2020, and we are now working to normalise services as far as we are able to. Obviously, the goalposts are constantly changing, and we have to respond to local Covid-19 figures by changing the advice we give on attending hospital.
Is there a risk of catching Covid-19 while in hospital?
Yes, there is a risk involved with coming to the hospital for an outpatient appointment or an operation. We do not know exactly what this risk is, but we feel that it is safe enough to allow normal clinics to run, with social distancing measures in place. If you feel that you are particularly vulnerable to Covid-19 on account of any medical condition you may have or drugs that you are taking, then please check with us or your GP before attending.
If you are awaiting an out-patient appointment:
With the ongoing social distancing requirements we have to meet, outpatient clinics will be very different to pre-Covid days. If we think that a face to face appointment is un-necessary, you may be offered a video or telephone consultation. You can also let us know if you would prefer this to a hospital visit, although for some conditions a diagnosis cannot be made without a face to face consultation.
When you come to hospital, you will be screened on entry to the hospital with a questionnaire and a temperature check. All patients will be expected to wear a mask whilst in the hospital. If you have any signs of a viral illness, we will ask you to go through the testing and self-isolating procedures.
The staff in the hospital will also be wearing masks and basic PPE (gloves and an apron).
If you are on the waiting list for surgery:
All patients awaiting routine surgery have been assigned a priority in order to rationalise how we send for patients. This is not done according to how long someone has been waiting, but on clinical priority. A rough guide follows:
- Category 1 – Surgery required within 1-3 days
- Category 2 – Surgery required within 1 month
- Category 3 – Surgery required within 3 months
- Category 4 – Surgery required, but can wait for more than 3 months
In elective hand surgery, most patients fall into category 3 or 4, with nerve compression (carpal tunnel decompression or cubital tunnel decompression) and trigger finger classed as category 3, and most Dupuytren’s surgery and osteoarthritis surgery classed as 4.
Current hospital policy regarding admission:
At present, the hospital guidelines state that all elective patients should socially distance starting 2 weeks prior to admission. This should not be too difficult since the official current advice is that we should all be socially distancing. 3 days prior to admission, you will be asked to take a Covid-19 test, and following this test we are asking patients to socially ISOLATE for the 3 days up until the time of surgery. On admission, patients will be ‘screened’ for Covid-19 infection. This involves a quick questionnaire and temperature check.
Policy is changing on a week by week basis, and although we will try and keep up to date with this, it is likely that the rules will change regularly. This always causes a degree of stress for both patients and for the secretaries, who are on the front line of communicating the policy.
Do I need to continue to self-isolate after my operation?
We are not asking patients to self-isolate again after their operation. We appreciate the significant impact that isolating yourself has for patients and their families. We do, however, encourage common sense, maintain social distancing and adhere to the guidelines from Scottish government. Above all, if you have a query following your operation, please contact our service.
Please be patient with us if you feel that the advice given seems to be shifting all the time – it is very frustrating for everyone, but the aim is to try and work through the backlog of cases that has been generated over the last few months.
© Fife Hand Service 2020