Clinical Scorecard: Assessment of the Regional Hub Model for Colorectal Cancer Services During the COVID-19 Crisis

At a Glance

Key Highlights

• The RM Partners Cancer Hub centralized colorectal cancer surgery across London during the COVID-19 pandemic to maintain elective cancer care.
• Patients were prioritized based on NHS England guidelines into urgent surgical categories to mitigate delays and complications.
• Two COVID-19 free sites (Royal Marsden Hospital and BUPA Cromwell Hospital) were designated to safely deliver elective cancer surgery.

Guideline-Based Recommendations

Diagnosis

• Patients underwent diagnostics and multidisciplinary team (MDT) discussion at their local NHS Trust prior to referral.
• Referral to the Cancer Hub required exclusion of active COVID-19 infection and completion of standardised online referral forms.

Management

• Surgical treatment was centralized at COVID-19 free sites to minimize infection risk and resource conflicts.
• Patients and their households were advised to self-isolate prior to surgery to reduce peri-operative COVID-19 exposure.
• Clinical prioritisation followed NHS England guidelines categorizing patients by urgency (Priority 1a/1b and Priority 2).

Monitoring & Follow-up

• Weekly multidisciplinary prioritisation meetings (Clinical Prioritisation Group) reviewed and scheduled cases within seven days of referral.

Risks

• Peri-operative COVID-19 infection is associated with poor post-operative outcomes.
• Delays in cancer surgery due to pandemic resource constraints risk disease progression and complications.

Patient & Prescribing Data

Patients with colorectal or anal cancer requiring elective surgery during the COVID-19 pandemic in London

Centralized surgical pathways at COVID-19 free sites allowed continuation of elective cancer surgery despite pandemic pressures, with prioritization to mitigate risks from delays and infection.

Clinical Best Practices

• Establish regional collaborative networks to centralize cancer surgery during healthcare crises.
• Designate COVID-19 free surgical sites with pre-admission screening and patient self-isolation protocols.
• Implement standardized referral and prioritization processes with multidisciplinary oversight.
• Maintain clear communication with patients regarding risks and infection control measures.

References

• World Health Organization COVID-19 pandemic declaration
• NHS England guidance on cancer care during COVID-19
• STROBE Statement for observational studies