Charmayne Oakey has suffered excruciating pain for more than a year after knee replacement surgery was delayed
An unprecedented audit of the effect of the pandemic has exposed the devastating impact on non-Covid care.
Almost a year on from the day we first locked down, analysis by a string of charities reveals the toll on patients with cancer, heart disease, arthritis and dementia.
NHS bosses last night admitted the disruption is ‘eye-wateringly clear’ and will leave ‘lasting scars’.
Thousands of preventable deaths have already occurred, with many more likely to follow, and others will be left disabled or in crippling pain as a result of the past year.
Hospitals cancelled swathes of ‘non-urgent’ operations to focus on coronavirus, while GPs switched to phone and video consultations. Screening programmes for deadly diseases such as breast cancer were put on hold.
In addition, many ill people delayed seeking help after ministers told the public to stay at home to protect the NHS.
The Mail’s audit of the Covid consequences paints a grim picture, with England recording the largest annual fall in life expectancy since the Second World War.
Waiting lists have already climbed to record highs – and are expected to get worse as more people come forward after the current lockdown ends.
Patients should wait no longer than 18 weeks for treatment after an NHS referral – but more than 300,000 have been waiting for over a year.
Health chiefs warn the backlog will take years to clear, with think-tanks predicting a decade of disruption after a crisis that has undone years of progress.
Professor Neil Mortensen, president of the Royal College of Surgeons of England, said: ‘The job facing surgeons and the teams they work with is huge. It will take years rather than months to catch up.’
The widow of a man who died last year after his cancer treatment was delayed due to the pandemic believes his life was unfairly cut short. Malachy Watkins, 73, was first diagnosed with lung cancer in December 2018 and after six weeks of chemotherapy doctors told him the tumour had shrunk. After a check-up last February, he found out the tumour was growing again but his treatment was postponed for three months
The number of face-to-face GP consultations fell by almost 80million. Millions also missed out on cancer checks, while tens of thousands missed out on dementia care. Many others missed heart operations, diabetes checks, rehabilitation for asthma and lung disease and stroke treatment – leaving many with disabilities that could have been avoided.
Measures intended to combat coronavirus have also played havoc with the nation’s mental health, with friends and families forced apart and many workers left in limbo – or worse.
The number of adults suffering depression doubled during lockdown, as did the number of urgent referrals for children with eating disorders. In addition, the number of dental checks was cut in half.
Rachel Power, chief executive of the Patients Association, said the impact of the pandemic on non-Covid patients has been ‘profound’.
She added: ‘Some have stayed away from the NHS, but it has been more common for people to try to access care but find it is not available.
‘The result for many is long waits in pain and discomfort, prolonged uncertainty and anxiety, worse outcomes from operations when they are eventually performed, and in some cases people dying from what would otherwise have been treatable illness.’
Patients needing ‘non-urgent’ hip and knee replacements have consistently seen some of the longest waits. Tracey Loftis of the charity Versus Arthritis said: ‘Thousands of people are enduring long waits with no end date in sight. We have heard from people who have lost jobs, are unable to care for relatives and are seeking help for depression because of the debilitating pain they are in.’
Danny Mortimer – chief executive of the NHS Confederation, which represents NHS organisations – said: ‘The disruption of the pandemic is eye-wateringly clear and it will take many years before the system can return to any sense of normality. The pandemic will leave lasting scars on the NHS after the immediate threat subsides.’
An NHS spokesman said: ‘Since the beginning of the pandemic the NHS has urged people to come forward if they’re concerned for their health and has offered care to everyone who needs it.’
I was lucky my cancer was found
Emma Gibson was diagnosed with stage 1 cervical cancer last October after her initial screening was postponed for five months
Emma Gibson was diagnosed with stage 1 cervical cancer last October after her initial screening was postponed for five months.
The 25-year-old, who works in marketing, believes she could have had a routine procedure to remove pre-cancerous cells if her March appointment had not been moved due to the pandemic.
She was left frustrated by the lack of urgency from doctors when she tried to find out when her screening would be.
She said: ‘I called three times to try to find out when my smear test would happen but each time I was told to call back again in a couple of months.’
Miss Gibson, of Wigan, finally had a smear test at her GP surgery in August and had a procedure called Lletz – large loop excision of the transformation zone – a month later to remove abnormal cells.
She was called to the Thomas Linacre Centre in Wigan for more testing and was told she had stage 1 cervical cancer.
‘It was a big shock. I never thought that at 25 I would hear that I have cancer,’ Miss Gibson said. ‘We then went into the second lockdown and it was very scary because I heard that hospitals were cancelling appointments.’
In November she had another Lletz procedure and later that month heard she was cancer free. She said: ‘I am one of the lucky ones because there are so many people who have missed out on tests and surgery because of the pandemic.’
Daily pain is off the scale
Charmayne Oakey has suffered excruciating pain for more than a year after knee replacement surgery was delayed.
The grandmother from Oxfordshire, who had severe osteoarthritis in her knee, was told in February that she could have the procedure at the Nuffield Orthopaedic Centre in Oxford within a few months.
But her appointments were changed to telephone consultations at the start of lockdown and she was told it was no longer possible to set a date for her surgery due to the pandemic.
After eight more months of pain and immobility, Mrs Oakey was warned that she might have to wait another year for her knee replacement surgery because of the backlog in the NHS.
She said: ‘It is affecting every aspect of my ability and it is putting my life on hold. The pain is off the scale and there is no date in sight.
‘I have severe osteoarthritis in my knee, it’s bone on bone and there’s no cartilage there.
‘It’s absolutely heart-wrenching and I have no idea where I stand.’
She has been asked to call back when the current lockdown ends to find out when she can have the procedure.
‘I understand Covid is a killer but surely they can keep a hospital in a safe area open so important surgeries can go ahead,’ Mrs Oakey said.
‘I live in pain every day and there are times when it really gets to me.
‘I cannot play with any of my grandchildren and it drains me mentally, not being able to do things that I normally could.’
‘Some days I think I can’t go on. I’ve had to just sit down in the supermarket and cry.’
Mrs Oakey, 47, was made redundant last October and she is worried she may not get another job because of her current condition.
She said: ‘I’m out of work, quite stressed out about money… How do I tell a prospective employer I am going to need surgery and time off to recover, but I have no idea when?’
Husband’s life was cut short
The widow of a man who died last year after his cancer treatment was delayed due to the pandemic believes his life was unfairly cut short.
Malachy Watkins, 73, was first diagnosed with lung cancer in December 2018 and after six weeks of chemotherapy doctors told him the tumour had shrunk.
After a check-up last February, he found out the tumour was growing again but his treatment was postponed for three months.
The grandfather from Stevenage, Hertfordshire, started chemotherapy and immunotherapy at Lister Hospital in the town in May but died on September 25.
He began to have heart problems as a result of the treatment and fluid had built up in his lungs so doctors said it had to stop.
Sheila Watkins, 72, his wife of 53 years, said: ‘I feel angry and it’s so wrong that people are being forced to wait for treatment. We could have had longer together if his treatment started earlier and the quality of his life may have been better.
‘His life was cut short, but the hospital is not going to admit that. They left us in limbo.’
Mr and Mrs Watkins met as teenagers and got married in 1967. Their son Craig, 43, said: ‘If the treatment was started then [last February] I think he would still be with us now.’ Both their children were not allowed to see their father until Mr Watkins’s final moments.
Nick Carver, of the NHS trust which runs Lister Hospital, said: ‘We offer sincere condolences to Mr Watkins’s loved ones at this incredibly sad time.’
Fiona Carragher, director of research and influencing at Alzheimer’s Society, said: ‘The toll of the pandemic on people with dementia stretches far beyond deaths from the virus.’
The crushing price of lockdown
The number of patients referred to cancer specialists and starting treatment has nose-dived.
Experts fear many have delayed care or been unable to access it, and will be diagnosed when their tumours are too advanced to cure.
Cancer Research UK estimates three million fewer people than normal had a cancer screening from March to September as programmes were ‘effectively paused’.
Almost 44,000 fewer started treatment for the disease in the UK from April 2020 to January 2021 compared with the same period a year earlier.
There were 4.4 million fewer diagnostic tests in England between March and January and 400,000 fewer urgent suspected cancer referrals.
Michelle Mitchell, chief executive of Cancer Research UK, said: ‘For the first time in decades, this country is faced with the prospect of cancer survival going backwards.’
Genevieve Edwards, chief executive of Bowel Cancer UK, said the pandemic has had an ‘enormous impact’ with screening, tests and treatment delayed as a ‘direct result’.
Prostate Cancer UK said 8,600 fewer men started treatment from April to January. Angela Culhane, the charity’s chief executive, said: ‘Many more men could be diagnosed when it is too late for them to be cured.’
Heart attacks and strokes
Deaths caused by heart attacks and strokes rocketed during the lockdown as operations were cancelled and care was delayed.
There have been more than 6,000 more deaths than usual from heart diseases and strokes during the pandemic and experts warn the numbers could be ‘just the tip of the iceberg’ as the true toll of lockdown may not be known for years.
At least 12,000 fewer heart operations than expected took place in England in the year to November 2020, the British Heart Foundation (BHF) says, while prescriptions for statins and blood thinners fell by 25 per cent. Other treatments, such as fitting stents, have been impacted too, with 100,000 fewer last year than in 2019.
The Institute for Public Policy Research found 23,000 cases of heart failure and up to 90,000 coronary heart disease cases have been missed.The institute estimates the disruption will lead to an extra 12,000 avoidable heart attacks and strokes over the next five years.
Dr Sonya Babu-Narayan, associate medical director at the BHF, said: ‘We’re now left with a ticking timebomb of unmet early detection and treatment.’
Bereavement, forced separation from loved ones and financial woes have all hit the nation’s mental health.
The number of adults suffering with depression doubled during lockdown, with one in five affected last summer. And emergency referrals to NHS mental health services hit record highs in June and July.
One in six children and teenagers are now thought to have a mental health disorder, up from one in nine three years ago. And the number of urgent referrals for children with eating disorders doubled last year.
There were almost 1.4million patients in contact with NHS mental health services in December last year – an increase of 27,000 from a year earlier.
Dr Trudi Seneviratne, of the Royal College of Psychiatrists, said: ‘Social isolation, loneliness, stress and anxiety, domestic abuse, bereavement, financial difficulties, unemployment and Covid-19 infection are all factors.’
Mental health charity Sane said that at some points during the pandemic almost a third of its callers were suicidal.
The numbers accessing non-Covid care plummeted and waiting lists hit a record high as the NHS reorganised to focus on coronavirus.
Many struggled to see their GP in person or saw operations cancelled. Others delayed seeking care out of fear of catching the virus or after hearing ministers repeatedly tell them to ‘stay at home to protect the NHS’.
Experts fear thousands may have died or suffered long-term harm as a result and warn the backlog will take years to clear.
There were 32million fewer GP appointments in 2020 than in 2019, with 79.4million fewer in-person consultations. Attendances at A&E fell from 25.64million to 18.77million, with data suggesting even those with life-threatening conditions stayed away.
Family doctors made 5.9million fewer referrals for elective treatment last year – a fall of a third. Planned operations fell by 56 per cent from March to May compared with the same period the previous year. Waiting lists climbed to a high of 4.59million, this is forecast to surge to ten million as lockdown eases.
Coronavirus has dealt a cruel blow to dementia patients and those waiting for a diagnosis.
Those living with the disease rely on regular contact with loved ones to put them at ease but over the last year have often been separated by lockdown laws.
Dementia diagnosis rates have also fallen with around 43,000 people potentially having missed out on a diagnosis over the past year, denying them access to specialist care and treatments.
The rate in England has fallen from 67 per cent before the pandemic to just 61 per cent now.
Alzheimer’s charities also say GP dementia assessments fell by 13,000 a month during the pandemic, while referrals to memory clinics fell by 1,000 a month.
Meanwhile researchers have discovered an increase in the use of antipsychotic medication among those with memory loss. Increased use of the drugs, which can have serious side-effects, suggests more people are suffering distress.
One in four adults who have died from coronavirus had dementia.
But there has also been an increase in non-Covid related deaths among dementia patients.
Deaths in private homes from dementia and Alzheimer’s are 75 per cent higher in England than the five-year average.
Hilary Evans, chief executive of Alzheimer’s Research UK, said: ‘People affected by dementia have been hit especially hard by Covid-19 and the drop in the diagnosis and referral rates means the pandemic will continue to have knock-on effects for years to come.