Re-visiting the impact of the first wave of COVID-19 on neurosurgical practice and training in a large UK neurosurgery unit: a retrospective review

Introduction The response throughout the National Health Service (NHS) to first wave of coronavirus disease 2019 (COVID-19) was substantial. With repeat winter waves COVID-19 or other viral pathogens in future being likely, we sought review impact on delivery and training neurosurgery a large tertiary neurosurgical centre. Methods We performed retrospective over three-month period 8th March 7th June 2020 as indicative peak pandemic UK. For referrals, our online referral portal reviewed (ORION). admissions operations, electronic patient records were (EPIC systems). Trust wide update emails policies also reviewed. Results In pandemic, service provision severely restricted early days form reduced beds, medical nursing staff theatres. This rapidly realised be unsustainable, resources slowly reopened although not pre-COVID-19 levels. Although referrals did substantially reduce, number elective emergency admissions, length stay, theatre efficiency operative numbers (by pathology grade operating surgeon) significantly reduce except for emergencies by consultants. If similar trainee would have persisted, this lead significant delay completion training. Conclusions All aspects detrimentally affected due rapid institution. Such repeated reductions acute services such unsustainable. It is pertinent re-visit these effects preparation infection better protect services.