Table 3.

Summary of Thematic Findings on ‘Impact on Surgical Practice’.

Impact on Surgical Practice
- Changes in Service provision and management
○ Cancelled elective surgeries
“Not doing any elective surgery since about mid-march – so that is 6 weeks. I have done 3 operations since about then” (P15)
○ Triaging of priority cases for surgery
“You are continually prioritising patients and risk stratifying” (P2)
“Emergency cases are also hugely influenced as you have to weigh the risks of increased mortality associated with COVID post-op” (P5)
○ Endoscopy changed to consultant led process outside the hospital
“I'm not doing any endoscopy at the moment either as it is currently a consultant led process … Led by gastroenterology and surgical consultants” (P5)
○ Telemedicine and Strategy Development
“Virtual clinics are not ideal – no interaction/examination with patient” (P5)
“Need to learn how to continue normal health care delivery with COVID as a presence. Need to start managing patients with this new risk” (P2)
○ Resource Management
“This onslaught of work when services begin to open back up will be really difficult to manage within current staffing levels” (P64)
- Additional PPE use
○ Slowed down efficiency
“Donning and doffing between wards makes everything so, so slow” (P16)
○ Negative impact on ergonomics of surgery
“Very difficult to operate in the heavy mask, particularly if the goggles fog” (P4)
“more difficult in theatre as you probably have reduced situational awareness” (P64)
○ Ineffective communication with patients
“I feel like we aren't really engaging properly with patients either. A lot of our patients are hard of hearing and they can't understand us when we are wearing the masks” (P64)
- New work-rotas
○ Continuity of patient care
“Handovers are sometimes not up to the mark and you end up missing parts of patients management when they are inpatients” (P5).
○ Team cohesion
“Don't get to see my colleagues as much which doesn't help with morale and engagement with work” (P64)