Table 5 Practice changes during the COVID-19 pandemic identified by respondents
From: A first census of skin cancer specialist nurses across UK secondary care trusts
Theme | Frequency | Relevant Examples |
|---|---|---|
No changes | 19 | |
Less face-to-face contact | 12 | “Most patients prefer face-face, and the telephone is not always suitable for all of the population i.e., deafness not aware why we were phoning” “We are short of space in the department due to social distancing with limited capacity in waiting area.” “We did move to virtual for patients but realized quickly that physical examination was important to us and patients as some patients presented later with new lesions” |
Telemedicine | 30 | “Some patients preferred telephone but felt that (she) was missing clinical symptoms and progression” “Recognizing the limitations of virtual consultations” “Telephone monitoring clinics so relying on patients to notice skin changes.” |
Less follow-up | 3 | |
More triaging | 1 | |
Photo-based diagnosis | 13 | |
Delayed or reduced surgery | 4 | “No theatre capacity” |
Less training | 1 | |
Changes to training | 3 | |
Virtual meetings | 6 | |
Increased nurse-lead clinics | 8 | “If patients had to be seen then it was the SCSNs who undertook Face-face assessments” |
Less support | 4 | |
Administrative changes | 6 | “Tried to collate appointments to tie in with procedures, scans etc. to minimise (contact)” email to respond to patients’ queries |
Redeployment | 11 | “Redeployed for 3 months to palliative COVID ward” “WTE of 3 due to redeployment” |
Short staffing | 1 | |
Fewer services | 5 | “Limited visits to inpatients” “Lack of CT scans, lack of SLNB, lack of MRI, lack of U/S.” |
Increased workload | 6 | “Managing increased anxiety of patients with COVID” “More support calls as patients’ emotional needs are higher” “Had longer time between each patient due to the amount of cleaning to do” “Reliant on ad hoc clinics to match the number of referrals that are received.” |
Patients’ presentation is more advanced | 4 | “Increased number of neglected tumours” |
Changes to treatment protocols | 11 | “Treatment regime intervals changed and used more primary care support” “Home delivery of oral treatments” |
Changes associated with investigations | 4 | “Community based blood tests.” “Histology and investigation results given by phone.” |
External support | 3 | “Used more primary care support (GP), Linked more with other hospital (Pathology blood tests).” “Surgery carried out in the private sector” |