7 ENT clinical activity during COVID19 pandemic

Background During COVID19 pandemic all ENT registrars and SHOs were re-deployed to other specialties and senior clinical fellows were upgraded to consultants. The aim of this project is to analyse ENT clinical activity during the COVID19 pandemic in order to assess appropriateness of ENT staffing level and contribute in preparation for future similar events. Methods Retrospective data collection was performed via Epic from 23/3/20 until 21/6/20. ENT admission and procedural data were collected and compared to other paediatric surgical subspecialties. Finally, a case study has been incorporated into our presentation to demonstrate the additional difficulties encountered in the care of complex airway patients during the COVID19 pandemic. Results 143 patients were admitted under ENT. In total, 220 ENT operations were performed on ENT patients as well as patients admitted under other teams. 52.4% of these cases were airway procedures. When considering relative workload during this period, SNAPS performed 251 cases while ENT and Cardiothoracics both performed 220 operations. The case report studied was an eight months girl with tracheal stenosis who required multiple admissions due to acute airway compromise. This case demonstrated that adversities encountered during the COVID19 pandemic included difficult access to local hospitals, challenging patient transfer, limited medical staff and theatre resources. Conclusion During the COVID19 pandemic ENT continued to have a high workload of complex patients, especially relating to airway issues. This was on a background of restricted access to paediatric inpatient facilities and resources at other hospitals in North Central London. Following the re-deployment of all ENT junior doctors, ENT at GOSH became a consultant only service whilst SNAPS and cardiac surgery kept their full complement of juniors. The results of this study have helped in planning for a potential COVID19 second wave response, particularly around operating theatre allocation and in surgical junior workforce deployment.