April 27, 2020

What’s the real impact of the COVID-19 crisis on Orthopaedic patients in the UK?

Written by Mr Matija Krkovic

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Despite the current COVID-19 lockdown, people are still experiencing problems related to their musculoskeletal system. Those problems would before the crisis be directly referred by their GP to an Orthopaedic surgeon. However, due to the pandemic most referrals have been stopped and delayed for indefinite period of time. At the moment no one actually knows how long it will last. There are certain predictions that the lockdown could be partially lifted in the next month or so. But even so, it won’t be “business as before” but more likely gradual return to where we were before. How exactly this will prevent future virus spread and another crisis (peak) resulting in another lockdown no one actually knows. 


Most NHS hospitals, region dependent are currently prioritising acute trauma and trauma consequences where the life is under threat or patients can sustain consequences negatively affecting their recovery from the injury or condition. At this moment in time non-acute cases are being delayed until the crisis is over. In the private sector, most private hospitals in the UK are helping the NHS with the COVID-19 crisis, predominantly with cancer and other urgent conditions which cannot be currently treated in the NHS.


It looks that the main obstacle for a non-urgent treatment or review at the moment is access to GPs to be reviewed and then referred further if necessary. It does appear that the NHS will start accepting referrals soon. This means that the GP surgeries will have to open for patients with non-acute conditions. How soon this will happen is very difficult to predict but it will have to happen soon as otherwise we are potentially risking causing more damage by delaying the necessary treatments than the actual COVID-19 outbreak. Hopefully we will soon get quality data about the actual impact of the virus on the mortality and morbidity of the population. This will certainly help making further decisions on how to proceed with the lockdown.


As a patient with a semi urgent or non urgent condition you should firstly explore online, whether you need a GP referral letter for who you are about to see, NHS or private. As a rule of thumb you will almost always need a referral letter for NHS hospital treatment, whereas private healthcare can differ. Whilst most private providers will still ask for a referral letter, there
are some who will be happy to review your case without an actual referral letter. If you can get a referral letter or not it is probably advisable to register your interest to be seen. In this case you will be put in a queue to be seen either face to face in a clinic when the lockdown is lifted or you will be offered a telephone or online appointment (at the moment this is how the majority of the follow up appointments are done). Either way you are securing your position for the future when the treatment  can be delivered. Even more importantly you might get advice which will either alleviate your symptoms or minimise them until the treatment is delivered. For example: If you have knee pain and you believe you need a knee replacement or keyhole surgery, after talking to the clinician you may learn that you only need a reasonable amount of painkillers and proper physiotherapy. At the moment face to face physiotherapy is restricted, but with an internet search you can find instructions on what type of exercises and how often you should do for the condition and you get on with it. Important to know is that it will usually get worse before it gets better after you started with your physiotherapy exercises. It is safe to say that any exercising is better than no exercising for the majority of conditions (excluding acute bone breaks and ligament/tendon injuries). There are not many conditions where exercises will actually make them worse. If you keep your muscles fit you are also improving your joints and their function.


In the current lockdown and COVID-19 crisis the advice is to be active and proactive. Explore your options and ask for advice if needed. You will be surprised how different the advice from a professional can be compared to your own opinion. Stay safe.

If you would like a specialist orthopaedic review by Mr Krkovic, please book a consultation today

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