Urology department: Impact of COVID-19 on prostate cancer diagnosis, treatment and support

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Dear Warrington and Halton Teaching Hospitals NHS Foundation Trust,

Prostate Cancer UK are undertaking a Freedom of Information Act (FOI) request of all Trusts, Health Boards and Health and Social Care Trusts, with the aim of assessing the impact of COVID-19 on prostate cancer diagnosis, treatment and support pathways.

Data will be used to identify how we can target future resources to ensure that all patients with suspected prostate cancer have access to pre-biopsy MRI and biopsy, treatment within a safe time period and support, with minimal risk of contracting COVID-19.

We really appreciate your help with this, especially as we understand that there are currently potential limitations on resources. Please pass the below on to your urology department for them to complete. If this is not possible, we would really appreciate your help to provide as much information as you can.

We ask that you please indicate your answer by marking with an “X” next to any answers that apply or by deleting all answers that do not apply. Please avoid answering by italics, underlining or bold, as these do not show up when we process your response.

Yours faithfully,

Thomas Harding (Knowledge Officer, Prostate Cancer UK)

1. Did you suspend your MRI before biopsy service for patients with suspected prostate cancer as a result of the COVID-19 pandemic?
a. Yes
b. No
c. We did not offer MRI before biopsy before the pandemic

2. If yes, have you now resumed MRI before biopsy for patients with suspected prostate cancer?
a. Yes
b. No
c. No, but we refer patients elsewhere (Please state the referral area:)
d. N /A

3. Do you currently use a pre-MRI clinical triage for patients with suspected prostate cancer? By pre-MRI clinical triage, we mean a process, often Clinical Nurse Specialist led, that determines patient suitability for MRI before biopsy
a. Yes
b. No

4. Has your radiology department introduced any new MRI exclusion criteria for patients with suspected prostate cancer as a result of COVID-19?
a. Yes (please specify:)
b. No
c. N/A

5. If yes, do you plan to maintain any of these exclusion criteria once restrictions to limit patients’ COVID-19 risk are lifted?
a. Yes (please specify:)
b. No
c. N/A

6. Did you stop conducting biopsies for patients with suspected prostate cancer as a result of COVID-19 infection risks?
a. Yes
b. No

7. If yes, have you resumed biopsy services for patients with suspected prostate cancer?
a. Yes
b. Yes, but only for a subset of patients (please specify:)
c. No
d. No, but we refer patients elsewhere for prostate biopsy (Please state the referral area:)

8. Do you offer transperineal biopsy under local anaesthetic?
a. Yes
b. No
c. No, but we plan to in future (please specify when if possible:)

9. Following an MRI scan for suspected prostate cancer, what criteria do you use to select patients for biopsy? Please include all that apply:
a. Patients with a PI-RADSs or Likert score of 1 or greater
b. Patients with a PI-RADS or Likert score of 2 or greater
c. Patients with a PI-RADS or Likert score of 3 or greater
d. Patients with a PI-RADS or Likert score of 3 or greater, but only if PI-RADS or Likert score 3 patients have other clinical indications (such as age, ethnicity, PSA density) that make them higher risk
e. Patients with a PI-RADS or Likert score of 4 or greater
f. We do not offer MRI before biopsy
g. We do not currently biopsy patients

10. Did you delay radiotherapy treatment for prostate cancer patients as a result of COVID-19?
a. Yes
b. No
c. Partially (please specify:)
d. N/A (please specify:)

11. If yes, have you cleared your backlog for prostate cancer radiotherapy treatment?
a. Yes
b. No
c. N/A – We did not delay prostate cancer radiotherapy treatment

12. Did you delay radical prostatectomy for prostate cancer patients as a result of COVID-19?
a. Yes
b. No
c. Partially (please specify:)
d. N/A (please specify:)

13. If yes, have you cleared your radical prostatectomy backlog?
a. Yes
b. No
c. N/A – We did not delay radical prostatectomy for prostate cancer patients

14. To address your backlog did or are you using a protocol to risk stratify patients and prioritise patients with high-risk and locally advanced prostate cancer for treatment within 3 months?
a. Yes
b. No
c. No, we did not have a sufficient backlog to require patient prioritisation

15. Does your protocol apply to new patients with high-risk and locally advanced prostate cancer with the intention to radically treat them within 3 months of diagnosis?
a. Yes
b. No
c. N/A - We do not have a protocol for patient prioritisation

16. Do you have prostate cancer Personalised Stratified Follow Up (PSFU) protocols in place?
a. Yes
b. No
c. We are in the process of developing PSFU protocols

17. If Yes, do you have a digital remote monitoring system in place for follow up?
a. Yes (Please specify the name of the system used: e.g My Medical Record, Patient Knows Best)
b. No

18. If no, do you plan to implement a digital remote monitoring system for follow up?
a. Yes - (Please specify the name of the system you plan to implement: e.g My Medical Record, Patient Knows Best)
b. No

19. Which of the following criteria are part of your follow up protocols? (please mark all that apply:)
a. Patients have access to a Support Worker who acts as their key worker for the duration of their follow up care.
b. Patients have access to an online patient service that allows them to check test results, complete assessments, view patient information and message their clinical team.
c. Patients attend a 4-hour supported self-management workshop with a group of 8 to 10 men to develop knowledge, skills and confidence to self-manage their condition
d. Patients do not need to attend routine appointments unless an issue arises.

FOI (WARRINGTON AND HALTON TEACHING HOSPITALS NHS FOUNDATION TRUST), Warrington and Halton Teaching Hospitals NHS Foundation Trust

Freedom of Information Act 2000 – Ref No: 20-319

Thank you for your request for Trust information under the provisions of the Freedom of Information Act 2000. I can confirm that the Team is currently attending to your request. A member of the team will respond within the statutory timescale which is currently 20 working days.

If applicable we will inform you if any of your requested information is exempt from release along with any fee required. We may require further detail from you to assist us in searching for the information you have requested. You may therefore be contacted in due course if it is necessary to clarify any part of your request.

If you wish to discuss any aspect of your request please do not hesitate to contact us quoting the reference number above.

Kind Regards

Freedom of Information Assistant

Warrington and Halton Teaching Hospitals NHS Foundation Trust
Kendrick Wing, Warrington Hospital, WA5 1QG

Email: [email address]

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Dear FOI (WARRINGTON AND HALTON TEACHING HOSPITALS NHS FOUNDATION TRUST),

As you have passed the date for submission we are just emailing a gentle reminder that we would really appreciate a response from yourselves on the above FOI request. We understand this is a difficult time and resources are limited.
Your response will be an integral part of our research on the impact of Covid-19 on prostate cancer diagnosis, treatment, and support. We are undertaking this research to ensure all men have access to the best possible care during this time so it is vital that we obtain as many responses as possible.

We look forward to hearing from you.

Yours sincerely,

Thomas Harding

FOI (WARRINGTON AND HALTON TEACHING HOSPITALS NHS FOUNDATION TRUST), Warrington and Halton Teaching Hospitals NHS Foundation Trust

Good Morning,

Thank you for your email, the respondent has been reminded and we will endeavour to provide this information as soon as possible, our apologies for the delay.

Kind Regards

Freedom of Information Assistant

Warrington and Halton Teaching Hospitals NHS Foundation Trust
Kendrick Wing, Warrington Hospital, WA5 1QG

Email: [email address]

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FOI (WARRINGTON AND HALTON TEACHING HOSPITALS NHS FOUNDATION TRUST), Warrington and Halton Teaching Hospitals NHS Foundation Trust

2 Attachments

Dear Sir/Madam  

 

Freedom of Information Act 2000 – Ref No: 20-319

 

Response to request dated 16/12/2020 made under the Freedom of Information
Act 2000

 

Questions and Response:

 

 

1. Did you suspend your MRI before biopsy service for patients with
suspected prostate cancer as a result of the COVID-19 pandemic?

 

b. No

 

 

2. If yes, have you now resumed MRI before biopsy for patients with
suspected prostate cancer?

 

N /A

 

 

3. Do you currently use a pre-MRI clinical triage for patients with
suspected prostate cancer? By pre-MRI clinical triage, we mean a process,
often Clinical Nurse Specialist led, that determines patient suitability
for MRI before biopsy

 

a. Yes – patients are seen in clinic

 

 

4. Has your radiology department introduced any new MRI exclusion criteria
for patients with suspected prostate cancer as a result of COVID-19?

 

b. No

 

 

5. If yes, do you plan to maintain any of these exclusion criteria once
restrictions to limit patients’ COVID-19 risk are lifted?

 

c. N/A

 

 

6. Did you stop conducting biopsies for patients with suspected prostate
cancer as a result of COVID-19 infection risks?

 

a. Yes - at the beginning of the first lockdown

 

 

7. If yes, have you resumed biopsy services for patients with suspected
prostate cancer?

 

a. Yes

 

 

8. Do you offer transperineal biopsy under local anaesthetic?

 

c. No, but we plan to in future

 

 

9. Following an MRI scan for suspected prostate cancer, what criteria do
you use to select patients for biopsy? Please include all that apply:

 

d. Patients with a PI-RADS or Likert score of 3 or greater, but only if
PI-RADS or Likert score 3 patients have other clinical indications (such
as age, ethnicity, PSA density) that make them higher risk

 

 

10. Did you delay radiotherapy treatment for prostate cancer patients as a
result of COVID-19?

 

d. N/A (please specify:)

Radiotherapy is delivered by Clatteridge

 

 

11. If yes, have you cleared your backlog for prostate cancer radiotherapy
treatment?

 

c. N/A – We did not delay prostate cancer radiotherapy treatment- as in
question 10.

 

 

12. Did you delay radical prostatectomy for prostate cancer patients as a
result of COVID-19?

 

a. Yes

 

 

13. If yes, have you cleared your radical prostatectomy backlog?

 

c. N/A – We did not delay radical prostatectomy for prostate cancer
patients – this is delivered by the Wirral University Teaching Hospital
NHS Foundation Trust.

 

 

14. To address your backlog did or are you using a protocol to risk
stratify patients and prioritise patients with high-risk and locally
advanced prostate cancer for treatment within 3 months?

 

N/A

 

 

15. Does your protocol apply to new patients with high-risk and locally
advanced prostate cancer with the intention to radically treat them within
3 months of diagnosis?

 

c. N/A - We do not have a protocol for patient prioritisation

 

 

16. Do you have prostate cancer Personalised Stratified Follow Up (PSFU)
protocols in place?

 

b. No

 

 

17. If Yes, do you have a digital remote monitoring system in place for
follow up?

 

a. Yes – My Medical Record

 

 

18. If no, do you plan to implement a digital remote monitoring system for
follow up?

 

N/A

 

 

19. Which of the following criteria are part of your follow up protocols?
(please mark all that apply:)

 

a. Patients have access to a Support Worker who acts as their key worker
for the duration of their follow up care.

 

 

 

If you are dissatisfied with the way your request for information has been
handled you can contact the Patient Experience Team lead to request a
review by writing to:

Patient Experience Team, Kendrick Wing, Warrington Hospital, Lovely Lane,
Warrington, WA5 1QG. 

 

If you are dissatisfied with the outcome of this internal review you can
submit a complaint to the Information Commissioner’s Office. You can do
this by writing to: 

FOI / EIR Complaints Resolution, Information Commissioner's Office,
Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9 5AF. Alternatively
you can complete an electronic complaints form and submit it to the
Information Commissioner’s Office via email. I have included a link below
for your convenience which explains how to complain to the Information
Commissioner’s Office.

[1]https://ico.org.uk/

 

Re-use of Public Sector Information Regulations 2005

 

The supply of information under the Freedom of Information Act is intended
to be for personal use only and does not automatically give the recipient
the right to commercially re-use it, for example, the right to publish it
or make it available to a wider audience [SI 2005 No: 1515 4(1)].

 

The Trust provides information under the Freedom of Information Act in
line with the template [2]Open Government Licence for public sector
information. Should you wish to re-use any information in line with this
Licence then you are not required to take any further action.

 

The Open Government Licence allows you to re-use information freely and
flexibly, with only a few conditions. If you wish to re-use information
outside of the Licence terms then please inform the Trust as unauthorised
re-use may be in breach of copyright law.

 

 

Kind Regards

 

Freedom of Information Assistant

 

Warrington and Halton Teaching Hospitals NHS Foundation Trust

Kendrick Wing, Warrington Hospital, WA5 1QG

 

Email: [3][email address]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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