{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T06:27:23Z","timestamp":1774592843968,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T00:00:00Z","timestamp":1617840000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The object of this work was to study how National Health Service hospitals in England and Wales aimed to maintain effective and safe colorectal cancer (CRC) services during the first peak of the COVID\u201019 pandemic (April 2020).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A national survey was performed among all 148 hospitals providing CRC services. Information was collected about changes in referrals, diagnostic, staging and therapeutic procedures, as well as whether there was access to a \u2018cold site\u2019 (a hospital facility free of COVID\u201019). Clinicians in each hospital were also asked to give the \u2018single most important lesson learned\u2019 about keeping services safe and effective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Full responses were received from 123 (83%) hospitals, and information about \u2018cold sites\u2019 was available for 146 (99%). Eighty hospitals (54%) had access to a \u2018cold site\u2019 and this was increased in regions with higher COVID\u201019 infection rates (<jats:italic>p<\/jats:italic>\u00a0&lt;0.001). Of the 123 responding hospitals, 105 (85%) indicated that referrals of patients with suspected CRC had dropped by at least 30%, and 69 (56%) indicated that treatment plans were altered in at least 50% of CRC patients. However, \u2018cold site\u2019 availability protected the capacity for diagnostic colonoscopy (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.013) and CRC resection (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.010). Many \u2018lessons learned\u2019 highlighted the importance of adequate structural service organization, often mentioning \u2018cold sites\u2019 and regional coordination as examples, good communication and triage of patients based on clinical urgency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Access to \u2018cold sites\u2019, as well as regional coordination, clear communication and strong leadership, were found to be pivotal in maintaining capacity for diagnosis and treatment of CRC during the COVID\u201019 surge.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.15622","type":"journal-article","created":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T08:36:06Z","timestamp":1615278966000},"page":"1733-1744","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["The impact of the first peak of the COVID\u201019 pandemic on colorectal cancer services in England and Wales: A national survey"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8429-957X","authenticated-orcid":false,"given":"Jemma M.","family":"Boyle","sequence":"first","affiliation":[{"name":"London School of Hygiene and Tropical Medicine London UK"},{"name":"Clinical Effectiveness Unit The Royal College of Surgeons of England London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Kuryba","sequence":"additional","affiliation":[{"name":"Clinical Effectiveness Unit The Royal College of Surgeons of England London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen A.","family":"Blake","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine London UK"},{"name":"Clinical Effectiveness Unit The Royal College of Surgeons of England London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajay","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine London UK"},{"name":"Department of Clinical Oncology Guy\u2019s and St Thomas\u2019 NHS Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"van der Meulen","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine London UK"},{"name":"Clinical Effectiveness Unit The Royal College of Surgeons of England London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"Walker","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine London UK"},{"name":"Clinical Effectiveness Unit The Royal College of Surgeons of England London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Braun","sequence":"additional","affiliation":[{"name":"Department of Oncology The Christie NHS Foundation Trust Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Fearnhead","sequence":"additional","affiliation":[{"name":"Department of Surgery Cambridge University Hospitals NHS Foundation Trust Cambridge UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,4,8]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30096-6"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.2648"},{"issue":"18","key":"e_1_2_13_4_1","first-page":"1775","article-title":"Case\u2010fatality rate and characteristics of patients dying in relation to COVID\u201019 in Italy","volume":"323","author":"Onder G","year":"2020","journal-title":"J Am Med Assoc"},{"key":"e_1_2_13_5_1","unstructured":"Royal College of Surgeons of England.Guidance for surgeons working during the COVID\u201019 pandemic 2020. Available from:https:\/\/www.rcseng.ac.uk\/coronavirus\/joint\u2010guidance\u2010for\u2010surgeons\u2010v1. Accessed 4 January 2021."},{"issue":"11","key":"e_1_2_13_6_1","first-page":"1440","article-title":"Elective surgery cancellations due to the COVID\u201019 pandemic: global predictive modelling to inform surgical recovery plans","volume":"107","author":"COVIDSurg Collaborative","year":"2020","journal-title":"Br J Surg"},{"key":"e_1_2_13_7_1","unstructured":"Macmillan Cancer Support.The forgotten \u2018C\u2019? The impact of Covid\u201019 on cancer care;2020. Available from:https:\/\/www.macmillan.org.uk\/assets\/forgotten\u2010c\u2010impact\u2010of\u2010covid\u201019\u2010on\u2010cancer\u2010care.pdf. Accessed 4 January 2021."},{"key":"e_1_2_13_8_1","unstructured":"EnglandNHS.Waiting times for suspected and diagnosed cancer patients for April 2020. 11 June 2020. Available from:www.gov.uk\/government\/statistics\/waiting\u2010times\u2010for\u2010suspected\u2010and\u2010diagnosed\u2010cancer\u2010patients\u2010for\u2010april\u20102020. Accessed 4 January 2021."},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30388-0"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31182-X"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.01933"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2020.09.047"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2020.10.019"},{"key":"e_1_2_13_14_1","unstructured":"Local Government Association.Local Government Inform Plus. Available from:https:\/\/home.esd.org.uk\/reporting. Accessed 4 January 2021."},{"key":"e_1_2_13_15_1","unstructured":"NHS.Cancer alliances \u2013 improving care locally. Available from:https:\/\/www.england.nhs.uk\/cancer\/cancer\u2010alliances\u2010improving\u2010care\u2010locally\/.Accessed 4 January 2021."},{"key":"e_1_2_13_16_1","unstructured":"Office for National Statistics.Estimates of the population for the UK England and Wales Scotland and Northern Ireland. Mid\u20102019: April 2020 local authority district codes edition of this dataset. Available from:https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/populationandmigration\/populationestimates\/datasets\/populationestimatesforukenglandandwalesscotlandandnorthernireland. Accessed 4 January 2021."},{"key":"e_1_2_13_17_1","volume-title":"Crossing the Quality Chasm: A New Health System for the 21st Century","author":"Institute of Medicine Committee on Quality of Health Care in America","year":"2001"},{"issue":"11","key":"e_1_2_13_18_1","first-page":"e521","article-title":"The impact of the COVID\u201019 pandemic on colorectal cancer service provision","volume":"107","author":"Collaborative CCR","year":"2020","journal-title":"Br J Surg"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.11627"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.15313"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.15056"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.11922"},{"key":"e_1_2_13_23_1","unstructured":"British Society of Gastroenterology.Endoscopy activity and COVID\u201019: BSG and JAG guidance;2020."},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/s43018-020-0074-y"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(20)30268-5"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m4087"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-020-03697-6"},{"key":"e_1_2_13_28_1","unstructured":"ACPGBI.Urgent Intercollegiate General Surgery Guidance on COVID\u201019;2020. Available from:https:\/\/www.acpgbi.org.uk\/content\/uploads\/2020\/03\/Updated\u2010Intercollegiate\u2010General\u2010Surgery\u2010Guidance\u2010on\u2010COVID\u201019\u2010final\u2010with\u2010logos13.pdf. Accessed 4 January 2021."},{"key":"e_1_2_13_29_1","unstructured":"NICE Guideline.COVID\u201019 rapid guideline: delivery of radiotherapy;2020. Available from:https:\/\/www.nice.org.uk\/guidance\/ng162. Accessed 4 January 2021."},{"key":"e_1_2_13_30_1","unstructured":"NICE Guideline.COVID\u201019 rapid guideline: delivery of systemic anticancer treatments;2020. Available from:https:\/\/www.nice.org.uk\/guidance\/ng161\/chapter\/6\u2010Prioritising\u2010systemic\u2010anticancer\u2010treatments. Accessed 4 January 2021."},{"key":"e_1_2_13_31_1","unstructured":"NHS England.Clinical guide to surgical prioritisation during the coronavirus pandemic. Available from:https:\/\/fssa.org.uk\/_userfiles\/pages\/files\/covid19\/prioritisation_master_240820.pdf. Accessed 4 January 2021."},{"key":"e_1_2_13_32_1","unstructured":"Academy of Medical Royal Colleges.Clinical guide for the management of essential cancer surgery for adults during the coronavirus pandemic. NHS England and NHS Improvement;2020."},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsb2005114"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.15341"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(21)00005-4"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/2327857920091067"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/PTS.0000000000000798"},{"key":"e_1_2_13_38_1","unstructured":"NICE.Quantitative faecal immunochemical tests to guide referral for colorectal cancer in primary care. Diagnostics guidance [DG30]. July2017. Available from:https:\/\/www.nice.org.uk\/guidance\/dg30. Accessed 4 January 2021."},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(20)30185-0"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.15622","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/codi.15622","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.15622","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T02:05:23Z","timestamp":1693361123000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.15622"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,8]]},"references-count":38,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1111\/codi.15622"],"URL":"https:\/\/doi.org\/10.1111\/codi.15622","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,8]]},"assertion":[{"value":"2021-01-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-04-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}