COVID-19: Breast Service guide

Updated: November 2020

Scope

This information provides guidance on the management of Breast patients in the Derriford Hospital catchment area during the Covid-19 pandemic. The information is based on:

National guidance

Association of Breast Surgery: COVID-19 resources

NHS England & NHS Improvement: Advice to Trusts on maintaining cancer treatment during the COVID-19 response

NG12 and Additional Advice

Letter: Cancer alliance information on managing cancer referrals (NHS England website)

Key Message

  • The Breast Screening Service is running a delayed service currently, with women being invited by letter to arrange an appointment but is still functioning.
  • A national ruling means that women over 70 are no longer able to self-refer and are advised to remain breast aware and report concerns to their GP in the normal way. We cannot, and the GPs cannot arrange mammography on request unless there are symptoms present.

2WW referrals

e-Referral Service Selection:
  • Specialty: Surgery – 2WW
  • Clinic type: 2WW Breast
  • Service: DRSS-Western-2WW Breast - Devon CCG-15N
  • Many e-RS referrals are vetted by telephone consultation to minimise unnecessary visits to Derriford Hospital and provide more timely advice and intervention for some.
  • There is limited availability of clinic appointments and it is not always possible to make the 2WW deadline due to high demand and service challenges
  • Limited surgical capacity remains, with COVID-19 adapted pathways, limited to those with active cancer diagnoses. Some pathways include a lower threshold for neoadjuvant treatments where clinically appropriate (non-surgical pathways initially).

Conditions with specific guidance

Breast Pain: Follow guidance supplied on Formulary and Referrals website

Urgent referrals

Standard pathway routes, telephone triage as above

Routine referrals

All new routine referrals will be clinically triaged and will either be added to a waiting list or, if appropriate, A&G will be given.

Please ensure that a practice-based system is in place to check daily for returning referrals with A&G.

Prior to making a routine referral, please ensure that any appropriate Policy or CRG has been reviewed and that all the suggested investigations and management options have been considered.

Urgent advice

Breast Care Nurses phone number: 01752 431898

Advice & Guidance

All referrals vetted, pending local introduction of Advice and Guidance service.

Covid-10 High risk patient advice:

Patients with breast cancer on chemotherapy should seek specific advice regarding self-isolation during their treatment from the advice line number above or their oncology team

If concerned about new symptoms of a lump, distortion of the breast or bloody discharge, seek advice from GP who will refer. Expect telephone consultation and timely appointment if required following that call.

Family history referrals are still being reviewed and will usually receive a phone call to assess risk and advise on management.

Screening for high risk women is continuing currently. Surveillance mammography post-operatively has recommenced and is up to date. Screening appointments are by arrangement with the screening office via 01752 431652, but unfortunately appointments can only be given to those who have missed a screening invitation, or who have an invitation letter.

We are unable to recommence screening women, at their request, once past screening age (once 71 or over). This is a national ruling.

Western Breast Service contact information

Sharon Cox: 01752 439410

Breast Care Nurses single point of contact: 01752 431898

Breast Screening enquiries: 01752 431652

Supporting Information

Pathway Group

This guideline has been signed off on behalf of the NHS Devon Clinical Commissioning Group

Publication date: April 2020

Last updated: 09-11-2020

 

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