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Addressing the challenges restoring clinical services during the COVID-19 pandemic by harnessing the alignment of clinical and management leadership: an example from a large colorectal service
  1. Henry Simon Tilney1,2,
  2. Sally Vaughan1,
  3. Timothy Ho1
  1. 1 Frimley Health NHS Foundation Trust, Frimley, UK
  2. 2 Imperial College London Department of Surgery and Cancer, London, UK
  1. Correspondence to Mr Henry Simon Tilney; henry.tilney{at}


Background The COVID-19 pandemic has posed the greatest operational challenge to the English National Health Service since its inception. Elective surgical services have struggled due to the need to protect both staff and patients from viral exposure, and perioperative COVID-19 infection has been associated with significant excess mortality.

Interventions In this brief report, we describe how through necessity, it has provided an opportunity to redesign services for the benefit of both patients and organisations, with attendant improvement in activity compared with prepandemic metrics. We present the experience of a large district general hospital, using the department of colorectal surgery as a case study, in responding to the pandemic by restoring services and achieving improved short-term outcomes and processes in newly redesignated facilities.

Conclusions These reorganised surgical services represent a ‘silver lining’ of the pandemic. Clinician-led service restructuring, with positive engagement with staff at all levels, has not only addressed backlogs of urgent elective patients in a safe environment, but has also led to patient benefits and high levels of patient and staff satisfaction.

  • clinical leadership
  • improvement
  • outcome

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  • Contributors All authors contributed equally to the conception, data collection, drafting and critical editing of this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.