LAUSR

The COVID-19 pandemic, caused by the coronavirus SARSCoV-2, has forced examination of much of routine healthcare provision in the UK, and necessitated changes in practice to protect patients from the virus while continuing to deliver high-quality care for their other health needs. This has been highlighted by the challenges in provision of elective surgical services while SARS-CoV-2 remains prevalent in communities. NHS providers have moved from preoperative assessment pathways routinely involving face-to-face appointments to remote (telephone, digital or combination) assessments. Telehealth-based solutions provide an innovative option to provide patient care during pandemic times while helping prevent and contain the spread of infection. They are also convenient for the patient and medical staff and are likely to become part of routine care in the future. This reduction in face-to-face contacts means there is a pressing need to rethink how best to prepare patients for elective surgery, ensuring comprehensive assessment is performed within the limitations imposed by pandemic-related changes to working practices. It is also an opportunity to review the evidence for best care to evaluate the benefit of certain aspects of what may have become routine practice in consideration of risk balance to the patient. In designing and redesigning clinical pathways, the following general principles should be applied: