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Covid-19 HSE Clinical Guidance and Evidence

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NCCP advice for Medical Professionals on the management of patients referred to the Symptomatic Breast Clinic in response to the current novel coronavirus (COVID-19) pandemic

NCCP advice for Medical Professionals on the management of patients referred to the Symptomatic Breast Clinic in response to the current novel coronavirus (COVID-19) pandemic (CD 19-102 001/22.04.2020)


NCCP advice for Medical Professionals on the management of patients referred to the Symptomatic Breast Clinic in response to the current novel coronavirus (COVID-19) pandemic (CD19-102 001 / 22.04.20)

Authors: National Cancer Control Programme, Breast Guideline Development Group/Leads Group

  • This document relates to patients who do not have COVID-19 or are not suspected of having COVID-19.

  • Current events surrounding the COVID-19 pandemic are challenging and all public health bodies are placing the safety of patients, staff and communities first in all decisions.

  • This is an evolving situation. This advice is based on current information, it is additional to the advice of the NPHET, the HSE and the DoH, and will be updated as necessary.

  • The NCCP acknowledges that each hospital is working under individual constraints, including staff and infrastructure, and as a result will implement this advice based on their own unique circumstances.

  • The purpose of this advice is to maximise the safety of patients and make the best use of HSE resources, while protecting staff from infection. It will also enable services to match the capacity for cancer care to patient needs if services become limited due to the COVID-19 pandemic.

  • Any clinician seeking to apply or consult these documents is expected to use independent medical judgement in the context of individual clinical circumstances to determine any patient's care or treatment.
     

NPHET, HSE and DoH advice

Hospitals will operate under the overarching advice of the National Public Health Emergency Team (NPHET), the HSE and the DoH. Information is available at:

Purpose
  • The purpose of this guidance document is to provide guidance to medical professionals on the management of patients referred to the Symptomatic Breast Clinic during the COVID-19 pandemic.
     

Patients referred to Symptomatic Breast Clinics
  • All referrals to the Symptomatic Breast Clinics will be accepted.
     

Triage
  • All patients will be triaged in the hospital and the triage category will be determined by the consultant.  Patients will be triaged into two categories:

    • Patients with a high suspicion of breast cancer or a breast abscess, or

    • Patients who do not have a high suspicion of breast cancer.

  • Clarification may be sought with the GP regarding patient symptoms. 
     

Patients triaged as having a high suspicion of breast cancer by the consultant
  • Patients that are triaged as highly suspicious of having cancer by the consultant will be prioritised.

  • Co-morbidites and age should be considered when offering an appointment. The potential risks of COVID-19 and the benefit of attending the clinic need to be carefully evaluated.

  • Patients of any age with a breast abscess will be seen as soon as possible.
     

Patients triaged as not having a high suspicion of breast cancer by the consultant
  • Patients that are triaged as not having a high suspicion of cancer by the consultant will be put on a waiting list. The GP will receive acknowlegment that the referral has been received and the patients are on a waiting list.
     

Staff and capacity
  • Clinic staff should be left in place to support the running of the service.

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