03 April 2020

The National Institute for Health and Care Excellence (NICE) has released new UK guidance which sets out how doctors should balance the risks of COVID-19 infection for patients needing radiotherapy or stem cell transplants.

It is the second set of guidelines fast-tracked by NICE in response to the evolving COVID-19 global pandemic.

In relation to stem cell transplants, the guidance states that most non-urgent allogenic stem cell transplant procedures should be deferred until the pandemic risks have been passed. This would include most patients with chronic blood cancers.

For radiotherapy, the NICE guidance advises that radiotherapy should be avoided if it is likely to provide little or no benefit or if there is an alternative treatment. If it is unavoidable, radiotherapy should be deferred if clinically appropriate, or doctors should use the “shortest safe form of treatment”.

Decisions should be made by multi-disciplinary teams on a patient-by-patient basis – and the reasons for any decisions should be recorded, NICE says.

The new NICE guidelines have been developed to maximise patient safety whilst making the best use of NHS resources and protecting staff from infection. The guidelines have been developed using the interim process and methods for developing rapid guidelines on COVID-19 and recommendations are based on evidence and expert opinion.

Meanwhile, the Royal College of Physicians (RCP) urged doctors to pay heed to its ethical guidance, released earlier this week.

The guidance says all patients should be treated equally, regardless of viral status. It also sets out circumstances in which doctors might refuse to be involved in the care of infected patients.

The guidance has been backed by more than a dozen medical royal colleges and faculties.

Dr Alexis Paton, chair of the RCP’s committee on ethical issues, said:  “Consistency and accountability nationwide are key to ethical decision-making during the pandemic, for the reassurance and protection of patients and health professionals alike. This guidance provides much needed clarity and consistency to all frontline staff during this crisis.”

Source: NICE/ RCP


NICE: https://www.nice.org.uk/covid-19

RCP Guidance: https://www.rcplondon.ac.uk/file/20551/download


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