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World J Gastroenterol. Nov 28, 2021; 27(44): 7625-7648
Published online Nov 28, 2021. doi: 10.3748/wjg.v27.i44.7625
COVID-19: Effect on gastroenterology and hepatology service provision and training: Lessons learnt and planning for the future
Muhammad Raheel Anjum, Jodie Chalmers, Rizwana Hamid, Neil Rajoriya
Muhammad Raheel Anjum, Department of Gastroenterology, The Royal Wolverhampton NHS Trust, Wolverhampton WV100QP, United Kingdom
Jodie Chalmers, Department of Medicine, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2WB, United Kingdom
Rizwana Hamid, Department of Gastroenterology, Royal Alexandria Hospital, Paisley PA2 9PJ, Scotland, United Kingdom
Neil Rajoriya, The Liver Unit, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2WB, United Kingdom
Neil Rajoriya, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, United Kingdom
Author contributions: Anjum MR led with literature search and submission of the article; Anjum MR and Chalmers J drafted the article; Chalmers J, Hamid R, and Rajoriya N contributed to editing of the article; Hamid R and Rajoriya N did critical appraisal of the article; Rajoriya N is the guarantor of the article.
Conflict-of-interest statement: All authors have no conflict of interests to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Muhammad Raheel Anjum, FCPS, MBBS, MRCP, MSc, Doctor, Department of Gastroenterology, The Royal Wolverhampton NHS Trust, C/o Dr. Anjum, Gastroenterology Secretaries 1st floor, McHale Building, New Cross Hospital, Wolverhampton WV100QP, United Kingdom.
Received: March 27, 2021
Peer-review started: March 27, 2021
First decision: June 14, 2021
Revised: June 28, 2021
Accepted: November 15, 2021
Article in press: November 15, 2021
Published online: November 28, 2021

In late 2019, reports arose of a new respiratory disease in China, identified as a novel coronavirus, severe acute respiratory syndrome coronavirus 2. The World Health Organisation named the disease caused by the virus ‘coronavirus disease 2019 (COVID-19)’. It was declared a pandemic in early 2020, after the disease rapidly spread across the world. COVID-19 has not only resulted in substantial morbidity and mortality but also significantly impacted healthcare service provision and training across all medical specialties with gastroenterology and Hepatology services being no exception. Internationally, most, if not all ‘non-urgent’ services have been placed on hold during surges of infections. As a result there have been delayed diagnoses, procedures, and surgeries which will undoubtedly result in increased morbidity and mortality. Outpatient services have been converted to remote consultations where possible in many countries. Trainees have been redeployed to help care for COVID-19 patients in other settings, resulting in disruption to their training - particularly endoscopy and outpatient clinics. This has led to significant anxiety amongst trainees, and risks prolongation of training. It is of the utmost importance to develop strategies that continue to support COVID-19-related service provision, whilst also supporting existing and future gastroenterology and Hepatology services and training. Changes to healthcare provision during the pandemic have generated new and improved frameworks of service and training delivery, which can be adopted in the post-COVID-19 world, leading to enhanced patient care.

Keywords: COVID-19, Gastroenterology, Hepatology, Training, Service provision

Core Tip: The coronavirus disease 2019 (COVID-19) pandemic has led to adverse effects on many aspects of life. Healthcare professionals have faced unique challenges with COVID-19 including surges in cases with easing of lockdown measures, the emergence of new variants, and the roll-out of mass vaccination. The pandemic has had a largely negative impact on gastroenterology and hepatology service provision and training across the world. These difficulties have affected job-roles and training across the medical profession. We review the available evidence on the COVID-19 disruption to gastroenterology and hepatology service provision and training, discussing recommendations to minimise the interference going forward.