931 COVID-19 and the Irish National Spinal Injuries Unit: Impact on Service Provision and Strategies to Protect Urgent Care

The COVID-19 pandemic has had a dramatic impact on the provision of healthcare worldwide. The delivery of a national spinal service for emergent surgery, elective surgery and outpatient assessment has been incredibly challenging. Method Prospectively collected data regarding referrals to, and operative workload of, the Irish National Spinal Injuries Unit (NSIU) during the period of national lockdown in response to the COVID-19 pandemic was compared to the same period in 2019. Results During the period of national lockdown there was a 47% decrease in the number of urgent referrals to the NSIU and a 61% reduction in the number of surgical cases performed. A particularly concerning finding was that for surgical cases there was a 400% increase in attempted suicide as the cause of injury with this cohort representing 11% of all surgical cases performed during the pandemic lockdown. The introduction of a national instant messaging application (Siilo) referral group resulted in a median time to first response by a National Spinal Injuries Unit (NSIU) surgeon of 15.5 minutes. Conclusions The COVID-19 pandemic has had a significant impact on the provision of a national spinal service, however innovative strategies have been adopted to protect the capacity to provide urgent care.