Remodelling of specialist services enables safe reduction in hospital admissions of patients with sickle cell disease: Lessons from the COVID-19 pandemic.

Sickle cell disease is characterised by recurrent painful crises often leading to hospitalisation. During the COVID-19 pandemic, it was important to try to reduce the need for hospital admission for these high-risk patients while at the same time ensuring that hospital avoidance did not put them at risk of deterioration from disease-related complications. In the 3-month period between March and May 2020, there was a significant reduction in the number of hospital admissions as well as mean length of stay compared with the mean figures over the same months in the preceding 5 years (2015-19), with an overall reduction in inpatient days of 77%. There were no cases of unsafe hospital avoidance or presentations to hospital that were inappropriately delayed. Frequent telephone communication with patients and provision of ambulatory care were, among others, two very important means of supporting our patient population.