United Lincolnshire Hospitals Trust could lose between 30-40% of its operations capacity every time there is a COVID-19 case — unless Grantham is kept as a coronavirus-free site, bosses have been warned.

The trust board voted on Tuesday to continue the arrangement and to increase capacity at Grantham for procedures including endoscopy and chemotherapy.

It comes after members of the Royal College of Surgeons of England warned of a "tsunami" of cancelled operations this winter as the NHS copes with rising numbers of coronavirus patients.

They doubt the NHS nationally could meet targets to restore surgery back to near pre-pandemic levels.

Responding to a question on the situation by trust chief executive Andrew Morgan, chief operating officer Simon Evans said ULHT was now carrying out operations at the highest level on record.

"If we reverted back, the question would be how could we operate green pathways and offer maximum protection.

"We would have to take a significant increase in the level of risk to patients being operated on because of the mixed environments.

"If we had one patient contracting COVID we would have to stop operating in that particular sector until we could go through a deep clean.

"If that were to happen, we might lose between 30-40% capacity every time we went through that particular process."

Mr Evans also confirmed the trust had "started to see an increase in cancellations".

He said some of this was because "we have seen some patients not completely adhering to isolation and social distancing guidance," but also that testing capacity had been limited or not worked.

However, he said: "The number of cancellations compared to last year is a great improvement and going forward believe the Grantham model will offer a great deal of protection."

Grantham's green site, introduced in April, sees the hospital operate as a COVID-free facility in all departments except the Urgent Treatment Centre.

Bosses reported that since it began, no coronavirus-infected patients had been treated in the green area.

Data showed that that around 88 surgical cases were being undertaken each week at Grantham.

2,500 outpatients were seen between August 17 and September 14 including 726 first appointments.

67% of Grantham patients in July were transferred to Lincoln or Pilgrim hospitals, going down to 63% in August.

The strict guidelines at Grantham to keep the site COVID-free also brought on some unfortunate incidents.

One example is an elderly patient who had laxatives before a surgery but was forced to defecate outside the hospital door.