To date, and out of necessity, the Covid-19 pandemic response has primarily been tactically delivered across our health and care services.
Despite a brief hiatus over the summer, we are now into a second wave of infections as cases and hospital admissions increase. Services will be even more severely strained and tested this time as they battle to save lives against a backlog of elective care procedures and annual winter pressures.
However, despite the immediate pressure facing our health service, it’s more important than ever to think strategically and proactively about how we can respond to the continued demand for pandemic services and crucially meet the overall health and wellbeing needs of our population. We need to take lessons learnt from the pandemic response and proactively apply them.
But how should we do that? Do we model trends seen in other countries? Take the learnings from the UK, the decisions that were made early on, their resulting outcomes and adapt policy accordingly? There are many options and a need to act quickly that makes it all too easy to provide knee-jerk responses. There is no doubt technology and innovation will be important going forward, but central to any strategic thinking are the patients themselves and we need help to join the patient dots.
‘Future proofing’ in healthcare is a fallacy as technology continues to change, adapt and evolve at a rapid pace. We should not focus on the shiny new things, but on the way health services can join up, adapt and grow around patient needs, relevant to each healthcare environment. Similarly, innovations in care will need to be evidence-based and population-based.
For example, there is a proliferation of apps currently being used by healthcare providers to manage outpatient activity, but no single agreed approach as to how the data they collect is recorded and compiled. In May, Graham Kendall from The Digital Healthcare Council wrote an article calling for a single agreed approach as to how data is collected for online consultation appointments. Remote consultations have been touted as central to maintaining healthcare services, particularly in primary care, during the pandemic, but if the data provided on them is unreliable decision makers could risk investing in the wrong services.
Accurate data can help to support all sorts of solutions at patient, place and system level and is an important part of the value proposition. I recently wrote about using data to model future capacity, pointing out the need to act promptly to avoid building further pressure in the system. Combining a predictive approach with the use of technology, such as AI, data modelling and algorithm-based triage amongst others, can ensure the flexibility of frontline services going forward, ultimately providing a health system better able to cope with fluctuations in demand.
Another outcome of the increased use of data provided by industry during the pandemic is the evolution of greater collaboration between healthcare services. A white paper published in August 2020 - Covid-19: Roadmap to Recovery - highlighted the importance of integration, suggesting and outlining a more joined-up approach. It found that the response to the pandemic has necessitated collaboration within regional clusters of UK healthcare organisations and acted as a catalyst to reform and reset the healthcare landscape heralding the end of CCGs in favour of Integrated Care Systems (ICSs).
As eConsult has now integrated into the NHS App and BMA guidance on choosing online GP consultation platforms is generating more standardised data with new collaborations being established, it seems that primary care is well provisioned. However, the rest of the sector hasn’t yet reached such a position.
An integrated system-wide approach, with the patient at the heart of it, should result in a world where it’s easy for every healthcare service to predict and model service demand. This, combined with every clinician having access to the technology and information they need to carry out a thorough medical consultation, would ensure every patient was able to get the right medical care.
As healthcare systems try to move back to strategic thinking, how do we work to deliver consistent services that enable these aims to be achieved across the patient journey? We’re already seeing more strategic choices being made, for example, having Nightingale hospitals ready to go in case we need them. However, it might be more strategic to think about what we should be doing with them, and how we staff them, when they are not needed for Covid-19 related cases; could they be used to clear elective surgeries or to catch up with diagnostics?
We all need to seek out opportunities for sustainable, effective transformation in healthcare, but be aware of the pitfalls of change for change sake. It is incumbent on all of us to not just start thinking strategically but, in these unprecedented times, to embrace out-of-the-box thinking which makes the most of the technology, data and resources we have available while keeping the patient at the centre of our thoughts.
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