Post-Covid-19 NHS leaders must be adaptable and agile

As the debate of how to exit the Covid-19 lock-down emerges in the UK, NHS leaders must not forget the lessons they have learned during the present pandemic, according to health expert Professor Chris Ham. In an article for the firm’s website, the Carnall Farrar Senior Independent Advisor has said that agility, flexibility and collaboration are key to strengthen the NHS after coronavirus’ first wave dies down.

While a recent edition of the respected Global Health Security Index predicted the UK was well-positioned to handle Covid-19, Government mismanagement of the situation soon saw the NHS issuing emergency calls for ventilators, and personal protective equipment. With a death-toll which has already surpassed 10,000, experts now expect the country will have one of the worst impacts in Europe.

The NHS was already facing unprecedented challenges, before the impact of Covid-19. Demand has spiked due to an ageing population, while the Government continued to reduce health spending, leaving the institution at a cross-roads in its existence. Now, the under-resourced NHS has been pushed to the brink by the severity of the coronavirus outbreak in the UK.

However, according to Professor Chris Ham, a Senior Independent Advisor on the board of healthcare consultancy Carnall Farrar, the crisis has also brought out a level of ingenuity in the NHS that could prove vital to its survival, after the crisis dies down. Ham, a former Director of the strategy unit at the Department of Health, wrote in a piece for the advisory firm’s website that “the old adage that ‘necessity is the mother of invention’ is playing out in real-time as the NHS responds to the Covid-19 crisis.”

According to Ham, NHS leaders have already demonstrated adaptability and agility during the pandemic. While general practices quickly collaborated, working together to create “hot hubs” for patients suspected of having Covid-19, and cold hubs for patients with other urgent needs, Ham pointed to the growing role NHS 111 has served in supporting primary care. Meanwhile, acute hospitals radically reshaped their work by discharging medically optimised patients and released around 30,000 beds, and cancelling many planned surgeries boosted capacity in combination with additional facilities at new Nightingale hospitals.

“NHS leaders are now beginning to turn their attention to recovery from the current crisis,” Ham went on. “Priorities include holding onto the gains of new ways of working and meeting the needs of patients whose care has been put on hold. The latter includes extending the use of telephone and video consultations that have been used in many hospitals in place of face to face communication. Supporting health and social care staff whose own physical and mental health and wellbeing has been put on the line is one of the highest priorities.”

The flexibility leaders have already exhibited will be key for the NHS, as it seeks to fortify its position after Covid-19’s first wave in the face of many uncertainties. While debates on how to end the current lock-down might be underway, research into vaccines and repurposing existing drugs to support the treatment of Covid-19 patients have yielded no magic bullet – meaning likely second wave of infections after the lock-down must also be taken into account.

Integration of care systems is another essential element of these preparations. Ham contended that “silo-working” was no longer affordable, and that the new partnerships between the NHS, universities and businesses cultivated amid Covid-19 must be maintained. These partnerships include the design and manufacture of ventilators and equipment like visors, while another partnership between the NHS and the armed forces has contributed to the distribution of PPE and other supplies and the construction of the Nightingale hospitals.

Ham concluded, “There can be no going back to old ways of working after Covid-19 has passed. The sense that ‘we are all in this together’ has helped mobilise people and resources and this will be even more important during the recovery phase. Leadership must be collective as well as shared, encompassing people and communities and all parts of the public sector. Only in this way will we secure our common future.”