Using Coronavirus as an unprecedented opportunity to transform health and care services in Wales

As we deal with the uncertainties of the Coronavirus pandemic we hear the expression ‘’nothing will be the same’’. In the past, how often have we heard the phrase ‘’don’t waste a good crisis’’? If there is any good to come out of these uncertain times, we need to exploit the opportunities which present.

The situation we find ourselves in is forcing us into new ways of using services and working together and at a pace to deliver change, which in normal times would have seemed unimaginable. Whether the forces are creative genius, entrepreneurial spirit, or a survival instinct makes no difference, what is important is that we are witnessing a fundamental shift in the way we conduct health and care business.

When we look back, it will be the agile organisations that will have come out the strongest in Wales; but they are also likely to look very different. These agile organisations will have implemented new, responsive ways of operating and new business /operating models, which will be significantly different from before. What we must do then is to ensure we do not simply revert back, but continue to build on these opportunities and learn from them for the future to ensure we achieve a healthier Wales.

When the NHS is at the epicentre of a pandemic, with so many lives reliant upon its resilience, will it have the capacity to recognise the changes taking place at speed around it and grasp the huge opportunities that present for genuine transformational change? 

It is reported that it took ten days for Sky to have 60% of its employees working from home to maintain its business. A care home charity I chair, which has homes spread across England and Wales, switched its whole HQ function to home working in seven days. Home Managers have provided computer/ tablet access for residents to family and friends who are no longer able to visit during the pandemic. These are just two examples of the scale and pace of change going on around us.

Most of us are doing business or staying in touch with family and friends by the use of Apps on our phones and computers. We hear of churches, which had previously counted their congregations in tens, are now live streaming to thousands. The NHS has also stepped up to the plate, with the majority of the population self-managing suspected symptoms through NHS 111. Here in Wales the announcement that the GP Video Conferencing Consulation which has been in development is to be fast tracked for roll out will be a game changer not only during the pandemic but as a revolutionary way of  accelerating access to primary care. The C19 Covid Symptom Tracker App is agreat example of how to harness citizen Science.

I doubt if things will ever be the same again after the pandemic is over; especially when the benefits of ease of access, reduced costs, wasted travel time and positive impact on carbon footprints are also fully taken into account. Clearly, there is also the downside of losing social interaction, which must be brought into the equation and a balance sought as we will have seen from the response to community volunteers.

There are around 350 developers in the market looking at Health Apps and Digital Tools, which include:

  • Support and prevention for a wide range of chronic conditions

  • Diagnostic algorithms

  • Advice and support for a number of cancers

  • Mental Health

  • Personal wellbeing

  • Telemedicine and tele-monitoring

This increasing range of apps and digital tools, combined with the overarching NHS core systems’ architecture and data bases, provide exciting opportunities to transform the way services are run and delivered. The potential for improving care, addressing shortages in the workforce, providing solutions for rurality, reducing costs and travel (including benefits for the carbon footprint) and encouraging individuals to take greater responsibility for their own care are really significant.

Prior to the pandemic, the key question was ‘is the NHS sustainable given the increasing numbers of the very elderly, persistent workforce shortages and ever increasing costs of new drugs and technologies.

No doubt when we come out of this pandemic, these questions will remain, exacerbated by hugely inflated elective waiting lists and a much more adverse economic situation. The question will then be ‘Can we go on as before, or will the opportunity for step change service transformation be grasped by learning from how many services quickly changed in response to Covid-19 and by fully exploiting the use of technology?

On workforce we have seen an amazing response from both the general public (through volunteering) and current and former NHS employees who have come back to work. Can some of those who have come back, be convinced to now stay and can Wales better harness the desire of many to help, by increasing the role of volunteers once things return to normal?

A final thought: hopefully, one of the few silver linings to the pandemic appears to be the global reduction in air pollution- with the obvious benefits to health and the environment. Will public opinion now demand or at the very least be far more receptive to new ways of receiving and delivering services?  Whatever the answer, we all know that nothing will ever be the same again.

Sir Paul Williams, OBE KStJ, DL is a Bevan Commissioner with a distinguished career as a Chief Executive of three NHS Trusts, culminating as CEO NHS Wales and Director General for Health and Social Services, Welsh Government.

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