Shifting the focus towards preventing illness. Few parts of society have faced the same strains that the pandemic has placed on our health and social care systems. The extra workload borne by the NHS has highlighted the challenges that the organisation already faced and to coin an old phrase, the need to focus on preventing illnesses rather than simply treating them is now very much the course of action needed post pandemic.
DIGITAL ADOPTION MEETS WITH PUBLIC APPROVAL
The pandemic has been a catalyst for the digital transformation of services. While some have criticised the failure to return to face-to-face services, our own research shows overwhelming support for online consultations – 60% would feel comfortable receiving a consultation with their GP over the phone or a video call, while 30% want to have more remote options to access the NHS by the end of this year.
60% of patients would feel comfortable receiving a consultation with their GP over the phone
There is a clear opportunity to digitise clinical pathways, this has been demonstrated in the work we do with both Frimley and Northwest London ICS leads, acute trusts, and community partners. Digital adoption plays a major role in clearing the backlog, resolving pre-pandemic challenges, and service-led decarbonisation. While worse-performing services will most definitely benefit from such innovations, it is shown in our recent work with our client that highly-performing services that are beyond pandemic recovery – such as maternity services – are in the ideal position to pioneer digital innovations in areas such as community engagement and service-led decarbonisation.
CATALYSING POST-PANDEMIC NHS PERFORMANCE
The perception of services provided during the pandemic stood up well, with an equal split saying services were “excellent” versus “fair” to “very poor”. However, 55% would like to see the NHS reduce non-urgent surgery waiting times this year, followed by 54% wanting to see a reduction in emergency department waiting times. Our findings contrast with levels of satisfaction at the height of the pandemic. According to the British Social Attitudes survey, “overall satisfaction with the NHS fell to 36% in 2021, an unprecedented 17 percentage point decrease on 2020”, with the main reasons given being waiting times, staff shortages, and government underfunding.
55% would like to see the NHS reduce non-urgent surgery waiting times this year
From our active engagements across the NHS, we believe there are multiple challenges that contextualise the current performance of acute trusts and system partners. Healthcare demand outstripped supply pre-covid; this situation has been exacerbated by the pandemic, both through an increase in demand and a decrease in supply. In response, all providers face the current challenge of increasing physical and virtual capacity to catch up on the elective backlog, deal with increased unplanned attendances and with new, amplified, and inter-related conditions; for example, long covid, acute respiratory syncytial virus, and increased mental health acuity. They do all this with the added challenge of a fatigued and currently depleted workforce, and an ageing estate.
While these immediate operational priorities need to be resolved, two strategic agendas sit alongside this: ICSs being put on a statutory footing on 1 July 2022; and the NHS’s commitment to becoming a net-zero health and social care system by 2045. While critical work is needed to both recover from the pandemic and re-establish services, we believe that the best health care system is one that doesn’t have to treat any patients. Since the root of all major challenges stem from a continuously-growing demand in healthcare, we support the outcome of our research in which four out of 10 people want more focus on preventing illness and on the nation’s overall health.
INCREASED FOCUS ON MENTAL HEALTH
If the pandemic has affected our views on digital adoption then our perceptions of the importance and impact of mental health are even greater. It has been a difficult two years for patients, both through depleted access to health services and from the direct negative social and economic effects of the pandemic on them personally. Half of those surveyed said the importance of mental health for them has increased. This highlights the need to take a holistic approach – a renewed focus on overall health is needed – one in which a critical balance is achieved against the treatment-focus of waiting list recovery.
We must view every patient pathway in its entirety, including the wider socioeconomic environment and its interactions with our physical and mental health at all stages of our lives, pre-birth to death. This includes health inequalities, access to mental health services, our education systems and campaigns, data collection methods, and family health. In the long term, the NHS needs to become a wellness organisation – not a treatment-focused one – if it is going successfully balance these challenges.