Here to stay? Measuring and monitoring the impact of COVID-19 on Health and Social Care
Head of Healthcare
At BJSS we have defined three stages of crisis management for our internal use and feel that it’s a good blueprint to share with clients who are also dealing with the uncertainty, flurry of activity and stress of COVID-19.
It mirrors (in reverse) the public sector strategic command response for dealing with emergencies which is Gold (strategic), Silver (tactical) and Bronze (operational). More details on how that works can be found here: https://www.gov.uk/health-and-social-care/health-emergency-planning
Dealing with the current situation and managing crisis and continuity plans
- Helping your staff – Planning and monitoring working hours is going to be hard with an ever-changing roster of available staff (both from an EWTD and an infection status perspective). Burnout and extreme stress will continue be significant and likely to affect people in the long term. Staff are likely not just to be working long and arduous hours, but outside their expertise, and exposed to very traumatic events. Prioritising their health and wellbeing is critical for sustaining what is likely to be a protracted period of heightened activity.
- Be flexible – the standard crisis response has Bronze to Gold commands for a reason. The routine roles of ‘lead and follow’ are significantly disrupted and many people who usually set direction must now follow. This means people thinking and acting differently as the usual systems and barriers have fallen away.
- Experiment – In an extreme understatement, this is not the ideal time to significantly change processes or destabilise efficient teams. Tweaks or even huge shifts in productivity won’t be enough to keep the system at an acceptable level of capacity. Exploring novel approaches is likely to be key to helping the health and social care sector rise to the challenge. Different thinking and ways of working are essential. Not all experiments will work.
Organisations learn and emerge stronger
- Stock take – Not everything which will be tried will have worked. That’s to be expected. Having an objective review process to classify which innovations and ways of working have and haven’t worked, which are still appropriate, and which are no longer relevant will be an important part of re-basing the organisation.
- Communicate and coordinate – The step-down response will need to be as coordinated as the ramp up, from repatriating staff and patients, to finding appropriate beds in care and nursing homes for those unable to return home. The sub-acute phase will include more organisations including private and third sector, driving the need for clarity and consistency, and significant information transfer to ensure continuity of care.
- Consistently scale – The challenge for technology and clinical staff will be to scale their efforts while ensuring that they maintain an equitable service nationally. This is difficult at the best of times but even more so when working across public and private health systems and working with different levels of capacity and demand.
Preparing for and organising for the “next normal”
- Rebaseline – A backlog of things such as financial planning, contract management and resuming planned elective activity which were postponed due to the crisis will need to be picked up again. For example, financial year end for all public sector organisations is 31st March. The challenge posed by drawing a financial line in the sand in the midst of the largest pandemic in a generation is going to be sizable.
- Pivot – Strategic rather than tactical procurements and rewriting strategies and business plans. There isn’t a digital roadmap out there which will not require review as a result of the changes which are unfolding. Local, STP and national plans will need to be reviewed and renewed. Many things which were assumed to be five years out which been achieved in weeks (for example the widespread use of digital outpatients, and the uptick in adoption of the NHS App). Incredible progress has been made in a short period of time. So where next?
- Progress – Some recent changes such as remote consultations and increased information sharing look here to stay. They have been trialled in extreme circumstances and are working for both patients and practitioners in many use cases. This will open the door for the landscape of patient pathways and population health management to look very different.