As we have moved beyond the first peak of the COVID-19 pandemic, we are starting to turn our attention towards restoration and recovery, recognising that we continue to look after patients with the virus including those who are still very ill and those who are starting the long road to recovery.
This next phase of work will involve partners across Surrey Heartlands working together to consider three key areas of work:
- Restoring those services which have been stopped, starting with those that are most urgent
- Reviewing our existing strategies and plans to make sure they are still valid and relevant post-COVID
- Learning from what has gone well/hasn’t gone well during the pandemic period – this will include maintaining new ways of doing things that make sense to continue longer-term
Restoration of critical services
When the spread of the virus was increasing significantly back in March, it was essential for the NHS to ensure enough bed capacity and staff to cope with the predicted increase in demand. Some services not related to COVID-19 needed to be paused or scaled back to allow the sickest patients suffering from the virus to receive the life-saving treatment they needed. Similarly patient and staff risks from the virus through continuing many routine services also meant other services were paused.
Whilst emergency and life-saving care, including critical cancer surgery, continued during the pandemic, we now need to start restoring services for patients who need the most immediate treatment, and whose condition may deteriorate if this is delayed. Services such as cancer testing and surgery, cardiovascular, stroke and general maternity services are all now slowly being restarted. Although we need to balance this with the potential for a second peak, it’s clearly critical to get these urgent services back up and running as soon as possible. Over time we will then look to step up more services when it is safe and appropriate to do so.
Partners are now working together to consider the best way to restart services, taking into consideration how to protect both staff and patients from the risk of infection and how we can offer the right assurance to local people that it is safe to attend face to face appointments and / or come into hospital.
Lots of new measures are being put in place to make sure the risk of infection is kept to a minimum – for example, continuing to use the independent sector for some planned operations; reducing the number of beds in wards to comply with new infection control guidance; deep cleaning between appointments/procedures and introduction of the national 14 day quarantine period for patients coming for planned surgery. And organisations are looking to be as creative as possible – at the Royal Surrey for example, new drive-thru services have been introduced for blood tests and implanted cardiac device check-ups which patients can have from the safety of their car.
These new measures will impact on the speed in which some services can be restored which will be carefully monitored over the coming weeks and months. At the same time, we need to recognise it will take time for some services to be fully restored and we need to continue to be flexible so we can manage this ongoing situation in the best possible way.
Reviewing existing strategies and plans
At the same time, we need to review our existing strategies and plans to make sure these are still the right ones for our local population. This includes our overarching Health and Wellbeing strategy, published last year here, and our response to the NHS Long-Term Plan link. Whilst we need to undertake a more detailed review, its likely these ambitions will remain broadly relevant but we would expect the way we deliver these to change – for example the move towards a more digital approach to providing care.
A key part of this work will be to consider and identify hidden harms – such as the increase in domestic violence and other safeguarding issues, the effects of isolation on people’s mental wellbeing, to harm caused from people being afraid or not able to seek the right health advice or interventions due to the pandemic. This also includes the economic impact which could have long-lasting health issues (particularly around mental health), and the impact on staff including burn-out and post-traumatic stress. Our plans also need to account for any future waves of the pandemic and the longer term needs of patients recovering from the virus with long-lasting chronic conditions.
Engaging our staff and citizens will be a key part of this work to ensure we focus on the areas that matter most to local people, to those delivering care and that we take a collective approach to redesigning the way we manage health and care in the future.
Learning from what’s gone well
During the pandemic we made many rapid changes to the way some services are delivered, some of which will make sense to retain. This includes the acceleration of improvements that were planned for the future such as greater use of telephone and video consultations and new ways of delivering emergency care for those with mental health issues.
We also need to build on the collaboration and joined-up working that has worked so well across teams and organisations in response to the pandemic. Not only has this made decision-making across partners more efficient, it has also directly improved the way services are working. For example, greater partnership working has significantly improved how we discharge patients who are medically fit to leave hospital to allow people with COVID-19 to get the urgent care they need.
We will be reviewing all the changes that have been made and engaging staff, patients and local people to understand their impact and develop proposals for consolidating those we want to maintain.