HEALTHCARE P LANNING
Increasing capacity – not least by expanding workforce capacity by identifying gaps across key staff groups and sectors. Part of the expansion will be by enlisting reservists; 75,000 are planned, to assist in different areas of the hospital including wards and departments who have shortages and need a “helping hand”. At the launch, it was claimed that full training will be given, and continuing support will be managed by existing full-time staff on a buddy system. They will be paid.
Retaining current staff – this will be a key focus for the hospitals facing huge workloads to tackle the backlog. Supporting staff needs equal focus, to look after their mental and physical health through up to 40 planned mental health hubs and free access to a range of apps and helplines.
Diagnostic centres – these will form part of the separation of different areas of the service, reducing the need for patients to always attend hospitals. This is extended by urgent and emergency care being delivered in different places from elective care. They will be known as ‘elective hubs’ and will focus on providing high volume, low complexity surgery – such as cataract surgery and hip and knee replacements.
Better information for patients – the Delivery Plan will include providing a new digital platform titled ‘My Planned Care’, which will provide transparency on waiting times and clinical support information for patients in the run-up to their care episode. In addition, there is an element of levelling up being proposed, in that areas of deprivation in the UK tend to have longer waiting lists and, in order to provide more equality, NHS systems will be required to analyse their waiting lists by looking at age, deprivation, and ethnicity characteristics, by specialty. Whatever happened to clinical need? There will be a new national network for long waiters, which will be managed by the national NHS team. It appears that
patients may be sent some distance from where they live in order to prioritise their treatment. This may be provided by either the independent sector or the NHS. In addition, there is a promise to provide more use of digital technology to continue the use of telemedicine for outpatient consultations and the concept of virtual wards, so that more care can be delivered at home.
Workforce issues
None of the aforementioned will be able to be delivered comprehensively or safely unless the reported 100,000 vacancies are managed. There is a desire to recruit 10,000 more nurses from other countries this year, which is a very big number, considering that the same shortages are affecting other developed nations’ healthcare systems, post-COVID – so we will all be recruiting from the same pool. We had better not be relying on the developing world to provide for us – that would be immoral. In the past, Nelson Mandela urged the developed world not to recruit too many nurses from Africa or other developing nations and this stemmed the tide, for a while. Proposals in the delivery plan include 5,000 healthcare support workers, together with the reservists, but the training and supervision of them will be left to the dwindling number of qualified staff. The workforce plan, which we have been waiting for, has not yet emerged and is critical to the success of the delivery plan.
Lessons learned The Nuffield Trust report highlights some challenges which COVID-19 has created, identifying that none of the healthcare systems were prepared for the disruption that COVID-19 caused. There are a number of different and common strategies that are being faced by them all – including catch-up on care backlogs and reform to the services to be better prepared for future difficulties. The pandemic has served as a catalyst to move system reforms further, so that long-
standing structural weaknesses and priorities are addressed. There is a move towards greater virtual care delivery, together with flexible staffing models. It is also apparent that there is focus not just on the acute sector, but also many systems are prioritising primary, community and long-term care capacity. The emphasis on non-acute health services identifies the interconnected nature of the health system recovery, and how efforts to catch up on elective care will be futile if primary care, community care and long-term care are not also strengthened.3 The health and economic consequences that must now be addressed, by many countries, are variable depending on the waiting lists that countries had going into the pandemic, how effectively they managed to contain COVID-19 infections, as well as how well systems protected access to routine and planned activity.
All these variables will impact on how quickly countries are able to catch up with the backlogs and what is needed to increase resilience and rebuild service strength. Workforce challenges are one of the most intractable constraints to recovery across all countries, and there is recognition that reducing backlogs and waiting times must not cause increased burnout and further healthcare staff leaving the professions. While the NHS is implementing similar strategies to other countries to clear care backlogs, its path to recovery may be longer than many other systems. We entered the crisis with higher bed occupancy rates and fewer doctors, nurses, beds, and capital assets, than most other high-income health systems, while experiencing higher rates of excess deaths during the pandemic, relative to many countries. Waiting lists were rising in the NHS before the pandemic started, indicative of the challenges health services
16 l
WWW.CLINICALSERVICESJOURNAL.COM JUNE 2022
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64
