The steps to re-establish services in the NHS can be seen as three inter-related stages. The first is to understand the nature and severity of the backlog. We need to understand where people are on their care journey either in pre-primary care, in primary care, or on a secondary care waiting list. We need to understand COVID-19 and non-COVID-19 related morbidity and mortality, and measure the patient experience associated with this.
The next stage is to design recovery plans for each of these cohorts based on risk models, balancing risk of infection, local capacity and urgency of treatment. Addressing this backlog requires creative models for mobilising resources, leveraging expertise and insights across teams, and using a combination of short-term and turnaround approaches, and more long-term solutions.
There are well-established processes that have shown to deliver fast responses in similar situations. These include user-centred design methodologies and ‘garage’ style sessions that bring strategy, design and technology together to accelerate the solving of an identified problem or need.
The emotional and mental wellbeing of all healthcare staff must also be considered. Many will have just been through one of the most challenging times of their professional lives. We need to ensure we take the time to measure that impact and provide support in an environment that makes talking about such stresses part of our next normal.
The third and final phase of the recovery plan is a more sustainable long-term model which embeds some of these new ways of working.
We will have to plan and prepare for the possibility of further waves or rebounds, and given the uncertainty of a vaccine in the short term, we will need to entertain the possibility of running COVID-19 services alongside usual services almost as a new speciality. We will also have to consider the impact of COVID-19 on the broader public health challenges, domestic violence, at-risk children, mental health and substance misuse in the broader population. It is an uncomfortable truth that this virus could make health inequalities worse in the UK.1 The societal and economic impacts of the pandemic will sadly be a major detriment to public health for some time.