Analysis

Discussions with the front line – COVID-19 Reflections and Recovery

Lara Brett

Following the recent publication of our Pandemic Perspectives: reflecting on one year of COVID-19 report, MHP Health was delighted to welcome a leading panel of healthcare experts for a discussion on their experiences of the pandemic and the impact of COVID-19 on the health sector on Friday 7 May.

The report details how the pandemic has shaped the NHS, with the event’s speakers providing personal insight into the challenges and opportunities that have arisen.

We were joined by speaker’s Dr Katherine Henderson, President of the Royal College of Emergency Medicine and Emergency Medicine Consultant at St Thomas’ Hospital; Professor Martin Marshall, Chair of the Royal College of GPs, a GP in Newham, and Professor of Health Improvement at UCL; and Shaun Lintern, Health Correspondent at The Independent. Rachel Rowson, MHP’s Head of Health Innovation, chaired the discussion, during which the participants offered fascinating insights into healthcare inequalities and technology, workforce challenges and the post-pandemic recovery.

Technology: how to strike a balance? 

The role that technology can play in improving or exacerbating healthcare inequalities was a key talking point from the event. The speakers explained how telemedicine could facilitate the provision of healthcare at home, but pre-existing socioeconomic factors may prevent some groups accessing online services. Dr Henderson stated that such technology could be hugely advantageous, explaining that it became possible to access patients shielding remotely, facilitated professional communication and enhanced information sharing. However, she commented that while NHS 111 had been used successfully for initial pandemic triaging, there could be an issue of equity of access to appointments and raised concerns about not knowing if those who needed appointments were able to secure them.

Shaun Lintern added that increased use of technology could in fact improve access to health services for harder to reach groups such as those in remote areas. Professor Marshall explained how the advantages and disadvantages of the increased use of technology were yet to be fully understood, highlighting the need for a balanced assessment of the benefits. The panel agreed that central to the discussion was the importance of alleviating digital poverty, noting that a truly National Health Service must cater for everyone.

 

What next for the NHS workforce?

The discussion then turned to workforce challenges experienced during the pandemic. Professor Marshall called workforce planning “the biggest oxymoron the NHS has ever seen” in that good workforce planning is vital yet has historically been poor, resulting in increased workload on the ground exacerbated by an increasing demand. Both he and Dr Henderson discussed the challenges that have arisen from the increasing staff shortages, with the former stressing that bureaucracy and limited capacity had put patient-provider relationships under strain. Nevertheless, Professor Marshall was keen to stress that, despite social distancing measures, GPs had been able to provide good quality care for the patients they did see, thanks to reduced bureaucracy and regulations. Building on the findings of MHP Health’s Pandemic Perspectives report where healthcare workers had described their experiences as “overwhelming” and “stressful”, it was discussed that much of the stress and intensity that has been placed on the workforce has led to many GPs currently working part-time.

Despite these challenges, the speakers believed that camaraderie had played a considerable part in the NHS’ ability to cope with the pandemic. They felt that the response of NHS staff to the COVID-19 crisis has enabled the NHS to recruit healthcare professionals, but the issue lies in retaining them. From the perspective of emergency medicine, Dr Henderson stated that the first wave was “an incredibly collaborative time”. This was due to staff quickly adapting to new roles and working together to deliver urgent care. She commented that the second wave was more challenging, as staff had to cope with COVID-19 patients on top of the winter pressures and an increasingly exhausted workforce. Echoing a finding in Pandemic Perspectives, where a respondent stated, “we have all pulled together to ensure we keep the service going no matter what”, Dr Henderson and Professor Marshall emphasised the value of the camaraderie that took place during the peak of the pandemic, which must continue in the months ahead.

 

A post-pandemic NHS

The panel also shared their thoughts on how the NHS could recover from the pandemic as it faces a period of transition. Whilst it continues to manage the impact of COVID-19, it must also prepare for post-pandemic life and the resumption of normal services. Before March 2020, it was noted that services had already been under immense strain, with staff now facing the challenge of catching up with the backlog of treatment postponed by the pandemic. Shaun Lintern commented that staff will have to tackle the biggest waiting list since 2008, with over 300,000 waiting over a year for treatment. The panel agreed that the workforce capacity challenge has signified the importance of implementing an NHS workforce plan, supported by recruitment budgets.

In spite of these challenges, our speakers were optimistic about the NHS’s COVID-19 recovery. MHP found that healthcare workers want greater recognition of the challenges they’re facing and continued support for digital transformation.  When asked to list three key gains from the pandemic and hopes for the future, a repeated theme was the altruism of healthcare workers. Both Shaun Lintern and Professor Marshall maintained that the public now has more recognition for the hard work of NHS staff, particularly nurses. They hoped this would continue into the next phase, as did the health workers interviewed for Pandemic Perspectives. Dr Henderson also praised the public’s response to the COVID-19 restrictions, stating that they should be given more information in the future and be trusted to make the right decisions. Overall, the discussion was a brilliant summary of the past 15 months and provided an excellent opportunity to hear from those who helped us through the challenges of the past year.

Pandemic Perspectives: Reflecting on One Year of COVID-19