Now is the time to act – using Wave 1 learnings to support the NHS in the months ahead

A couple of weeks ago, PanSurg, an academic project launched by the Department of Surgery at Imperial College London in response to the pandemic, launched its COVID-19 Aftershock Report.

The report is the outcome of a series of live peer reviews, and sets out 13 critical action points that are now being put before policy makers and government to drive collaborative action across the UK to ensure the continued safe treatment of patients and protect the well-being of NHS staff.

Johnson & Johnson Medical Devices (JJMD) UK & Ireland is the lead industry partner to PanSurg, so we were involved in the creation of the event and supported the publication of the whitepaper.

Now, you may say I’m biased, but as a former surgeon and in my current role as Medical Director at JJMD, I believe it makes for very interesting reading, particularly in the current COVID landscape. What’s clear is that we have a responsibility to act now and use the learnings and insights gained from the first COVID wave, to drive action – both in the immediate term to protect the NHS as it navigates the second wave we unfortunately now find ourselves in, and, to influence our preparedness for future pandemics and the ability to reform services when required.

I’ll begin by reflecting on the day of the peer review, which instigated the Aftershock report. Nineteen panelists are driving the debate over three sessions, with broad experience ranging from frontline healthcare professionals, to an NHS board member, a health economist to a medical device industry director. Over the course of the day, they are joined by hundreds of delegates who debate three big topics:

1.     How the COVID-19 rapid rising of infection in a virus na?ve population managed to disrupt the normal functioning of the NHS.

2.    What learnings can we use from COVID-19 to improve services for people with chronic disease?

3.    The future of healthcare – how can we use the resilience and agility shown by the NHS during the pandemic to improve care and services in the long-term?

The PanSurg team extracted learning from the COVID-19 experience in the healthcare system via a novel approach that mixed an online panel with a large number of virtual attendees able to share ideas and ask questions. This debate then shaped what’s now the Aftershock report and I want to draw your attention to 3 of the 11 main themes.

Duty of care:

Every person has the right to access appropriate treatment for his/her condition. This is straightforward when a surgeon sits in a clinic with a single patient who has cancer. There is usually a discussion about the diagnosis, the treatment alternatives, a consent form and the planning for the admission. However, the complexity emerges when there is a new disease, like COVID-19, that starts hitting an entire population and drives the healthcare system towards exhaustion of resources and collapse. Everyone has the right to treatment but who do you treat first? Who can wait and for how long?

System working:

As the complexity increases, the solution cannot be found or implemented by a single individual or a single team. Here is where the importance of collaboration among different teams and different NHS Trusts is fundamental to manage capacity and ensure access.

COVID-19 has forced the NHS to be agile and quickly reform. It’s shown that when properly coordinated, there is potential to deliver care whilst also in the middle of a pandemic. There are real life examples detailed in the whitepaper where it has been possible to provide care to acute unwell patients and patients with cancer and chronic conditions when the system was tested by COVID.

The intersection of Staff Safety, Biosecurity and Innovation

The interaction among the three themes of Staff safety, Biosecurity and Innovation is one of the pillars of long-term resilience in the healthcare system.

The people who work in the system are the most valuable resource the NHS has and the people who need care should not be exposed to additional risks. The physical safety and mental wellbeing of staff and patients is paramount to delivering and receive the best care. Protecting staff and patients is impossible without a robust biosecurity plan that is effective in the short and long term. At the beginning of the pandemic the number of unknowns was overwhelming and it was extremely difficult to make evidence based decisions. The uncertainty and the focus on avoiding COVID infections in patients and healthcare professionals correctly drove a conservative approach regarding non-urgent care and long-term conditions.

Now, there is still much to learn, but we do know what worked well to protect staff and ensure biosecurity in the first wave. Among it, innovation and especially the rapid implementation of digital technologies, has allowed the safe delivery of care in situations where, previously, physical contact was exposing peoples to unnecessary risks. Industry has played an important role in facilitating access to the right technology and is continuing to offer support in novel ways. For many people involved in healthcare, the MedTech industry has emerged as trusted partner in the delivery of care and not just the provider of medical devices.

The above is only a few of the reflections that the Aftershock whitepaper has triggered. I’d love to hear your thoughts.

What would be your answers to the questions posed to the panel and attendees?

• How will diagnostic and prevention strategies for surgical chronic disease change after COVID-19?
• How should we re-design elective surgical services during and after COVID-19?

My ask to you:

Please read the report and share your views because we are all continually learning together. The wisdom that we will extract from this ongoing conversation will support the NHS to be better prepared for the difficult few months that lie ahead and in the long term.