Preparing our health system for a long-term relationship with COVID-19

As we recover from the first wave of COVID-19, it is indisputable that healthcare systems around the world will have to do things differently. The resilience shown in the face of an unprecedented global pandemic has been remarkable. However, we must now brace ourselves for a long-term, challenging relationship with the virus. With this comes rethinking how care needs to evolve in order to better support patients.

Since the pandemic struck, my team has engaged regularly with a number of HM Government departments and the NHS on this very subject, just as many of my counterparts have engaged ministers, officials and healthcare systems leaders in their own markets.

It is a relief to see HM Government now prioritising the safe return of non COVID-19 services and, crucially, calling for lessons learned and evidence of technologies used during the first wave of the pandemic so that patient pathways and outcomes can improve under any circumstances, pandemic or otherwise.

As we look ahead, there are many discussions to be had and decisions to be reached. I look forward to contributing to these, especially as we head ever closer to winter and the added pressures this creates for the NHS. Having reflected on the Secretary of State for Health and Social Care’s recent speech on the “Future of Healthcare” and the UK’s learnings from the first wave of the pandemic, I want to set out the key issues that we must work in partnership with HM Government and the NHS to urgently address.  

1. Learning lessons from the first wave

From our own research with Imperial College Consultants (launching in Autumn 2020), we have found waiting lists for planned surgical and diagnostic activity at unprecedented levels. This is compounded by data from NHS England [1] which shows that urgent cancer referrals have dropped by as much as a fifth during the pandemic, potentially resulting in a backlog of undiagnosed cases. This is a deeply concerning and life-threatening statistic.

Clearly pathology services have particularly suffered during the COVID-19 crisis, with resources re-allocated to address the pandemic. Given the dramatic fall in the number of urgent cancer referrals, combined with the long-term problems for patient treatment this will cause, I believe that digital pathology services are key to enabling pathologists to continue diagnosing cancer, while working remotely and safeguarding their own health.

As an example of this much needed service, we are currently providing the University Hospital Crosshouse (part of NHS Ayrshire & Arran) with the Philips IntelliSite Pathology Solution, comprising of an Ultra Fast Scanner and Image Management System.

These remote digital pathology capabilities will support the hospital to best serve residents of Ayrshire & Arran. It may also help set a new standard of diagnostic services and care for communities located outside of main city centres, highlighting how we can maintain vital services and treat new patients in the immediate future and during future outbreaks of COVID-19.

2. Ensuring digital technologies come of age

In a short space of time, COVID-19 has also accelerated the use of digital technologies such as telemedicine by several years. As the Health Secretary stated in his speech to the Royal College of Physicians, in the four weeks to mid-April this year, 71% of routine appointments were conducted remotely, compared to just 25% the year before [2].

The assumption that primary care requires most interactions to be conducted in-person has been significantly challenged this year. In many instances, the pandemic has taught both patients and care providers that telemedicine, email or digital messaging services can be faster, easier and safer.

There will always be a place for face-to-face interactions and examinations, but the virus has shown that a large part of care – from electronic health records, telemedicine, diagnostics, remote monitoring and care devices, to digital pathology, AI and predictive analytics – can and should be provided digitally.

Technology possess the potential to further transform healthcare, however we all need to go further to ensure every that patient, or their carer, can access new technologies and can realise the wealth of benefits they can bring to their treatment.

3. Breaking down barriers to deliver better care

In his speech, the Health Secretary argued that a sense of pragmatism is “mission critical” to keep the NHS running and that this new mind-set is critical in increasing the volume of treatments for non COVID-19 patients to pre-pandemic levels as soon as possible.

Addressing the significant backlog will require innovative models of care, including greater integration of healthcare data and automation of services that capitalise on digital infrastructure and digital services.

In our view, it also means working in partnership with our hospital and trust counterparts in a way that goes far beyond a transactional relationship, in order to support the needs of patients and deliver improved patient outcomes.

These relationships should not be driven by commercials, but how they can best support the care of the 66 million people in the UK. Where possible, they should also set a trailblazing standard that other healthcare systems around the world might consider implementing, especially as the global community navigates its way through any treacherous future waves of COVID-19 outbreaks.

[1] Last accessed August 25, 2020: https://www.theguardian.com/society/2020/aug/13/people-waiting-for-hospital-treatment-in-england-at-highest-level-ever

[2] https://www.theguardian.com/society/2020/jul/30/all-gp-consultations-should-be-remote-by-default-says-matt-hancock-nhs