As government begins to ease lockdown restrictions, this article looks at what this will mean for the health sector.
The government set out its COVID-19 recovery strategy (the Strategy) on 11 May, which details its ambitions to "rebuild the UK for a world with COVID-19". The Strategy recognises the importance of securing NHS and social care capacity and ensuring its sustainability, both in the short-term to maximise confidence in dealing with the COVID-19 pandemic and in the long-term in delivering the government's manifesto commitments.
Key points for the health and social care sectors are set out below.
The Strategy sets out that a number of health outcomes have been taken into account in its development and will continue to be considered in the government response to COVID-19. In addition to minimising direct COVID-19 mortality, these include reducing:
- indirect harms, such as critical care services being overwhelmed meaning the NHS is less able to provide effective care;
- increases in mortality / ill health as a result of measures implemented, such as postponement of non-urgent care and public health programmes; and
- the health effects of an increase in deprivation, i.e. the impact of economic recession on health.
The Strategy sets out 14 supporting programmes to deliver the government's plan and health outcomes. Of particular relevance to the health sector are those relating to the NHS and care homes, including bolstering the PPE supply chain, the use of new and resilient care models, protecting care home residents and testing and tracing.
Personal protective equipment (PPE)
Sourcing and delivering adequate PPE to frontline health workers has been one of the government's key challenges to date in dealing with the COVID-19 pandemic. It is unsurprising that one of the supporting programmes is ensuring staff in all NHS and health and care settings have appropriate PPE. The Strategy sets out a plan to ensure a resilient supply chain to:
- expand PE supply from overseas;
- improve UK manufacturing capacity; and
- expand and improve the logistics for delivery.
This involves securing new supply chains through the new cross-government PPE sourcing unit, scaling-up manufacturing opportunities identified in the UK (in particular those offered by small companies) and continuing to improve distribution efforts with the support of the NHS, industry and the Armed Forces.
Care models and continuing manifesto commitments
The NHS Long Term Plan, published 16 months ago, detailed ambitious plans for digital health and the COVID-19 pandemic appears to have catalysed these. The Strategy asserts the government's intention to seek innovative healthcare operating models, with express reference to telemedicine and remote monitoring, to enable care to be delivered remotely where possible.
The Strategy also sets out the intention to establish a dedicated team to review how the NHS and health infrastructure can be bolstered to deal with COVID-19 and remain resilient following the pandemic. The strategy goes on to reassert the government's manifesto pledge to build 40 new hospitals, reform social care, recruit and retain 50,000 more nurses and create 50 million new GP appointments.
Protecting Care Homes
The Strategy explains that infection control in care homes is the government's top priority, due to the vulnerability of their residents. The Strategy includes the intention for widespread and rapid testing of symptomatic residents and patients discharged from hospital to a care home.
Further PPE distribution to the care sector and providing guidance on infection prevention and control is also described, as well as forging greater links between the care home sector and the NHS, with a named NHS contact and named NHS clinician for every care home requiring one by 15 May. These named individuals will provide enhanced health support to care homes, including through the use of video consultations.
The government has also provided £3.2 billion additional social care funding for local authorities, which is intended to absorb some of the rising costs encountered by care home providers and local authorities will be ensuing that each care home within its area has access to the extra support made available.
Testing and Tracing
The focus is to rapidly test people experiencing COVID-19 symptoms, with a recognition that speed is fundamental to the success of this strategy. The integrated system explained in the Strategy comprises:
- widespread swab testing, with digital elements ensuring rapid and secure reporting of results;
- local authority involvement to add a key public health dimension in tracing and supporting individuals who need to self-isolate;
- the delivery of the NHSX COVID-19 app to provide alerts where people may have been infected; and
- online and phone-based contacting tracing, staffed by healthcare professionals, again with local government input.
It has been widely publicised that the NHSX COVID-19 contact-tracing app is in the later stages of development and is being tested the Isle of Wight. The government will use the data collected through the above measures to create a core COVID-19 dataset to gain a greater understanding of the COVID-19 coronavirus.
The COVID-19 pandemic has resulted in and continues to cause tragic loss of life and remains a monumental challenge for the government, the NHS and the care home sector. The Strategy sets out ambitious steps for dealing with the COVID-19 pandemic, whilst also continuing to work towards the government's manifesto promises and the delivery of the NHS Long Term Plan. The Strategy makes clear that the NHS has shown "great creativity and energy" in adapting and transforming its processes for procurement and the use of data and analytics to confront the huge challenge posed by COVID-19 and that this creativity and energy presents an opportunity to build foundations for the future.