Let local clinicians and managers lead the redesign of services

Responding to the letter from NHS England and NHS Improvement outlining the second phase of the NHS response to Covid-19, Niall Dickson, chief executive of the NHS Confederation, which represents organisations across the healthcare sector, said:

“We do need to resume operations and other treatments halted because of Covid-19, but just like relaxing social distancing this must be a carefully managed and measured response. Covid is with us and going to be with us for the foreseeable future.

“As such, we cannot afford to compromise safety of patients or staff and the NHS will want to make sure we do not risk the infection spreading. This will certainly not be a return to normal overnight. For example, simple basic theatre procedures will require additional PPE and infection control measures; as will home visits by mental health nurses and in care homes, infection control is radically changing the way care can be given. All this will stay.

“Managing the virus on a day-to-day basis will be a harsh reality facing our health and care services and local communities for many months to come.  The NHS and social care will need to work in unprecedented ways to bring back services, and in many ways it will mean delivering a ‘new normal’ in this different and demanding context.

“Perhaps above all what we now is a joined-up approach, responding to local needs and circumstances - firing up hospital treatment will have a major impact on community services, general practice and social care. More than ever, this pandemic has shown the interdependency between these services.

“In particular, at this time we all need to do what we can to support care homes and home care where they are facing a nightmare. This matters not only for the residents and staff who are both vulnerable, but to all of us, as we will not be able to move safely out of lockdown while the virus is still out of control in parts of our community.

“This guidance from the centre is welcome but this critical next phase will require local systems to take control and create local solutions.  We need to let local clinicians and managers lead the redesign of services, freed of any bureaucracy that could get in the way.

“Today’s guidance rightly talks about the need to ‘lock-in’ the positive changes that we have seen in recent weeks. The pandemic has unleashed innovation across the service at breath-taking speed. We do not want to go back to the NHS as it was – in spite of all the huge challenges, this is a great opportunity to reset the way we deliver health and care across the UK.”

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