As we come out of a second national lockdown the promise of mass vaccinations looms; enabling the NHS to move from an acute rescue phase to a long-term recovery phase in managing the health & well-being impact of the Covid-19 pandemic.
The acute phase has witnessed a large investment in acute services and I suspect more to come in addressing lengthening waits for routine hospital services. But the recovery phase will require so much more than simply reducing acute waiting times as we seek to address the health & well-being deficit in communities and health & care teams alike.
Prior to the pandemic the workload in primary care had been growing year on year. Meeting the ever increasing population health & well-being demands was becoming unsustainable and it will be even more challenging in mounting a recovery response to the pandemic. As a result we cannot afford simply to go back to doing things the same way.
So what have we learned and what do we need to do differently?
In General Practice, 2020 has seen a huge shift away from GP face to face consultations being the prime delivery mechanism to new ways of communicating and supporting communities. Whilst this change might be represented as an increase in GP admin with more emails, texts and on-line querys; in essence it reflects the different ways general practice has been meeting people’s health & well-being needs.
The nature of our communities health & well-being needs has also underlined the importance of a primary care team response that aligns across medical, nursing and social needs. In many places we have witnessed a more proactive team based approach that has been more personalised around individual people’s needs and engaged the full breadth of the primary care team. This has resulted in professionals and communities coming together to respond to issues such as isolation, loneliness and the provision of basic supplies.
In a truly person centred care planning approach the make up of “my” best primary care team is defined by an individual’s needs not by professional or organisational boundaries and barriers. Therefore the choice that those of us who work in communities and neighbourhoods are faced with is not whether we are in “their” team but whether we wish to be part of a highly functioning team (a real team) or a dysfunctional team (a pseudo team). Unsurprisingly, real teams deliver significant improvements. Perhaps more surprisingly, pseudo teams deliver relative harm in comparison to not working in a team at all and therefore building great teams is an imperative.
Moving forward in to 2021 we need to build on the genuine benefits that have been accrued by critically evaluating where these new ways of working have added value. Alongside this we must acknowledge and address the challenge that more digitalised access to health & well-being support presents to those who are less digitally literate or in situations where a face to face consultation provides a unique relationship based added value.
As we enter this recovery phase we also need to acknowledge that the pandemic has had a negative impact on virtually everybody’s health & well-being and that individual members of each and every primary care team are just as susceptible. The recovery phase is likely to last a decade or more so understanding how we can support our teams to strengthen resilience is critically important. You can’t pour from an empty cup.
NAPC is working in partnership with our membership and health & well-being services within the NHS and beyond to generate practical solutions that help address these challenges. These include wellness activities for self and others, supporting communities and neighbourhoods better through effective team working, workforce development, care navigation, supporting new roles, place based leadership and a population health approach to our collective Covid recovery plans.
We invite you to join us in this initiative. You can find more information about how to do that here.