It’s hard to know quite what the new normal looks like. It changes every week. 2020 and perhaps 2021 will be unusual years with the need to prioritise services at short notice for future smaller and larger outbreaks of COVID-19 as well as supporting our community with their long term and urgent needs. Our patients have played their part in ‘staying away’ but there is a lot more unmet need out there.
In such a short space of time remote consulting has become part of the norm. GPs, pharmacists and community services are providing care that might have taken place in a hospital setting. Hospital colleagues are remote consulting. Will we creep back to how things were done before or will we find ways of sustaining those things that have worked well? Will commissioners enable a shift of care and resources and infrastructure that might be necessary? Regulators flexed their approach at the outset of the pandemic. Can they help to catalyse more productive change in a more developmental approach?
What has made all these changes possible? Being able to focus on what matters and not on specifications, targets and contracts. Therefore the ability to deploy time, money and brain-power differently. Having some head space and strong sense of purpose.
Great teams have risen to meet the challenge so far but how do we ensure teams have resilience, skills and ability to make best use of their workforce going forward. The challenge ahead for primary care is far greater than the one we have been contending with so far. Our approach is about looking at population groups who have similar needs and to look at their needs with them and develop functions, skills and roles to meet these needs. This is population health management.
Over the last 2 weeks, we’ve used this approach in East Grinstead to re-imagine, plan and implement how we support people with their long-term conditions – a new ‘pathway’ with virtual clinics, enhanced online resources, preparing for group video-consultations and a change of team skill mix to support this. Not forgetting though that we need keep physically seeing people where it is appropriate and necessary.
We’ve been on a journey to enhance self-care and supporting people to manage their own long-term health and care needs. Will we need to accelerate this journey using technology, new pathways and a different conversation with our communities and individual patients. How will we re-invent face to face care for people with log-term conditions and our most complex patients when we need to practise safe social-distancing? We will need to engage strongly within our networks, hospitals, community providers and local authorities to find new ways to deliver socially distanced primary health care.
As I write, my local town council has agreed to help us work through how we may deliver a safe and effective flu vaccination programme.
Participate in our webinars, surveys and twitter chats to contribute your skills and knowledge to this important debate.
Dr Minesh Patel
Chair of NAPC