Transforming care for long-term conditions must be at the heart of the NHS recovery
When the history of 2020 and 2021 is written, there will be pictures of empty streets and people wearing masks. There will also be photographs of rainbows painted in windows and ordinary people applauding on their doorsteps.
The COVID pandemic reminded the nation that the NHS is an institution that connects us all. As we emerge from the pandemic, private and public sector organisations involved in healthcare have a shared responsibility to find new ways to help the NHS recover to build back better.
Key to achieving this will be transforming care for people with long-term conditions. This is a patient cohort that accounts for 50% of all GP appointments and 70% of all NHS bed days. Harnessing innovation to transform the care of these patients was the focus of a timely recent roundtable organised by leading pharmaceutical company AbbVie.
Ruth Robertson, Senior Fellow at The King’s Fund, opened the discussion with a stark reminder of the way that the pandemic has impacted on the care of the 15 million people in the UK who currently live with a long-term condition.
Referring to a recent AbbVie commissioned report by leading healthcare consultancy Carnall Farrar, Robertson drew the panel’s attention to the way the pandemic had affected both ongoing treatment pathways and initial diagnoses. “It is important for us to not just focus on innovating for those people already in the system,” she reminded the event. “Huge numbers of people aren't accessing care at the moment for long-term conditions.”
The Carnall Farrar report supports this. It estimates that there are 124,000 patients in the UK missing from the health system due to missed or late diagnoses as a direct result of COVID. All of the speakers acknowledged that finding ways to connect those people into the system will require new approaches, new treatments, and new partnerships.
For existing patients too, the pandemic impacted on their lives and treatments. Patients like Wendy Broderick who has lived with multiple long-term conditions for many years. “The surgery didn't know what to do,” she recalls. “They didn’t know whether I could safely come down. Simple things like picking up a prescription were considered dangerous activities.”
Wendy’s experience is far from unique. Over the pandemic period there was a 41% drop in referrals from primary to secondary care and a 25% drop in outpatient attendances. In effect, the pause button was pressed on the routine care that people relied upon to live with long term conditions.
The event heard from senior clinicians who are clear that new approaches are needed to connect existing patients like Wendy to treatments and care pathways and to ensure that new patients are not falling through the net.
Johnson Yan Ning Neo, a senior ophthalmology registrar who works in a number of London hospitals, believes that the challenge faced by the NHS is so significant it will demand new thinking and new solutions.
“The status quo is not going to be enough for us to cope with the demand that's coming post-pandemic,” he argued. “Some innovations have to take place.”
Making that innovation happen demands new ways of working, new partnerships, and new collaborations.
Todd Manning, Vice President and General Manager of AbbVie UK, thinks that a foundation for these relationships was laid during the recent pandemic. Manning believes that the way that private, and public bodies worked side by side during the COVID crisis provides a useful template which shows the value of collaboration when it comes to transforming care for patients with long-term conditions.
“During the acute period of the pandemic, that collaboration was incredibly strong,” Manning reminded the event. “We all recognise that there's a massive pressure on the system at the moment, but we must make sure that that doesn't stop us from collaborating.”
It is clear that there is now an opportunity to build on that foundation, but doing so will require cross-sector leadership, and an appetite for innovation at local, regional, and national levels. The risk Manning identified is that, as we move out of the crisis stage and return to business as usual, the impetus to collaborate and innovate to find new solutions will be lost.
“We have a lot of skills, a lot of capabilities and resources to throw at this problem,” he told attendees, “but we need to be at the table in order to do that.”
Lindsay Hughes, Director of Policy and Strategy, for the NHS’s Innovation, Research and Life Sciences Group, agreed that creating transformational change will require new collaborative approaches. “There's a huge amount of opportunity to innovate,” she argued. “Partnership working is absolutely key to that.”
Amy Bowen, Director of System Improvement for North London Partners, shared Hughes’s view that the solutions ultimately lie not with a single organisation, but with a range of partners working together. “We need a system-oriented approach,” she said, “where we're bringing some of our expertise to work collaboratively, to optimise people's health. That breaks down the barriers.”
The key message from all speakers was that transforming care for patients with long-term conditions is too big a challenge for any one sector or organisation to address alone.
Instead, to deliver that transformation, there is a need to mainstream pandemic learning about the value of collaboration. If we are able to do this, then it can help develop new technologies, innovations, and approaches that will lead to better care for patients like Wendy.
This article is a summary write up of an online event hosted by the King’s Fund on 8th November, 2021, both of which have been commissioned and funded by AbbVie.
Date of Preparation: November 2021
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