How did COVID-19 impact the NHS? – weekly update webinars from Mtech Access

For our first webinar on 9th April we were joined by Hilary Snowdon (Management lead for West Northumberland PCN) and Mike Proctor (Former Chief Executive of NHS Foundation Trust) who shared their insights into how the NHS is responding to COVID-19 and where changes are likely to stay to transform the health service in the future. We asked Mike and Hilary:

•  What have you seen in the NHS over the last few weeks?
• What has struck you most and where do you expect to see lasting change?

Next, on the 17th April, we focused in on primary care and community settings with insights from Liz Cross (Advanced Nurse Practitioner) and Dr Su McCole (GP & Area Clinical Director). Tom asked Liz and Su:

• What changes have you seen to clinical practice over the last few weeks?
• What challenges and risks has working differently presented?
• Do you expect these changes to last, and what support do you need to embed the change?

On Friday 24th April we discussed finance and commissioning, with the help of Patrick McGinley (Head of Costings and SLR, Maidstone & Tunbridge Wells NHS Trust) and Patricia Whelan-Moss (Head of Organisational Development – Brent CCG). Tom asked Patricia about the changes she had seen in the world of her CCG. He then spoke to Patrick about the changes in NHS’ finances as a result of the COVID pandemic. Tom asked Patrick what changes he expected to last and what these could mean for care delivery in the long term. He then came back to Patricia to discuss how COVID might change the commissioning landscape.

Pharmacy and medicines management was our topic on Friday 1st May, where our NHS speakers were Samantha O’Connell (GP Clinical Pharmacist) and Johnathan Laird (Prescribing Pharmacist & Founder of Pharmacy in Practice). Tom began by asking Johnathan about the changes he had seen in the world of pharmacy in response to the COVID-19 pandemic. Tom then asked Samantha about how clinical practice had changed, in terms of prescribing and getting medicines to patients. They discussed which changes Samantha would like to keep and what risks and opportunities these might pose. Tom then came back to Johnathan to ask how changes in prescribing practices and processes might impact medicines suppliers.

On Thursday 7th May (we switched our usual Friday slot due to the VE Day bank holiday), we were joined by Phil Webb (Head of Value Based Healthcare, Cwm Taf Morgannwg University Health Board) and Tony Cambridge (Lead Biomedical Scientist, Plymouth Hospitals NHS Trust) to explore innovation and rapid change.

Phil’s day job focuses on innovation, so Tom began this webinar by asking Phil what stood out as the highlights of the NHS response to COVID-19. Tom then turned to Tony to focus specifically on the positive elements of COVID testing. Having explore the ‘good’, Tom asked Tony to discuss the ‘bad and the ugly’ of testing, implementation and testing capacity. Tom then asked Phil for his thoughts on what the NHS has learned about how to innovate and how this could affect innovation and risk appetites going forward.

We then explored strategic procurement and medicines management with Keith Pearson (Head of Medicines Optimisation, Heywood, Middleton and Rochdale CCG) and Simon Wootton (Non Exec Director, Rossendale West PCN), on Friday 15th May.

Tom began by asking Simon about recent work to review strategic procurement in the NHS and how the crisis has impacted thinking around procurement and the supply chain. Tom then spoke to Keith about how COVID has impacted how he approaches his job commissioning medicines, before asking him for his opinion on what the lasting impact may be on how medicines are commissioned and how decisions are prioritised. Tom then turned to Simon to discuss how the NHS may approach procurement differently in the future as a result of the lessons learned from COVID-19.

On Friday 22nd May, we held the first of two sessions looking at the changing face of care delivery. For this first session, we were joined by Berenice Groves (Director of Operations, Blackpool Teaching Hospitals NHS FT) and Tina Teague (COVID Resilience Manager for Devon) to explore the system and hospital view.

Tom began this webinar by asking Tina to tell the audience about her experiences of how the NHS has reorganised, at a system level, to handle COVID-19. He then asked Berenice to highlight the most notable changes in care delivery within her Trust. Tom and Berenice discussed how hospital services might adapt to start increasing routine work, whilst also managing the COVID risk. Tom then asked Tina whether she sees the organisational and pathway changes lasting, and what could be the most profound differences in how care is delivered in the NHS in the future.

The following week, on 29th May, we revisited the changing face of care delivery, this time from the viewpoint of primary care and the community.  Steve Reed (Head of Community Services, York Teaching Hospitals NHS FT) and Dr John Ribchester (PCN Clinical Director, GP and Chair of Encompass GP Partnership, Whitstable, Kent) spoke, giving us their perspectives on out of hospital care and how it has been transformed during the pandemic.

Tom began by asking John to describe how primary care has changed since COVID-19 hit our shores in the UK, and the context of the pace of change for general practice. Tom then asked Steve to explain how he had been developing community services before COVID and the impact the pandemic has had on this agenda. Steve discussed how community services could change going forward and what role his teams could play for patients in the future. Tom then asked John about whether this could be a tipping point for primary care in terms of its scope and purpose, and what the most profound lasting changes could be.

On 5th June we hosted an extended 1-hour ‘Questions Time’ special, where we put your questions to a panel of experts from across the NHS. The panel featured:

• Cameron Ward (Interim Director of Strategy and Outcomes, Sefton CCG)
• Hilary Snowdon (Management Lead, West Northumberland PCN)
• Patrick McGinley  (Head of Costings and SLR, Maidstone & Tunbridge Wells NHS Trust)
• Dr Su McCole (GP & Area Clinical Director).

We then explored a different view of the COVID response; the tech perspective. On 12th June, we spoke with Stephen Bourke (Co-Founder of Echo) to learn about how they and other tech companies have been supporting patients with new ways of accessing healthcare, throughout lockdown. Tom asked Stephen:

• Can you briefly outline Echo’s origins and purpose?
• How soon did you sense that Echo would have a key role to play in the national COVID response?
• Can you talk us through the impact the pandemic has had on Echo, in terms of your need to upscale and respond?
• What have you noticed about the Echo patients population? – numbers, demographics, behaviours, etc?
• What have you noticed in other areas of health tech through this period?
• We have heard from many NHS colleagues that this is a ‘tipping point’ in care delivery, do you sense that for Echo and digital healthcare?
• What needs to happen to embed the positive behaviours and technologies in ‘the new normal’?
• What are the risks to digital healthcare in a post-Covid world?
• What advice would you give to anyone looking to design or implement digital health innovation?

On 19th June we were joined by Jim Easton (CEO of Care UK) to discuss the role of the independent sector, now and beyond the COVID-19 pandemic. Tom asked Jim:

• How has the independent sector responded to COVID?
• What have been the biggest challenges/risks in independent provision?
• What has been the impact of COVID on public-private relationships and collaboration?
• How important is the independent sector going forward, and in which service/therapy areas?
• What does the future hold for independent providers?

For the final webinar in this series, on the 26th June, we were joined by  Stephanie Edusei to explore the future of the NHS and where we go from here. Currently Chief Executive of St Oswald’s Hospice, Newcastle, Stephanie brings great experience from patient organisation, NHS and social care roles to this discussion.

Tom and Stephanie explored how the NHS and its partners can overcome health inequalities, deliver person driven care and achieve integration. They explored how person-orientated care (care focused on and driven by the patient) has become more prevalent through COVID. They discussed how services need to evolve further to deliver for their populations. Tom asked Stephanie about health inequalities, how the NHS can translate the rhetoric into positive actions and how ‘new inequalities’, such as tech poverty, might be mitigated. We closed the webinar with a discussion about integration; whether it will result in a better experience and better outcomes for patients and what the role of non-NHS organisations might be going forward.