To fix the NHS, we must look at what went wrong, but also use what went right
As we continue to rebuild from the effects of the pandemic, it is important to look at what went wrong, to take stock. We also need to look at what worked and where this can be applied elsewhere. This will not only help us to prepare for future pandemics, but in the shorter term will be critical in rebuilding our healthcare system to be more efficient, helping the NHS to tackle the long waiting lists that have built up as a result of facing the sudden problems of Covid-19.
When faced with the immediate challenge of building and creating testing and vaccine roll out capabilities, red tape was removed and new systems were built. They were unburdened by the old ways of doing things. The report from the House of Commons Health committee allows us to do this; it points to our failures – and our successes. It acknowledges that what enabled the vaccine roll-out was largely an innovative strategy, free from the usual bureaucracy the NHS is normally subject to.
A national problem requires a whole-system solution. Prevention is not just a government or healthcare issue, everyone is responsible and the public, as well as the independent sector and employers, must pitch in.
In the early stages of the pandemic, we saw national frameworks created that nourished autonomy in local areas. This meant the immediate needs of local communities were prioritised. Remote working enabled easier access to a wider range of services at more accessible times.
Taking inspiration from the task forces that enabled our vaccine development, we should take a similar approach and build prevention boards in local communities. With the support of groups and businesses based in the area, they can reach out to groups at high-risk of developing health problems. Early intervention should be de-medicalised, in order to make our systems more efficient.
We’ve relied on the healthcare sector heavily during the pandemic; we need to find broader shoulders for the support we need.
This is simple, and things we all know. For example, regular exercise is extremely effective at reducing the risk of major illnesses, such as heart disease, stroke, type 2 diabetes and cancer by up to 50 per cent. Local communities can help encourage physical activity, and patients who wind up in GP surgeries should be given advice on how to start an exercise routine. This should be prescribed more often as treatment, even ahead of medicines where appropriate. We need to start treating health and fitness as two interlinked industries.
Knowledge sharing is the critical third pillar. Too often, different bodies are segmented off from one another. Siloed in by bureaucratic walls. The Government and health organisations must share information and be honest about what is working and what’s not. The beauty of the vaccine programme was in the way the regulator, the MHRA, was able to have access to rolling data from each developer and enable the public to have a swift roll-out of the jab. When there were concerns about one vaccine for a particular age group, these were quickly fed back and the roll-out was adjusted.
One size doesn’t fit all. But too often our health systems prescribe cookie-cutter approaches. Ministers too, are often quick to jump on simplistic check-lists to prove the efficacy of the NHS.
We need to be open about the challenges that need to be overcome, adopting the test and learning attitude which helped us navigate our way out of the worst of the pandemic.