The virus is a chance for the NHS to change for good

In a matter of weeks we have seen the NHS deliver the kind of transformation that would ordinarily have taken years, writes Niall Dickson

NHS workers have been granted free access to more than 85,000 online games (Getty Images)

It is no coincidence that the NHS is the institution that the British public is most proud of. Our staff continue to put their lives on the line for the health of the nation – the NHS has performed heroically under extreme pressure. We are not out of the woods yet with Covid-19, but the message from the NHS is clear: we are open for business and ready to begin the slow path to recovery.

The obvious first issue is to restore services to hundreds of thousands of patients who have had their care and treatment halted or curtailed, while we focused on coronavirus care. This will mean reviewing clinical priorities.

But the universal cry from every quarter – hospitals, community and mental health services, GP practices – is that we must not return to where we were before Covid-19. We have an opportunity not just to recover, but to reset the way that we think about health and care in the UK.

First, we must not throw away the innovations that, in a matter of weeks, have seen the NHS deliver the kind of transformation that would ordinarily have taken years – from the digital revolution to building Nightingale hospitals to better management of emergency and outpatient departments.

An important lesson from this crisis is the interdependency of the NHS and social care: we cannot continue to see them through different lenses. This is even more critical given that many residential and nursing homes face a nightmare situation in the days and weeks to come. The positive news is the pace at which NHS and social care services have worked together to discharge medically fit patients – a much faster rate than is possible in normal times – shows what can be achieved.

We have also seen much greater flexibility in how staff have been deployed during the crisis. We have seen paediatric nurses working in adult intensive care units and surgeons taking on nursing roles. We will not want to maintain all of these changes but it’s clear the virus has helped break down traditional professional boundaries that haven’t always put the patient first.

Our staff are our number one asset and we must support them through this crisis. As one chief executive said to me, many staff are coping now by suppressing emotions that will appear when the immediate pressures dissipate. The weekly “clap for carers” is endearing but our staff need much more than that if they are to cope on the other side of the crisis.

But it is not just our staff who need support. We know there will be a major fallout from the virus when it comes to the mental health and wellbeing of people across society – the quiet surge that will hit mental health services for years to come. We need to gear up for this now and ensure we have the capacity in place to meet the rising demand for talking therapies and other services that will inevitably follow.

And finally, the dismantling of vast swathes of bureaucracy has freed up frontline staff and leaders to respond quicker to the challenges on the ground. A good example is how the NHS has freed up 33,000 beds (the equivalent of 50 hospitals) to expand capacity within intensive care so that local services are ready for any surge in demand. No one is arguing for regulation and inspection to be abandoned altogether, but we need to move to the lighter touch approach that is now in place.

We know the economic and social implications of this crisis will be unprecedented. We know it will have further exacerbated underlying health inequalities that pervade our local communities, and we know that we have to address the factors behind why a disproportionate number of people from black and ethnic minority communities have died as a result of coronavirus. These issues, along with the need to finally grasp the nettle on reforming social care, cannot be ignored when the dust has settled.

These are critical challenges in the days and weeks ahead, but we also owe it to our friends, families, neighbours and to NHS and care staff to use this crisis as an opportunity to reset how we deliver health and care services.

For as one hospital chief executive told me this week: “We cannot and should not go back to the way things were.”

Niall Dickson is the chief executive of the NHS Confederation, which represents organisations across the healthcare sector