In 2019, the UK government laid out plans to ‘bring British healthcare into the 21st century’. The unprecedented challenges arising from the COVID-19 pandemic created unprecedented challenges for the sector. This has led to an urgent requirement to reimagine how the sector operates into the future.
Nowhere is this truer than in primary care. With hospital capacity overwhelmed by the pandemic, GPs were forced to hold-off routine referrals and health checks, as well as making difficult decisions regarding medicine access throughout lockdowns. This has led to an increase in preventable diseases - and some calling for an overhaul of how primary care is structured in the UK.
In this article, we explore three factors in primary care which will change in the wake of COVID-19 - hopefully all for the better:
Reduced bureaucracy
COVID-19 saw a relaxation of some regulations GPs have historically been subject to - and this is something many hope will be carried into the future.
The KingsFund undertook research in December 2020 which showed that individual healthcare practises had benefited from this reduction in bureaucracy - it gave practices & clinics, as they put it, the freedom to ‘be the key drivers of change’.
This has significant structural implications within Healthcare. It enables organisations to work more directly with suppliers and it allows GPs to make decisions related to the technology they will use, and when to implement their chosen solution.
With Primary Care Networks (PCNs) taking more control of their services, they were able to collaborate and share workforces, and exercise strong local decision making when sorting patients into “hot” and “cold” hubs. Ultimately, this demonstrates how greater freedom could unlock greater efficiency and innovation in approaches to primary care.
Increased acceptance of telehealth
In 2017, Nuffield published research suggesting that the healthcare sector was roughly a decade behind other industries in its adoption of digital technology.
However, the constraints of the pandemic have led to increased uptake and acceptance of digital approaches to primary care. As Martin Marshall - chairman of the Royal College of General Practitioners - has stated, “it has taken just two and a bit weeks to achieve more than we achieve in the last twenty years,” as far as adopting technology in healthcare.
Having seen the benefits during COVID-19, these methods may well even become the preferred means of accessing care for many. March 2021 saw the highest number of GP telephone appointments in history - 11.4 million, which is more than three times higher than two years ago. And PWC suggests the area most experts predict telehealth will have a lasting role to play in is primary care.
The challenge then becomes enablement: access to the internet, high-quality phone signals and suitable devices is hugely unequal across the UK. The result is a move towards a greater reliance on telehealth risks and further disadvantaging communities that have weaker access. We should therefore expect adoption of digital approaches in primary care to be done in tandem with policy efforts to fix the ‘digital divide’.
Ultimately, the pandemic’s legacy is unlikely to be a wholesale move towards phone and video-based primary care. Instead, Health.org predicts a gradual blending of these methods with traditional face-to-face care. This will require healthcare providers to develop far greater agility and adaptability - particularly in how they manage their staff.
Greater support for staff
Staffing shortages are not new to British healthcare, but the pandemic has again highlighted how urgent the issue remains. With NHS hospitals, mental health services and community providers now reporting a shortage of nearly 84,000 FTE staff, according to the King’s Fund, the need for a fundamental reappraisal of specialist healthcare talent procurement is key.
A key piece of the puzzle will be reimagining recruitment and staffing to ensure they make better use of available talent - largely by enabling as much flexibility and providing as much support to workers as possible, and in combination with workforce management solutions.
Another component of these issues is mental health. While the pandemic has had a widespread impact on public mental health, many argue those on the frontline have suffered most. Between significant changes in working patterns, unprecedented stress and pressure, isolation from their families and a high risk of infection, rates of burnout and depression have increased dramatically in healthcare professionals.
Mental health struggles for HCPs are hardly new: up to 52% of doctors reported anxiety or depression in the decade leading to the pandemic. But with the pandemic, it seems that these issues will be addressed more directly.
This will likely manifest in two ways: increasing initiatives to promote wellbeing and work-life balance for HCPs, and increasing emphasis from trainees on their employers’ mental health policy. There is also room for how shift-work is managed to be transformed, allowing for greater flexibility and ultimately making life easier for primary care professionals to manage their staffing, and engagement for workers. Now more than ever organisations need to choose to adopt such strategies.
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[1] https://www.longtermplan.nhs.uk/publication/nhs-long-term-plan/
[3] https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(20)30388-0/fulltext
[4] https://www.kingsfund.org.uk/blog/2021/02/rapid-digital-change-primary-care-covid-19-pandemic
[5] https://www.bmj.com/content/368/bmj.m1279
[7] https://www.ibisworld.com/united-kingdom/market-research-reports/telehealth-services-industry/
[8] https://www.thetimes.co.uk/article/how-pandemic-is-set-to-future-proof-the-nhs-ms63678r8
[11] https://post.parliament.uk/covid-19-and-the-digital-divide/
[12] https://committees.parliament.uk/publications/6158/documents/68766/default/