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Wil's Blog - Capturing Learnings From Phase 1

Tuesday 5th May 2020

​In an email sent out last week, NHS England signalled a move from phase 1 to phase 2 of its Covid-19 response. The email maps a move to restart urgent elective care procedures in the next six weeks, as well as some non-urgent elective care procedures.

As we move to the next phase of our Covid-19 response, we must take a moment now to analyse our learnings from phase 1, so we can lock-in beneficial changes and also understand how the first phase of Covid-19 has affected the trajectory of the NHS Long Term Plan.

The first phase of our Covid-19 response has seen the health system make significant changes to manage the outbreak of Covid-19 as well as continue to manage non-Covid-19 related patients. We need to capture the emerging best trends from this phase of the response. During phase 1, we have seen the enhancement of local system working, an increase in remote working, improvements in digital consultation, the rapid scaling up of new technologies and increased access to innovative treatments.

You can read about the plan for phase 2 of NHS England’s Covid-19 response here.

We cannot underestimate the significance of these changes, and it is crucial that we capture the learnings as we move forward in the next phases of the Covid-19 response. However it is important we do not lose sight of the NHS Long Term Plan, and these changes should play an essential role as we continue our work towards achieving it.

For valve disease, the objectives of the NHS Long Term Plan are two-fold:

  1. To develop a best practice in diagnosis, treatment and management that will support healthcare professionals involved in the patient pathway to deliver high-quality care of the disease
  2. To help heart valve disease patients to understand better what they should expect from their healthcare professional and treatment pathway when diagnosed and treated for their condition.

Within our response to Covid-19, we have seen how practical priorities have been able to drive digital transformation, and our response is transforming the below three objectives in the LTP:

  • Digital technology will provide convenient ways for patients to access advice and care deterioration of health and reducing symptoms to improve quality of life.
  • Patients benefit enormously from research and innovation, with breakthroughs enabling prevention of ill-health, earlier diagnosis, more effective treatments, better outcomes and faster recovery.
  • We will speed up the pipeline for developing innovations in the NHS, so that proven and affordable changes get to patients faster. We will create a more straightforward, clearer system for Medtech and digital that will apply across England.

This scaling up of new technologies and increased access to innovative treatments is a perfect example of emerging best practice culture. Throughout our response, innovative treatments have streamlined pathways, and reduced hospital stays, reducing the risk of infection and alleviating stress on the workload by freeing up bed space. This strategy was an important component of Heart Valve Voice’s Gold Standard of Care, where we mapped best practice and optimal pathways for valve disease patients and set out a Gold Standard which the health service should be working to achieve.

For me, I would like to see hospitals using these treatments and their experiences in phase 1 to be aggressive with their hospital stay targets. Throughout phase 1 we have seen reduced hospital stays for both surgical and minimal intervention patients, and George's story is an example of how we are able to reduce admission times to alleviate pressure on beds and treat patients timely, effectively and safely. If we can get patients discharged 3-5 days post-treatment, then that should be the benchmark we are working towards to ensure we are efficiently working through the backlog of patients in a practical, timely and safe manner.

By developing straightforward digital access to NHS services, the NHS has helped patients and their carers manage their health during the outbreak. We need to harness this digital transformation and move forward with it. Before the outbreak, I was at a roundtable with Health Innovation Manchester where we discussed how technology could be used to improve services, waiting lists and treatment times. At this discussion, we discussed teleconference appointments and it was estimated that, in best case scenario, this digital transformation could reduce treatment times from 55 weeks to just 21 weeks. In phase 1 this infrastructure and culture has been developed, and now it is right that we move forward and utilise it in the future.

In addition to this, in our Innovation Report we identified app technology as a means of empowering patients and streamlining pathways. Now is the time to encourage a world-leading health IT industry in England with a supportive environment for software developers and innovators. Then, we will empower patients with records that support their care and ensure that patients and clinicians can access and interact with patients records and care plans wherever they are. In doing so, we can aid clinicians in applying best practice, eliminate unwarranted variation across the whole pathway of care, and support patients in managing their health and condition.

We must not let go of the lessons learned and the developments made in phase 1. From this time, we can enhance our health care culture, and together with the Long Term Plan and our Gold Standard of Care, we can develop a system of best practice that will improve the future diagnosis, detection of treatment of heart valve disease.