James Seaman
Head of Advisory Services
Almost from the outset of COVID-19, but particularly recently as we emerge from full lockdown, there’s been a persistent reference to the “new normal”. It’s left me thinking what it actually means?
We have seen clear evidence of resilience and commitment to meet the unprecedented demand for both human and technological innovation to navigate the complexities (and strains) of delivering the best healthcare and patient outcomes. Yet, despite the huge scale of our healthcare services, it is still apparent that resources (both human and technological) were inadequate to demand in ‘normal times’, let alone in times of a pandemic. In short, the “old normal” wasn’t working.
Big change, little time
COVID-19 has plagued (I think that’s a fair adjective) the entire planet, crippled economies and affected the very fabric of most people’s lives – without question – there isn’t an upside! (I have a particular dislike for the concept that there’s a positive side to all this!)
The impact it has had on the people has been profound. As a chief technologist working predominantly with the UK Public Sector, any role I’ve had in adding value through our services to the health sector is outweighed by the personal pride that I hold for the NHS. I regard each and every individual working on the front line as nothing less than heroes.
The overall Public Sector has had a seismic change in a short space of time. This is a sector that cannot furlough staff easily, nor mothball its facilities; it must continue to provide care, education, emergency services and more; and it must do this in the context of a spike in demand never seen before.
The results have been varied. Please understand – that is not a slight or a criticism. It’s just a fact.
Trying to react to a health crisis with little or no information about cause and effect is hard, and what has been achieved is incredible. However, it wasn’t right everywhere all at once. Lessons learnt created the need for rapid improvement as our public health services were required to operate in a very different way, and through a myriad of different means.
Home working is now a big thing - not just the domain of the “hipster” app developer, self-employed contractor or YouTube vlogger. Digital services within the broader public sector and in healthcare specifically have been fast tracked (mostly… turns out this doesn’t extend to contact tracing apps) and the IT services have had to make a step change in their processes and technology to enable this new remote, online dynamic. Again, some of this has been a resounding success, yet some not so much! Let’s be honest – this type and pace of change, even this type of service, is not normal, especially in the public sector.
No new normal, just new
The point is that “the new normal” that is often referred to will be anything but normal. The world has changed irrevocably as a result of the pandemic experience, and new ways of working will set new expectations. In short, the new normal will need the support of all stakeholders within the public sector, leaders, the government (oh <insert deity of choice> help us!) and the supply chain. The basis of which includes changes that have taken place across the supporting IT landscape and which now need to be underpinned with change management, process changes, training, governance and benefits realisation.
There have been what some might define as forced investments during this crisis – a pace and type of procurement that is not natural in the Public Sector and certainly not across the healthcare landscape. Technologies relating to Public Cloud Services, Third Party App development, the deployment of video consultation services to every GP and Patient in the UK are all examples of significant investments and changes in operational behaviour. Is the ability to enable a patient to have a video call with their GP instead of a consultation in surgery, an interim fix or a mark of progress? What about the wider changes to processes, governance, data security and privacy, and dependent services like prescribing, referrals etc?
The COVID-19 pandemic has highlighted it is more important than ever that every penny spent and every investment made is as strategic as possible and not simply a sticking plaster. Take the Nightingale hospitals for example – they may not have been as needed or utilised as we expected (thankfully!). Some have argued they were a waste of money (to those who do: I would rather have had them ready and empty than not!), yet so many lessons were learnt about the “why” the “how” and the “who” of deploying such a service. The training, logistics and clinical process that were developed to enable patient care to function means that the NHS is richer because of it. There are long term operational benefits to completing the process even if the outcome was that they were not utilised as expected.
Assessing the future
It’s important that we look at the biggest digital / IT successes arisen during this crisis; the applications of technology that stakeholders, citizens, patients and students did, or were able to, adopt; and as a result, extract learnings that inform the future agenda of healthcare.
Having worked closely with healthcare, and personally invested in its long term success, here are my top three:
1. Take stock of the learnings: what worked and what could have been done differently?
2. Update your strategies and investment plans to utilise the tactical investments that were needed for the longer term.
3. Take stock of the technology that was deployed and adopted: be clear on the why, where and how to ensure that it will continue to deliver in your “new normal”.
There is constant and growing pressure to get the public sector and the healthcare services back to normal after Covid-19. However, going back would mean throwing aside the changes that have been made, the money spent, and the digital surge with the associated benefits. Change has happened to serve a critical purpose and we have the opportunity to extract even more value from it if change continues. This isn’t my “positive upside”, just a practical view.