NHS Voices blogs

Salvaging positive outcomes from dark and difficult times

Let’s not lose sight of the innovation and new ways of working that have characterised the NHS response to COVID-19.
Sam Allen, Prof Mark Hayward, Dan Charlton

18 January 2022

Confronted with a crisis, it's a natural instinct to respond rapidly to the immediate situation, deal with it swiftly and get things back to normal as soon as you can. But this approach doesn't work so well when  dealing with a protracted crisis of pandemic proportions.

Two years on from the onset of COVID-19, and during these dark, winter days of the Omicron variant, it's difficult to avoid yearning for a return to something more like normality. At the same time, health and care leaders remain preoccupied with the scale and complexity of the task to restore services onto a post-pandemic even keel.

However, there's a compelling case for resisting the understandable urge to turn the clock back completely. Difficult, daunting and devastating as this pandemic experience has been, it would be a missed opportunity to lose sight of the innovation and new ways of working which have characterised so much of the NHS response to COVID-19.

Learning for the future

We set up a 'live learning' project to evaluate and inform our ongoing response to the pandemic

As COVID-19 took hold, it became apparent that health and care services faced an unprecedented challenge that would require thoughtful and bold decisions, and focused, timely action under pressure. We set up a 'live learning' project to evaluate and inform our ongoing response to the pandemic, capture innovation before it became lost in the midst of the crisis, and harness knowledge to inform future ways of working and providing services. This project was founded on three cornerstones.

Firstly, understanding patient and staff experience using robust research methodologies.

'Learning for the Future' was led by our Research and Development team, which designed a programme of semi-structured interviews with leaders and patients, staff surveys and data analysis that could be delivered through a series of iterative phases.

Secondly, fostering an ethos of open learning.

Rather than 'holding on' to the project data to unveil in a weighty report, every phase of the project has been published online once the analysis was completed.  

All project outputs have been shared and discussed through a series of webinars. This is in keeping with both the ethos of the project and our overall approach to engagement; both of which are based upon actively listening to feedback, discussing it across the organisation and acting upon it.

Thirdly, embedding positive changes introduced in the midst of COVID-19.

The project has informed the development of a 'Learning for the Future' framework outlining the principles and expectations that teams are invited to use when considering future working practices. This includes the opportunity to embrace flexible working practices that support staff wellbeing and which promote work-life balance.

So, what have we learned so far?

  • There have been positive views about the agile and rapid organisational decision making that came into play during the pandemic. This included new care pathways that were introduced to respond to the needs of patients, carers and families.
  • The swift adoption of digital technology to support online consultations – change that might have taken years in more 'normal' times – was valued by staff and patients. Having provided over 100,000 online consultations during the pandemic, the feedback we received has been used to develop guidance on how we use digital technology to provide future care and treatment: informed by patient choice / need, assessment of risk and clinical judgement.
  • There has been favourable feedback about the greater, much needed focus on workforce wellbeing at a time when health and care staff have faced huge pressure in extremely demanding circumstances
  • People found the approach to staff communication supportive, particularly the focus on clear, concise and relevant messaging which was communicated through multiple channels.

The next phase of the project will involve case studies, surveys and qualitative interviews to explore the extent to which the positive changes have become embedded in practice.

Translating learning into action

As we look to the future, it's important to take a moment to realise what we have achieved across the NHS during the pandemic

Change is an ever present and necessary facet of continuous healthcare improvement. But in

this ever-changing context, there's a risk of public sector reform being compromised by the ‘organisational amnesia’ that comes from change that is too rapid and which can pay insufficient attention to lessons learnt from the past. 1

As we look to the future with hope and optimism for a time when COVID-19 ceases to dominate our lives to the extent it does now, it's important to take a moment to realise what we have achieved across the NHS during the pandemic. We can learn from this and use the knowledge to shape the way we lead and care for the local communities we serve in future. This, at least, will enable us to draw some positives from an experience that has disrupted and devastated lives over the last two years. 

Sam Allen is outgoing chief executive of Sussex Partnership NHS Foundation Trust and chief executive elect of the integrated care board (ICB) for the North East and North Cumbria Integrated Care System @samanthallen.

Dan Charlton is director of communications for Sussex Partnership NHS Foundation Trust @Dan_Charlton1

Professor Mark Hayward is director of research at Sussex Partnership NHS Foundation Trust @Research_SPFT

Follow Sussex Partnership on Twitter @withoutstigma

Footnotes

  1. 1. Wettenhall, R., 2011. Organisational amnesia: a serious public sector reform issue. International Journal of Public Sector Management. Vol. 24, no. 1, pp. 80-96.