17th April 2020
Service Recovery Documents: the What, When and How
Another week on and many of us around the country are pondering the uncertainties of how the epidemic will unfold in our own locality. Regions around the UK are at different stages of evolution of COVID-19. The shape of the epidemic peak and plateau will differ across the country as the epidemic finds its equilibrium over time.
Planning future service is made more difficult with these, and other variables outside the control of clinicians and hospital management, impacting on that process.
National distancing measures to flatten the epidemic peak, and early action by GI Units to control demand, review activity and implement emergency rotas to support acute service colleagues (ED, HDU/ITU palliative care, etc), have created the opportunity to manage non-COVID-19 related diseases for vulnerable patient groups differently within the specialty. Emergency and essential work continues but planning for the re-establishment of non-urgent or deferred specialty work needs to be made.
The overall strategic priorities for such activities remain unchanged. Service delivery cannot safely move forward without the following immediate necessities: a secure PPE supply and widely available and rapid testing for COVID-19.
In the medium to longer term, access to evidence-based effective treatments and the introduction of a vaccine will be the final exit strategy permitting the normalisation of service delivery. This process, however, is likely to be long and the vehicles of delivery complex: a fluid workforce working flexibly as the phases of the epidemic pan out and, within regions, networked service delivery accommodating services in the recovery phase which can no longer be traditionally delivered.
The BSG has given considerable thought to these challenges and put together a ‘tool kit’ for service recovery planning. The Society is proposing:-
- a definition for the phases of the epidemic cycle
- a prioritised list for clinical activities across the specialty
- a practical approach to the delivery and planning of service
All encourage sequenced decision making and planning during a period when the devolved administrations for health are evolving guidance. We aim to stay in advance of the ‘national guidance curve’, shaping and informing it through our specialist advice. This will be an iterative process and the grids will be revised as appropriate.
I hope this ‘tool kit’ will be a starting point and a practical support for your teams locally. The BSG continues to share this widely with our colleagues in other specialties and directly with governments to help shape the future of health care delivery in the UK.
Out of this challenging and difficult crisis comes the opportunity to take a transformative step in health care provision; supporting clinically-led prioritisation of service with early senior triage, direct specialty support to patients and the widespread use of digital technology to deliver this change.