Well, this is all very odd isn’t it? Ordinarily I’d be quite content to be working at my dining table with some crisp spring sunshine streaming in but today it feels slightly inappropriate to have a nice day.
We are seeing humanity at it’s best and worst, from the half a million and climbing volunteers for the NHS and all the returners to the frontline (I may join you if you need me!) to those who are robbing hand gel from hospitals and breaking into stores to steal sorely needed PPE equipment.
I have no idea where we will end up after this period but I’ve been trying to think of things which I’m massively impressed by and changes I hope will stay once this horrible virus has been wrangled under control by science (I really love science. A lot)
Things I hope are here to stay...
- Remote GP and outpatient consultations. I’m seeing a lot of positive comments from both GPs and patients about video and phone consultations. They seem to be helping clinics run to time and reducing DNAs and allowing GPs to see inside the homes of their patients. I remember some clinical signs were a bit of a puzzle but then when I would do a home visit it would make sense – the wonky steps and the trip hazard rugs. Remote isn’t appropriate for everything but they seem to be working for a much larger proportion of cases than some of the detractors had claimed.
- Data sharing. #datasaveslives is not a new concept. It has long been known that having a holistic patient record increases the quality of care and reduces clinical errors. Understandably there has been a lot of hesitancy for information to be freely shared between organisations but, as articulated in the report ‘One-way mirror: Public attitudes to commercial access to health data’ undertaken for Wellcome Trust in 2016, the general public believe that the NHS is a single entity and includes NHS branded services such as dentists and GPs and don’t appreciate the current spaghetti of systems, information governance processes which is meant to safeguard unauthorised use and access but also prohibits some really valid use cases. I’ve seen quite a few projects abandoned because of Information Governance stonewalling and I hope I see far fewer of those in the future.
- One NHS – The public response has been incredible. I come from a long line of public sector workers and I know those who are still working in the NHS have been buoyed immensely by the public response to them and their service and sacrifice. All organisational politics has been swept aside in a matter of weeks. I do think that when this subsides there will be a different organisational landscape left behind. From NHS England taking on central commissioning power from CCGs to London Trusts sharing staff to get the Nightingale Hospital off the ground, I think that a lot of previously fractious relationships will be forever changed (and hopefully for the better).
- Rapid innovation – There is bound to be some things which don’t work and that’s to be expected but it’s amazing how quickly the attitude has changed from ‘I need a bespoke purpose built solution which meets my needs’ to ‘I think we can probably FaceTime or do a Zoom call and we can iterate as we go’. The retooling of the gtech factory to produce ventilators is pretty awesome and the fact they published their plans is even better https://www.gtech.co.uk/ventilators .
- Appreciation for others – I have had my fair share of shitty jobs over the years. I’ve cleaned hospital wards and the loos in the job centre, I’ve worked in a supermarket and I’ve worked behind many a bar. None of these jobs is easy and it’s not directly saving lives but they are all critical in keeping the country running and the infection spread to the minimum. I hope there is a carry-over of this realisation that delivery drivers and shelf stackers are pretty bloody important.
Things I hope will go as quickly as they came
- Marketing emails with ‘unprecedented times’ in the title. Normally from someone I bought a badge from on the internet once in 2004 emailing me to tell me how they are supporting me in ‘unprecedented times’. Two main issues with this 1) – GDPR 2) Please can we find another phrase other than ‘unprecedented times’. I know it’s accurate but can we get some variation in copy writing please? A friend pointed the phrase repetition out to me and now I can’t unsee it. You’re welcome.
- Well meaning tech people trying to help but getting it wrong. There are three nested threads pointed to by @edent (Terence Eden – Head of Open Source Technology at NHSx) https://twitter.com/edent/status/1243883717652819968 which flag the complexity of the systems which surround healthcare and why you need to really understand these before you fling something out. I’ve been working in it for 20 years and I would say there’s still things I’m learning. By all means, work with people on something together but make sure there’s a decent use case before building stuff at the moment.
- Any references which compares this crisis to the Second World War. A point which requires no expansion.
Co-Curator, OHT Midlands
Head of Health & Social Care, BJSS