22 June 2020
As we reach the halfway point of the year, and with COVID-19 continuing to dominate the political and health landscapes, our Head of Policy John Hopgood takes a look at what to expect over the next six months from Westminster.
A new year and a new government can often bring a big shake up for policy across the board – and particularly within healthcare – but nothing in modern times has brought such dramatic changes to the way the NHS works as has COVID-19. And let’s be clear right now – the policy context for health has fundamentally changed, and it isn’t going to be changing back any time soon.
That’s not a bad thing – at least not entirely. The reaction of the NHS to the pandemic has proven two things – firstly, that our health service, our clinicians and our support services are almost infinitely resilient and resourceful. Over the course of not much more than three months, the NHS has completely redefined how it delivers care across every specialty, adapting to evolving knowledge on one of the most dangerous situations that the health service – and the country – has faced since its inception.
The second is that preparedness is the key to success. Health policy can’t be made on the fly and it can’t be reactive. You’ve got to anticipate problems before they arrive and build in solutions well ahead of the time that they’re needed.
Take staffing levels. A large part of the early stages of pandemic response centred around ensuring that the NHS wasn’t overwhelmed at a time where, inevitably many clinicians were among those getting infected. We’ve talked previously about the number of vacancies within rheumatology departments, and we know this isn’t something unique to our specialty.
Politicians know this too – at the last election, every party made promises around numbers of doctors and nurses. The Conservative manifesto promised to deliver 50,000 more nurses over the course of the current parliament, along with 6,000 more GPs and 6,000 more primary care professionals such as physiotherapists and pharmacists. Alongside this, they announced an NHS Visa to help attract clinicians from abroad post-Brexit.
Of course, we’ve already seen how COVID-19 has impacted on these pledges. Debate around the so-called healthcare surcharge has highlighted the mismatch between the aim of bringing in new people to the health service, and the environment that faces potential immigrants should they come. Expect this to be an ongoing issue of debate over the next months – and for a greater focus on how staffing numbers can be delivered and maintained once Brexit is finalised.
There will be other ways that Covid-19 shapes government priorities. The Conservative manifesto pledged to build 40 new hospitals over the next 10 years – but many will question this in the post-pandemic health service. We’ve already responded to a major committee enquiry on delivering core services during and after the pandemic, and will shortly be publishing some principles for the delivery of virtual consultations.
Over the coming months, there will be a great deal of focus on alternative delivery methods for services – think virtual consultations, community-based care, and new ways of caring for vulnerable people. BSR is taking a proactive approach to this, and we’ll continue to share the approaches that members develop as widely as possible. Lastly, it’s worth mentioning mental health.
This is something we’ve already been looking at within BSR – the National Early Inflammatory Arthritis Audit has shown us how few rheumatology MDTs currently have a dedicated mental health component – and it’s absolutely going to be a growing focus as the effects of shielding and lockdown are felt over the months ahead.
This list is by no means exhaustive – clinical research, for example, is going to get even more focus as the Brexit negotiations continue, and it’s something to look out for more information on the BSR website over the weeks ahead. In the meantime, please do let us know what are the key issues you think we need to be focused on – get in touch on policy@rheumatology.org.uk or via our dedicated member forum.
Finally – it’s worth noting that while the above applies first and foremost to England, many, if not all of these issues will be felt across the devolved governments as well. It’s worth remembering too – the next elections for the Scottish and Welsh Parliaments are in May 2021, so expect perhaps even more scrutiny on health planning in the run-up to those, something that we’ll take a careful look at as things continue to develop.