Comment / Safe supply

24 April 2020 Caroline Clarke

I think this is the seventh week that my organisation has been in incident mode. I think it’s exactly one calendar month since the UK went into formal lock-down – 23 March – nearly five weeks ago.  And time has developed an extraordinary quality – a day feels like a week, a week feels like a month.

But this week, as Covid-19 admissions have stabilised and we are starting to see non-Covid demand come back, my organisation has been a bit more reflective. And we are trying to look ahead with more certainty.

It turns out that certainty is a commodity in short supply. Planning to start services up again – to make sure that we prioritise patients most in need of our services safely, without passing on infection to either staff or other patients – is very, very difficult.

There are so many variables. How do we ensure that patients are virus free when they come for a procedure? How do we ensure that we treat the patients most in need? How do we stop our waiting times growing even further? How do we capture some of the great new ways of working that we’ve introduced in this period and not revert to old bad habits?

I’m an economist originally and I tend to think about things in terms of supply and demand. The issue we face now is about safe supply. How can we learn from the rest of the world about infection-beating processes? Will our hospitals and other care settings need to be radically reorganised to do this?

And it’s about prioritising demand across systems. I’ve been really proud of the way that our integrated care system has worked over the last month. We’ve really managed resources across the system in pursuit of patient safety without letting institutional sovereignty get in the way. The patient has come first at all times and that’s the thing we need to hold on to.

I know London’s running a bit ahead in terms of disease progression. So this thinking may feel like a bit of a luxury. I hope not, and I hope that as a finance profession, we can lead the way in helping set the course for the next phase of our NHS.