DR MAX PEMBERTON: Why the NHS MUST learn lessons from coronavirus

DR MAX PEMBERTON: Why the NHS MUST cut the bureaucrats, dump the futile form filling and hold fewer meetings to beat another pandemic

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The past four weeks have seen changes in the NHS that none of us could have imagined.

As the severity of the coronavirus pandemic became clear, emergency plans to treat the sudden influx of very sick patients swung into action. The way the NHS has responded has been extraordinary. The scale and speed has been breathtaking to witness. 

A friend who works in intensive care told me how they created a unit from scratch from what had been a geriatric ward. This kind of thing would normally take months if not years of planning. They did it in 48 hours.

Of course, not all the changes have been good. Many services have been cut back or cancelled to free up staff and space for treating Covid-19 patients.

Here are some lessons our NHS has learnt and which, once this is all over, I hope will continue to shape the way we work.

Dr Max Pemberton said the coronavirus crisis should change how the NHS is run day-to-day

Action taken in hours not months

One of the things that has shocked me is the speed at which things are now done. It has forced people to prioritise jobs.

The NHS has had to start behaving more like a Silicon Valley start-up than the dusty, bureaucratic organisation it is known as.

Decisions that used to take months or even years because of endless, pointless form-filling and meetings are now made in less than the time it takes to boil a kettle.

This is how it should have been in the health service all along — but at some point the apparatchiks took over and stifled innovation.

Staff better than many bureaucrats

It’s been fascinating to watch natural leaders taking charge in place of those we can now see were just in management positions because they’d been on the right courses. I’ve seen junior nurses step into the shoes of senior managers who have gone sick and bring a new passion.

Services haven’t disintegrated — in fact, if anything they have got more efficient. Long term we need to target resources at nurses, physiotherapists, doctors, healthcare assistants and porters — not the bureaucrats.

Nurses lay out bedsheets at the new NHS Louisa Jordan hospital in Glasgow, UK

Fewer meetings creates more time

Social distancing has shown we don’t need lots of meetings to get things done. In fact, quicker, more efficient meetings and a can-do attitude are taking over.

Now only essential people meet and most of the time decisions are made with just the patient and staff directly involved in their care. This is how it should be.

…as does ending futile form filling

ONE of the changes that came with the NHS response to the crisis was suspending many daft and pointless assessments doctors and nurses need to do to keep up registration.

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While these were introduced with the best intention, they have morphed into pointless form filling and training for the sake of it.

Suddenly, we now only have to attend training that is necessary for patient care — resuscitation training, for example. The General Medical Council should reconsider the whole exercise as it has no clear benefit to patients.

Experts returning from retirement

How refreshing to see retired clinicians and those who left the NHS return to help. They’ve brought with them a wealth of expertise and it has shown how much incredible knowledge and skill is lost when someone retires early or leaves the service. We must do everything we can to get those who have returned to stay.

More flexible working

We’ve had to adapt to providing as much care digitally as possible. In the service I work for, we have moved to therapy using video conferencing. If we can maintain this as an option after the crisis, hopefully more patients will be able to access care. It’s also easier to fit in childcare when you can work flexibly, and we’ve seen staff who work part-time able to take on full-time work. Perhaps this could go some way to solving the NHS staffing crisis? Video isn’t always a substitute for face-to-face contact, but can be a useful tool.

An ambulance drives past a sign reading ‘Thank you NHS’ in Liverpool, north-west England

A NEW RESPECT for all our cleaners

they have been neglected, undermined and undervalued, yet the work of cleaners is now at the forefront of fighting this damned virus. All of us have come to realise the enormous debt we owe to them.

They are literally saving people’s lives every day and doing it with a dedication and humility that is inspirational.

…but we must STOP cutting BEDS

THE speed at which Covid-19 hospitals have been built is quite astonishing. But they are necessary because the number of beds has been reduced year on year.

NHS England figures show about 17,000 beds have been cut since 2010. There is no flexibility for sudden surges in patients. We need to now stop cutting beds.

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