The changing context of NHS care during the pandemic

The launch of the NHS Long Term Plan in 2019 outlined ambitions to move to a new health care model, where patients are more involved in decisions around their care.

A key component of this model is making sure that patients get accessible information about their care and actively provide feedback so that the design and delivery of services can be improved.

Patient feedback and monitoring is particularly useful during the COVID-19 pandemic, as it provides an opportunity to understand the resilience of the healthcare system when put under unprecedented pressure. While the full impact of COVID-19 on the NHS has yet to be fully understood, there are many ways in which healthcare has rapidly adapted to the pandemic:

• During the first COVID-19 peak, visits from family and friends were heavily restricted to reduce the risk of face-to-face transmission. In response to this, some providers encouraged alternatives to visits, such as communicating through digital devices and laminated messages. Some patients would need help from staff to help them use alternative methods of communication.
• A COVID-secure environment has become paramount for infection prevention and control in health and social care settings. In line with recommendations from the World Health Organization, Public Health England published guidance on protecting healthcare workers and patients. This highlighted the importance of social distancing, optimal hand hygiene, frequent surface decontamination, and appropriate use and disposal of personal protective equipment (PPE) in all hospital settings. These measures should be communicated with clear, accessible signage that can be understood by patients and visitors.
• Worry about catching COVID-19 has been consistent and prevalent for many people since the pandemic. A survey by the King’s Fund found that people may be avoiding healthcare settings, such as hospitals, due to the perception of increased risk. Since the start of the pandemic, there has been a drop in accident and emergency attendance figures, indicating people are not using these services as they usually were pre-pandemic. Not seeking help or delaying treatment can lead to consequences such as less successful medical interventions, the need for more intensive treatments, premature death and an increase in waiting lists. As a result, it is crucial that hospitals not only provide a safe environment, but also ensure people feel safe and protected when attending hospital.
• It is now standard procedure for healthcare professionals to wear PPE, face masks and shields in hospital. However, this may be a communication barrier for some people, especially those who are hard of hearing or rely on lip reading. It is important to measure the impact of this on communication between hospital staff and patients. Good communication is essential for the delivery of patient-centred care for all patients, an approach encompassed by the NHS. Patients often find staying at a hospital overwhelming and stress-inducing, so it is important that hospital staff can verbally reassure them.
• The Department of Health and Social Care (DHSC) has introduced a new discharge policy to facilitate a speedier discharge from hospital. As soon as it is clinically safe to, patients should now be discharged from hospital on the same day, with any further assessment to be carried out in a non-acute setting. Patients who need to be discharged into a care home must be tested for COVID-19 before release from hospital. Aftercare requirements depend on individual need, but range from short-term assisted living support to a recovery support package and follow up visits.

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Results from the survey

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Introduction