In the second part of our exclusive interview with Dr David Fluck of the Ashford & St Peter’s Hospitals NHS Foundation Trust, the discussion focusses on how the Covid-19 pandemic has accelerated the digital agenda of the NHS, what impact this will have on the health service, and the lessons that healthcare leaders can take forward from the crisis.
Changing the delivery of healthcare
Reflecting on the increased digitisation of healthcare that came about out of necessity as Covid-19 took hold in the UK, Dr Fluck explained that the advancements seen over recent months would likely bring real changes to the way in which healthcare is delivered in future.
He recalled: “The remarkable thing is that during this time, despite all the disruption there was an enormous amount of innovation and change. Many barriers and layers of bureaucracy were removed within the healthcare sector to allow things to happen more quickly. That is hugely beneficial for the care of patients and we need to hang onto community spirit and these advancements and positively change the way we deliver healthcare in future.
“It is now clear that patients and families like easier access to care and when that can be delivered remotely, then they are receptive to it. Also, maintaining the infection prevention control measures that have been implemented as we go forward will be important to guard against subsequent transmission and the spreading of other infections we have known about for some time. So, all in all, the consequences of Covid will have a huge impact on shaping things going forward.”
Elaborating on the benefits that the NHS has seen from the increased embracing of technology, Dr Fluck highlighted that it had not only fallen into the favour of both patients and clinicians but also helped alleviate a growing backlog of work.
“What Covid has done is accelerate the digital agenda and the willingness to embrace technology because the benefits of it are now so transparent. It is well-received by clinicians and patients alike and it is another huge advantage from all of this that we can hold onto in the future. Technology has also helped us cut down on a backlog of work that has been building up, and it has not risen as rapidly as it perhaps may have done. This has helped us not only look to return to normal capacity more swiftly but also given us extra headroom for when we emerge from the pandemic. Technology will continue to be an important factor as we look to return to fuller capacity and catch-up on work that we have not been able to carry out during Covid.”
Logistics key to pandemic exit route
The recent good news coming from vaccine trials has boosted national morale that the end to the Covid-19 pandemic could be in sight once the winter months have passed. While Dr Fluck hailed the achievements of science, research and business in pulling together to make the development of a potential vaccine possible, he stressed the importance of tempered optimism since the logistical challenge of a mass vaccination programme looks likely to be a significant one.
Dr Fluck said: “It is extraordinary what science, research and business can do when it puts its mind to it. We have two or three vaccine candidates now with good efficacy and to have developed them in that timeframe is unbelievable. The step of getting them into vulnerable communities and protecting those people, as well as to healthcare workers to protect them, will happen quickly. But the logistics of vaccinating large swathes of the population, although currently being planned, will be a large-scale operation. It does offer real hope, however, that we can return to normality.
“Of course, we do not yet know the timeframe for when we can expect such a return. Most think it will be the spring or the summer of next year where we do see the end of Covid, and in anticipation of this return we have been trying hard within the NHS during this second wave to get back to the same levels of activity in many of our services as we saw pre-pandemic. We are close to achieving that and we have had to in order to ensure that we do not fall further behind. We are seeing light at the end of the tunnel and we have to be ready for when we emerge from this.”
Continuing to promote health awareness
Drawing attention to the heightened focus on physical and mental health and wellbeing as more of the population has sought to lower their risk of succumbing to Covid, Dr Fluck believes that people in the UK should continue to talk about health more and encouraging people to venture outside, take regular exercise and eat well should be encouraged.
He said: “Maintaining good personal health can reduce the risks of illness and therefore reduce the burden on the healthcare system. During the first wave, the advantage many people had was that the weather was better, and people could go outside and take exercise and the roads did not have much, if any, traffic on them. We saw a lot of people take up running and walking more regularly and people started enjoying their natural surroundings more and have become more open to talking about their health. This must be continued and encouraged.”
The lessons from the crisis
When asked about what he had learned from the pandemic after leading his team through the crisis thus far, Dr Fluck revealed that the immense dedication shown by all of his staff had made leading a simpler task and he had been left feeling privileged as a leader by the effort put in by all, as well as benefiting from picking up more practical knowledge.
“The last few months have taught me to recognise how amazing all of my staff are. It is not solely about clinicians but also about the supporting structures. The cleaning staff are central to what we are doing to protect staff and patients, we have our admin staff looking after so many things, IT staff keeping our virtual infrastructure going, and R&D teams have tirelessly recruited patients to Covid trials to understand this virus and pandemic more. It has been a real team effort from everyone and a privilege to watch unfold as a leader.
“Outside of the hospital, I have also seen the wider community and health system working together in tandem and it has been so easy for me to lead because everyone has been wanting to help each other and pull together toward one mission. We have had a real clarity of purpose during this time and seen so much unity toward that aim, and perhaps this is the biggest lesson that we can take forward.
“Furthermore, prior to Covid I did not know a great deal about ventilation and air purification systems, but now I know quite a lot on the subject and realise the importance of them not solely in ICUs, but also in building infrastructure. We can learn much from this pandemic and look at how we can cut down on risks of infection transmission by reducing congestion in buildings and designing them differently to make sure they do not become hotbeds for infection. Covid-19 may have happened in 2020 but risk of transmitting infections will remain with us going forward and we can be much more active in preventing it.”
Looking kindly on history
Concluding by focussing on the leadership of the government throughout the pandemic, which has so often come under scrutiny, Dr Fluck took a moment to emphasise that ministers have been left with the unenviable task of finding a balance between reducing transmission, protecting the economy and avoiding exacerbating other health issues, with many decisions taken on the basis of information presented to them shortly before making a decision. In light of that, Dr Fluck hopes that history will judge the actions of the government kindly and learn from the courses of action taken, as opposed to harshly criticising them.
Dr Fluck explained: “The impact of government measures to reduce transmission from a healthcare perspective do have wider implications. We must understand the balance of this and acknowledge that shutting down only causes economic hardship and other healthcare issues such as mental health troubles. That is the tricky part we must investigate more, and we cannot forget that government has been left having to make a lot of decisions that are not easy and ministers have had to try to find a balance which won’t always leave everyone happy.
“It is important that when we look back on history, we realise that our leaders worked with the information they had at the time and we must judge peoples decisions kindly going forward and learn from what they did and improve ourselves based on that, rather than judge it negatively.”
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