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Back to Health - DHSC approach to restoring suspended or reduced services: part one

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23/05/2020

Careful planning is underway to begin the process of restoring health and care services which have been suspended or reduced since the coronavirus outbreak in early March.

A document published today Back to Health explains the approach to reinstating a range of health services, and will be followed by a second document mapping the process for social care.

The government’s Covid-19 response required many services to be scaled back, to ensure resources were repointed to deal with a potential surge in demand from the pandemic and to create additional capacity in hospital and in the community.

It was also essential to reduce the number of people visiting the hospital to prevent the spread of infection and protect vulnerable patients. A number of services, including some hospital outpatient clinics, continued in a different way through video and telephone consultations.

With low level community transmission of Covid-19 it is now time to plan for the gradual return of services. This process is being carefully mapped in stages, to ensure the return of services is safe for patients and staff while remaining alert to any rise in demand from the pandemic.  

DHSC Minister David Ashford said:

‘From a position where we could deal only with emergencies, we are moving to the early phase of return of services. It is a balance, as we continue to treat Covid patients and must ensure we can meet any escalation in numbers.  
‘Across hospital, community and social care services we will balance risks associated with the virus with the long-term needs of patients and service users. In the hospital setting this may allow urgent and time-sensitive elective appointments and procedures to be resumed, as well as screening programmes where possible. Use of technology has helped maintain mental health services during the pandemic, and the next stage will be to increase opportunities for face to face contact for those who will benefit most.

The Minister concluded:

‘But as in every area of health and social care delivery, this will have to be conducted safely and in line with infection control measures. There is much planning to do to put appropriate measures in place.’

Detailed pathways have been drawn up to guide each service area in the resumption or expansion of activities, taking into account demand, assessment of need and teams’ ability to manage safe practices for both patients and staff.  These service areas include:

  • Hospital
  • Metal health services
  • Primary care – including general practice, dentistry, optics, MEDS
  • Community services – including district nursing and adult social care
  • Women and Children’s services in hospital and the community
  • Therapies
  • Radiology

In addition to restoring suspended services, the Department is keen to progress new initiatives developed in recent months. By providing additional homecare support, the new Integrated Community Services team has ensured vulnerable residents can remain at home safely during a period of increased demand on existing community services and while day services are closed.  

Additional capacity to help care for patients with a positive diagnosis but not requiring a hospital bed has been successfully established at Newland’s and may be needed for some time to come. Elsewhere, a new task force has provided support to residential care homes across the Island to prevent and manage the virus. This includes a rapid response capability to ensure appropriate care and safety measures are in place should a resident or staff member test positive. The operation has brought together a range of health care professionals and works alongside the existing Registration and Inspections team.

These initiatives have been achieved through a significant reconfiguration of services and commissioning of additional capacity, including from the third sector, and it is hoped they will continue in some form in future.  

A return to full service of all health and social care provision will take many months as capacity allows and consideration of Covid-19 demands. The department will however, look to continue new ways of working established during the pandemic which have proved successful, and in some areas traditional care pathways are being transformed as services are brought back on stream, to ensure improvements are captured for the benefit of patients and service users.