Weathering Covid-19 and preparing for the next outbreak – getting UK hospitals ready
With the coronavirus outbreak being declared a pandemic by the World Health Organisation (WHO) last week, there is a huge strain on industries currently being challenged – obviously, healthcare is on the forefront, along with pharma and research. They are reacting to the crisis – by accessing information, creating understanding and insights, and trying to predict the ways in which it will affect patients, vulnerable groups and the healthcare infrastructure itself.
NHS is gearing itself up to tackle the growing threat of a Covid-19 outbreak at a time when our health service is already strained. To respond to the current situation in the most appropriate way, NHS announced that hospitals should look to cancel all non-urgent surgeries for at least three months starting from 15 April. The operational aim is to expand critical care capacity to the maximum – free up around 30,000 of England’s 100,000 general and acute beds. Such actions are unprecedented in the history of NHS.
Independent healthcare providers in the UK like Spire Healthcare have postponed some services based on new guidance from the Department of Health. They may see a softening of demand for elective surgeries from self-pay and insured patients as the patients may want to avoid non-urgent contact at this time. At the same time, the independent sector has been called in to help NHS cope with this crisis. There are reports that the government will pay £2.4m-a-day for the use of 8,000 private hospital beds to relieve pressure on the NHS as the coronavirus outbreak intensifies. Therefore, the independent sector is also likely to play a crucial role in managing the current situation.
At SAP, we take our mission of helping the world run better and improving people’s lives very, very seriously. At this time of uncertainty and fear around the world, SAP has opened access to its technology to address this global challenge. Additionally, SAP can support and inspire healthcare providers in the UK to plan, prepare and respond to current situation while staying close to patients, employees and suppliers at a time when they really need support.
In this brief blog, I have highlighted what actions hospitals and providers can take immediately and in coming weeks and months to manage the current situation and be prepared for the next, inevitable outbreak.
Understand, protect and enable employees: Communication with employees with the right level of specificity and frequency is quite important to understand the pulse of employees in a crisis. Workplace communication improves employee morale, productivity and commitment and software can be used to communicate effectively with employees for different purposes- for example, mass emails can be sent to employees to convey important messages. SAP has stepped up and beginning immediately some employee experience management tools are free and publicly available for all organisations. These tools will help organisations understand how their employees are doing and what support they need as they adapt to new work environments, helping organisations close experience gaps and maintain continuity. In just four days, thousands of organisations have signed up for this free Experience Management (XM) Solution.
To manage the current patient care demand, there is the issue of imparting refresher/customised training to staff to provide all the extra care. NHS Trusts and independent hospitals can deliver training to all clinical and patient-facing staff using mobile/handheld devices anytime and anywhere. Once the staff is adequately trained they can take extra care of Covid-19 patients; keep themselves safe by using proper protection; support patients who will need respiratory support, and begin work setting up makeshift intensive care wards. To help support organisations, SAP Litmos is offering a completely free Remote Readiness & Effectivity Academy, with training content for anyone, anytime, anywhere. The ready-to-watch video-based courses are designed to help mental wellness for workers, maintain the highest levels of hygiene and develop leadership during times of change and challenge.
Technology can also help in identifying business-critical positions, making replacement plans and managing the increased need for care staff. Hospitals can quickly optimise their use of external workers/contractors by hiring, onboarding and training a large number of people quickly so they are up to speed to manage the surge in demand at a short notice.
Each hospital must be developing a plan of not only finding more beds but also finding the staff to be able to staff those beds. Some reports suggest that there are plans to ask recently retired medics or those on a career break to return to NHS to handle the current situations. This could work out provided onboarding and safety procedures are handled effectively. To manage the coordination of these efforts, there is a free of charge collaboration software, from SAP, which can be used for project management, task management that help teams spend less time on admin and more on execution. However, in the long term, with proper planning, such actions shouldn’t be needed if recruitment and retention of NHS clinicians is made a priority. There are various solutions available which can be used to do strategic workforce planning and plan employee succession, development and performance to build a strong workforce.
Patient management to experience management: ‘Ready to discharge’ patients occupied an average of 3,450 beds a day in acute hospitals in January 2020, which means a total of 160,637 bed days were lost to people who did not need to be there. When a hospital is flooded with more critically ill patients than it can handle, more patients die. By planning and coordinating with community health providers, acute providers can urgently discharge patients who do not need to be in the hospital. Hospital trusts manage as many as eight million outpatient appointments every month. The current situation necessitates a surge in telemedicine, remote screening, and remote patient management in order to free up doctors’ time. Health Engagement tools are designed to allow patients to closely interact with their caregivers without the need to see the caregiver in the physician’s office. Patients can take an active, involved role in their journey and physicians can access real-time insights which can be used to intervene when needed thereby improving patient outcomes.
Stablilise the supply chain: Healthcare supply chain is increasingly globally integrated and Covid-19 has affected supply chain dynamics across China and other parts of the world. Pharma manufacturing is a case in point. A parliamentary report on the impact of Brexit on the pharmaceutical sector, published in May 2018, highlighted that 80–90% of generic medicines used in the NHS are imported, with China and India in the top five providers of UK medicines outside of the EU. People in ICU need all kinds of specialised equipment such as IV pumps, ventilators and monitors of different kinds. Healthcare workers are going to need personal protective equipment (PPE) – FFP3 masks, goggles, gowns – because if they can’t protect themselves, more and more of them will start to fall sick. Doctors in Italy are already making a choice of equipment i.e. ventilator versus bag valve mask based on age and likelihood of survival. The government has released its national stockpile of protective gear held back for pandemics and urged UK manufacturers to regear factories to build ventilators for the NHS.
Swift changes in demand across multiple geographies require agile actions; inventory optimisation, route optimisation, transportation optimisation, demand prediction and sensing are crucial more than ever. For the next 90 days, SAP is opening free-of-charge access to SAP Ariba Discovery, so any buyer can post their immediate sourcing needs, and any supplier can respond to show they can deliver. Buyers and suppliers will connect quickly and effectively, and minimise disruption caused by shipment delays, capacity issues, and increased consumer demand in times of crisis. SAP can help make the connections to keep the supply chain intact, which will ultimately have an impact on everyday life of consumers, like this example where SAP Ariba has helped a client secure 500 hospital beds in just 30 minutes.
For the longer term, NHS could look at alternative sourcing methods and suppliers to diversify the supply base and reduce extensive expediting costs.
Travel and spend management: The virus is demonstrating the need for travel to be managed holistically for employees. NHS and independent sector providers have a duty of care and therefore need to know where their people are to support and help. Healthcare workers must leave their home and family and may also need to be offered the alternative option of staying in NHS-reimbursed hotel accommodation while they continue to work – away from their families. SAP wants to do its part to help those who must travel. Between March 13 and March 31, any individual traveller can sign-up for TripIt — and download the app as a first time user — and receive TripIt Pro for six months. Existing TripIt users will also get the premium service complimentary for six months. By doing so, we hope to make things a little easier for care workers.
Mobilise ‘Control Centre’: Better management of contagions requires planning, collaboration, and a comprehensive, systemic approach within each hospital. Hospital ‘control centre’ can operate as an air traffic control centre, using advanced technology and Artificial Intelligence (AI) to efficiently move patients coming into and going out of the hospital. It can also provide more accurate predictions about demand; enable real-time information about staffing constraints, bed, operation theatre/equipment availability, discharge planning, and improve the flow of information. With this advanced functionality, hospitals should be able to treat more patients, cut waiting time, improve the patient experience, and reduce pressure on staff.
Establishing such a command centre is dependent on the availability of clean data in digital format but for some of the digitally mature trusts, this should be achievable in the medium term.
Finally, in response to the COVID-19 outbreak, NHS has been true to its purpose of serving patients and advancing the health of the nation. As we brace for months of heightened risk from the disease, it is possible that this outbreak changes the healthcare sector and the world economy for the years ahead. SAP will help make this change a positive one.
House of Commons Business, Energy and Industrial Strategy Committee. The impact of Brexit on the pharmaceutical sector. 2018. Available at: https://publications.parliament.uk/pa/cm201719/cmselect/cmbeis/382/382.pdf