According to a report, post-pandemic integrated care systems in London will need to move to a “mixed” approach of digital and personal care.
Research by the Kings Fund found that the five integrated care systems (ICS) in London worked more closely to align their services and made “massive” digital gains during the pandemic.
However, the challenge would be to maintain and build on that progress to produce the best results for local communities, the report said.
“As the system recovers from the pandemic, ICS officials and others must support a long-term move to a ‘blended’ delivery model that best combines the best digital approaches with the benefits of face-to-face contact,” it says.
“Greater collaboration”
Covid-19 created a common purpose that enabled health and care organizations across the capital to work more collaboratively, the report said.
In some cases, changes that took years to achieve could be implemented in a matter of weeks or days. The commitments to improve access to digital health technologies and better use of data made in 2019 when ICS were set up have been “accelerated rapidly”.
There has been a “massive expansion” of remote access, according to the report, with most Londoners having access to virtual outpatient appointments and remote GP services.
There was also faster inter-organizational problem resolution and a “less prudent” approach to data exchange with organizations that saw the need to “quickly resolve longstanding information governance concerns”.
Richard Murray, Executive Director of The King’s Fund, said: “One of the few silver linings from the pandemic has been the big leap forward in working health and care together across London.
“This enabled the London health and care services to respond to the unprecedented challenges of Covid-19. However, Covid-19 also exposed the deep health inequalities that are affecting the lives of many Londoners.
“London’s leading health and care companies must now harness this momentum and sense of common purpose as a catalyst to eradicate inequalities and address health challenges in London.”
Rapid advances in digital have been rated “broadly positive”, but concerns about digital exclusion remain, with digital-first approaches “not for all or all”.
“In some cases, more evidence is needed to ensure that new regimes are clinically effective and appropriate,” the report said.
“Severe Health Inequalities”
The capital’s ICS officials must also “seize the moment” to address London’s “strong” health inequalities highlighted by the Covid-19 pandemic.
Life expectancy varies between counties by up to 15 years for women and 19 years for men, according to statistics from the Greater London Authority.
These inequalities have been exacerbated by the pandemic among people from black, Asian and ethnic minorities, the homeless and people with learning difficulties.
The report called on those responsible for the ICS to step up the collective measures observed during the pandemic to eliminate health inequalities. ICS will play a “crucial role” in linking the work of the boroughs with London initiatives and public health expertise.
Further recommendations are:
- Locally led responses to health inequalities should be coordinated by partnerships based in the London borough
- At the London level, partners need to re-examine which areas will benefit most from a coordinated response across the capital and update them in light of the impact of the pandemic
Become law
The government recently announced new plans to reform the NHS to provide more shared care and benefit from advances during the pandemic.
In some of the reforms, the ICS would be enshrined in law, with each area covered by a system in England. The proposals would make integrated care the standard and allow the NHS to use technology in modern ways to support staff and patient care, including improving the quality and availability of data, the DHSC said.
The rules for procurement and data exchange would also be relaxed in order to reduce the bureaucratic effort in the healthcare system.
The plans follow Health Secretary Matt Hancock’s “bureaucracy-busting mission,” which aims to improve the use of data within the NHS.
Digital Health Networks executives said the plans offer digital executives a “real opportunity” to shape the future of healthcare, while suppliers warned that interoperability should not come at the expense of “transparent” procurement.
