Open access article
The Royal Pharmaceutical Society has made this article free to access in order to help healthcare professionals stay informed about an issue of national importance.
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It is difficult to comprehend quite how different life will be in a post-COVID-19 world. Certainly for the foreseeable future, there will be considerable changes in how we all work and interact with others.
However, for the NHS, the landscape already looks very different. More than 2 million non-urgent operations have been cancelled in an attempt to release hospital beds and staff have been redeployed to other areas of the service to focus on the care of patients who have COVID-19.
Inevitably, there will be a cost to all of this; there have already been warnings about the lack of treatment for those with heart conditions and cancer, but there are aspects of the pandemic response that will be important to preserve.
For example, clinical staff in hospitals have had to work differently to manage the crisis. Most notably, the leadership shown by clinical staff — including pharmacy teams — pulling together and working at speed to build emergency field hospitals to house COVID-19 patients, has been remarkable (see Feature).
This flexible, multidisciplinary approach must continue. Breaking down barriers to change has long been a problem in the NHS, but this pandemic has shown that it is possible if healthcare professionals are empowered to make decisions in the best interests of patients.
Much of what was deemed “essential” before the pandemic, will suddenly not be
General practice has also experienced a minor revolution. Routine work has moved rapidly to embrace remote consultations, with the proportion of telephone appointments increasing by over 133% in March 2020, compared with the month before.
Patients are also becoming more familiar with consulting digital sources of help. NHS App usage has increased dramatically, with 119,512 new registrations in March 2020— an increase of 111% from the previous month. The number of repeat prescription requests rose by 97% and the number of patient record views increased by 62% during the same period.
There has been a welcome reset in the public perception of community pharmacy’s role at the forefront of the NHS. Indeed, with secondary care appointments being postponed and GP surgeries in lockdown, community pharmacy has been the only accessible face of the NHS on the high street.
However, as with so many other areas of society during this pandemic, COVID-19 has highlighted and exacerbated many of the structural problems already there. In England, there has been a particular reluctance to commit additional funding, new clinical services have been put on hold and there has been a stark lack of importance placed on supplying personal protective equipment to enable the face-to-face interactions that community pharmacies have with their patients.
Pharmacy will need to change in this new world. Patients will expect more immediate and increasingly digital, interactions with NHS services, with face covering and social distancing becoming an everyday part of life.
The NHS will also change. Much of what was deemed “essential” before the pandemic will suddenly not be. Test and trace, immunity testing and/or vaccination for COVID-19 will be a major undertaking for public health. Much more care is likely to be permanently shifted to the community, rather than in hospital. Social care, in particular, is likely to face major reform and will require much greater support from “traditional” NHS services to care for older people and the most vulnerable.
The vulnerabilities exposed by the pandemic need urgent attention. There is no going back to where we were before. Pharmacy has a lot to offer, but the sector must quickly begin planning for the opportunities and risks that a post-COVID-19 world presents, and prepare to adapt accordingly.