COVID-19 Should Change Healthcare Planning Forever. It Will Require Vision and Leadership

The COVID-19 pandemic has disrupted healthcare around the world on a scale not seen since the Second World War.

With certain services such as intensive and acute hospital units overwhelmed by demand, widespread suspension of elective care, a drive to keep patients away from clinics and walk-in centers to prevent transmission and staffing and resources stretched to their limits and beyond, it is fair to say that healthcare delivery already looks very different now to what it did just 18 months ago.

Within this cycle of rapid change, there have been successes and failures. Where some services have adapted to the ‘new normal’ and find themselves operating on solid foundations still, others are close to crisis point, facing a toxic cocktail of spiraling costs, exhausted resources and mammoth backlogs in patient delivery it could take years to work through.

What is the difference between those that have adapted successfully and those that have not? When we look at the shared characteristics of services that have been able to pivot, it is clear that agility is key. It is the providers that have been able to reimagine patient flows and use of space, adopt digital telehealth solutions quickly, redeploy and retrain staff and more that have negotiated the challenges better than others.

Agility is not something that just happens in healthcare delivery. Like everything else, it has to be planned for as part of the strategic fabric. By and large, prior to COVID, healthcare planning was not designed with agility in mind. It has taken real vision and dedication on the part of the leaders who have introduced agile thinking into their organizations through this crisis.

Building resilience into healthcare systems

As Deloitte puts it, most healthcare systems around the globe were not set up to handle such an unpredictable, disruptive event as a global pandemic because organizational and operational priorities lay elsewhere.

For example, in recent decades, the majority of healthcare spending has gone on treating chronic non-communicable diseases rather than communicable diseases. Prevention programs, which in theory might have halted the spread of COVID-19 before it could do such enormous damage, have also been a low priority. As recently as 2015, prevention accounted for less than 3% of healthcare spending in OECD countries. Of this amount, immunization and screening received less than 10% each.

Deloitte therefore rightly asks if, in the wake of the pandemic, we will see a notable shift in healthcare spending towards communicable disease and prevention. But it also asks if we will see other systemic changes — will organizational infrastructures be designed to be more flexible to make it easier to reallocate resources as and when required? Will healthcare worker skillsets change to make them more adaptable to different requirements? Will we see a reversal in the trend towards centralization of healthcare planning to allow for more rapid, agile decision-making at a local level?

All of the above would put healthcare services in a better position to deal with another event like the current pandemic. The UK-based King’s Fund, for example, contrasts the success of that country’s highly centralized vaccine rollout program with the expensive failure of its test and trace scheme, which controversially sidelined existing local contact tracing apparatus in favor of a national, government-led outsourcing program.

The King’s Fund therefore speaks of the “need to balance central control with resources, autonomy and support for local leaders”, and argues that many of the success stories in the UK’s pandemic response have been achieved by new partnerships created across the spectrum of service providers working at a local level, allowing them to adapt more swiftly to needs on the ground.

KPMG’s five-step plan for resilient health service recovery is threaded with calls for more flexible thinking and planning. It calls explicitly for the creation of an ‘agile workforce’, characterized by the return of ‘generalist’ practitioners who are better suited to rapid redeployment than today’s highly compartmentalized specialists, and for a “re-thinking [of] staffing models and deployment according to tasks and competencies rather than roles and job titles.”

Elsewhere, like the King’s Fund, KPMG argues that cross-provider integration and coordinated planning should be at the heart of post-COVID care models, which it sees as key to tackling the health inequalities that have been so cruelly exposed by the pandemic.

And on the topic of operational resilience, it states explicitly that “a shift away from globalism will drive more organizations to explore localizing their supply chains for critical supplies,” with a new data-driven health economy created by wider adoption of digitized delivery solutions opening the door to more efficient and dynamic resourcing.

Strong leadership is needed to drive change

All of these points require a considerable shift in mindset away from what has been the established norm in healthcare planning. This is where the need for vision and leadership comes in.

KPMG also touches on how the pandemic has exposed a drastic need for improved continuity planning across healthcare. This is because the standard model is to plan for specific, predictable incidents, and draw up regimented plans for each scenario.

The problem with this approach is that pandemics and other major disruptive events are by their nature unpredictable. Instead of planning specific contingencies for specific situations, COVID has highlighted the critical need for planning to embrace the unpredictable.

Decentralized decision-making, a workforce with more flexible skillsets, the creation of stronger cross-provider partnerships and embracing technology all lay the foundations. But the key ingredient that ties them all together is capable leadership.

Healthcare leaders have a critical role to play in forging the new partnerships, making the infrastructure changes, formulating the investment strategies and implementing the changes in workforce organization and skills that will achieve KPMG’s vision of a resilient recovery. Their communication and motivational skills will be key to guiding already exhausted and over-stretched staff through a period of major transition, selling the vision of better times to come.

On the positive side for healthcare leaders, the pandemic has swept away many of the obstacles that previously stood in the way of achieving such far-reaching changes. Established norms in everything from service delivery to procurement have been sidelined, bureaucratic structures have been abandoned, innovation and agile thinking have come to the fore.

This is the time for healthcare leaders to grasp the opportunity with both hands, and use it to forge lasting transformations in healthcare delivery that will benefit society for decades to come.