North London Partners in health and care

How we are planning for the second phase of NCL’s Covid response


How we are planning for the second phase of NCL’s Covid response

The numbers of patients requiring specialist care for Covid-related illness and presenting to services with suspected Covid symptoms are gradually reducing, but we expect to be managing Covid related illness in NCL for at least the next 12-15 months. We also need remain prepared as we may experience further peaks in demand for services.

In the second phase of our Covid response, we are planning together the best way to deliver health and care services to residents, and keeping resident, patient and staff safety at the forefront of everything we do. This is an opportunity to learn and benefit from new ways of working that have improved services, so we will not just return to past ways of working.

We have received national guidance from the NHS England to help us plan our way forward. Decisions will be made in the coming weeks about how we safely provide access to a more comprehensive range of services than has been possible since the start of the pandemic. We need to ensure this is done in a safe way, meeting the necessary infection control standards.

This is also a time to think about how we can work differently to provide health and care services safely for both Covid and non-Covid patients, for both urgent and planned care in the short, medium and longer terms. We also need to ensure that all staff can feel safe doing their jobs and that they have access to the right equipment and testing.

Continuing to respond as a system

Out of necessity in recent weeks, North Central London’s health and care services have been provided as a system – with health and care organisations working collectively to focus on the needs of patients and residents rather than as separate organisations. We will be planning our longer term response as a system, building on the fantastic collaborative effort to date. We will also ensure that our plans relate appropriately to the rest of London.

The system of working together more closely between health service and local authority institutions is north central London’s “Integrated Care System”. We will build on the significant amount of Integrated Care System (ICS) thinking in 2019/20 to develop the NCL response to the NHS Long Term Plan. Our system includes GPs, NHS acute, community and mental health trusts, public health and social care in local authorities across Barnet, Camden, Enfield, Haringey and Islington.

NCL’s approach to delivering health and care

We will plan care around patient pathways, thinking from end to end so primary care, community, mental health and hospitals work together to meet the needs of residents.

We will need to be flexible so that we can adjust our services depending on the different peaks and troughs of demand.  We need to be able to run urgent and planned care in parallel, with the ability to respond to another surge of Covid patients if necessary.

We are going to separate, as much as possible, the facilities where we care for patients with Covid, or who may have symptoms of Covid, and patients being treated for other urgent or planned health needs. This is so we can treat patients for Covid and non-Covid related care, and manage the risk of infection. This means services may be temporarily delivered in different locations.

How we’ll make decisions

We are working together to plan for different scenarios and agree the best way to move forward. We will make decisions based on data, the needs of residents and patients and ethical considerations and principles. We will provide fair and equal access to services for all residents, particularly for those at risk of health inequalities.

We will need to plan carefully how we arrange and deliver services, using the resources we have (including workforce, medicines, facilities, beds and equipment, supplies of PPE, testing facilities, diagnostic capacity), to meet the urgent needs of residents, making sure we can manage Covid and non-Covid related illness, urgent and planned care, safely.

Some of the new ways of working have been really successful and we want to benefit from what we have learnt during the pandemic as we plan for NCL’s future.

Involving our partners, stakeholders and residents

We are working with clinical advisers, frontline clinicians, colleagues across London and partners to plan the best ways to involve residents in our decision-making.

We want to make sure that the needs of residents are central to our plans and we use insight and themes raised at previous engagement activity about what matters to residents.

Recovery will take some time

We need to be clear and honest it will take time to get all services running. This may mean patients with a non-urgent condition could have to wait longer than usual. We are doing all we can to ensure NCL residents have the care they need in a timely and sustainable way.

We are using all the tools at our disposal, including digital technology, our specialist centres, workforce, including returners, and collaborative working with colleagues across London.

Next steps

NHS England have requested that we submit preliminary plans for the next phase of our response by 11 May. This will be a high level plan and there will still be discussion to be had with stakeholders and decisions to be made about how we implement our ambitions. We will continue to keep our partners and stakeholders informed and involved in these discussions.