Improving Health And Care Outcomes: Collaborating To A Better Normal

David Segal is a Manger at PPL. He leads PPL’s Integration, Partnerships and Primary Care practice. David is an expert in system change and integration, specifically in the use of co-production to improve outcomes for people and communities. David has been supporting health and care systems in England to tackle COVID-19 while working towards a “better normal”.

The COVID-19 pandemic has had an almost unimaginable impact on society and our communities.

It has placed incredible pressure on society’s support structures including those that are provided by health and care systems. The long-term impact of the pandemic will not be clear for a significant period of time, and it is essential that system partners and communities come together now to build a vision for the future.

Whatever happens, a return to normal is not possible for health and care systems.

Doing what they did before will not be an option. The “new normal” has become a buzzword across media reports, referring mainly to the constraints that all of us will experience as part of the ongoing and lengthy COVID-19 recovery process.

But alongside the devastating impact of COVID-19 on families, communities, our economy and our public services there are some new and positive realities.

Whether it’s the army of volunteers signing up nationally and locally, the mobilisation of communities to support those who are most vulnerable, or the extensive donations, COVID-19 has forced the creation of real and functioning community asset models, often operating in a way that could have only been aspirational a few months ago.

As a volunteer food courier supporting vulnerable people in my area, I have visited community centres I had never been to before, cycled down roads I had not been down before, and met people I would not have met otherwise.

This isn’t because of a dramatic shift in my world view or my sense of social responsibility, but is simply due to knowing that there is something I can do to help, and a set of very dedicated people using simple communication tools to make that happen.

Health and care organisations have also changed how they work to deal with the colossal task of tackling the pandemic.

In order to survive, organisations have had to come together, re-defining what system working and collaboration means, and in the process of collaboration crossing boundaries that had previously been impossible to break down.

My local authority colleagues describe the development of relationships with providers that are both supportive, pragmatic and honest (on both sides) and that would have been extremely unlikely in normal conditions. System processes have had to become adaptive, agile and innovative, finding new ways to tackle very new problems and old problems alike.

Working with health and social care partners we have witnessed positive changes in system:

• Effective community engagement: a public willingness to participate in their local community and an organic mobilisation of those people, moving beyond traditional models of volunteering.

• A focus on local needs: the ability to identify different needs and vulnerabilities in the local area and an active approach to shielding those people.

• Genuine commitment to agile change: the value of an experimental approach has been demonstrated in practice.

• A shared goal: the effectiveness of having one clear goal and mobilising multi-disciplinary working to achieve this.

• Data sharing and better use of data: especially in order to support early prevention.

• Personalised approaches: these challenge assumptions on how to support families e.g. providing flexibility in how families in hardship or crisis are supported.

• Use of technology to support people more efficiently: both in how we provide care but also how we communicate with each other.

• Different modes of leadership: adopting a more distributed model has been shown to be helpful, allowing creativity and innovation at all levels of an organisation.

And yet the road ahead will not be easy.

The “new normal” will be something that we will all have to endure, with the impact on some being much harder than on others. However, communities and local systems have shown that they can come together in ways that we did not think were possible to tackle these challenges.

If we can capture both the learning and spirit of this moment, there is a genuine opportunity to move to a “better normal” delivering improved health and care outcomes in the future.