Agility is the key to surviving the crisis

Mr Alan Farthing

As the profession faces ongoing challenges over winter, how can consultants plan strategically for their practice while adapting quickly as the situation unfolds?

Mr Alan Farthing, director of clinical strategy at King Edward VII’s Hospital, gives Independent Practitioner Today his views.

When a global pandemic such as Covid-19 arrives, there are no rules or previous randomised trials. There is no textbook to refer to nor tutorials from a respected senior figure. 

King Edward VII Hospital in Beaumont Street, Marylebone, London

The situation is unique and the medical profession with its associated support teams is at the head.

Clinicians are well versed in the art of making rapid and meaningful decisions. An intraoperative change of plan may occasionally make the difference between life and death and will frequently increase or decrease the risk of complications. 

Clear and logical thinking on those occasions will determine the quality of care that patients receive. 

Decisive thinking

Despite the uncertainties of the pandemic, the same clinical principles still exist, whereby clear, logical and decisive thinking will make all the difference to a patient’s outcome – and a consultant’s practice. 

‘Good things come to those who wait, but only what is left over from those who hustle’, said Abraham Lincoln.

This was certainly the case back in March. King Edward VII’s Hospital is an independent hospital in central London and we were able to be agile, responsive, decisive and able to hustle when Covid struck.

Consultants working across private and NHS practices are uniquely positioned to see what services were needed in this situation. We were able to act, stepping up to support the emergency response and providing priority care to patients according to need. 

We did not wait to be told what was required, but simply got on with the job. 

The first plan on how we could play a role in this national crisis was put forward on Thursday morning; that plan was activated at 7pm on the Friday and at 9am on the Monday – the day the contract with the NHS commenced – there were NHS patients anaes­thetised in every theatre commencing their urgent cancer treatment. 

As the needs changed over the coming weeks with the sector being centrally organised, the hospital changed again to provide care for patients with urgent benign conditions.

Moving forwards, the private sector will need to provide care for more self-funding patients. 

The number of people waiting more than a year for their NHS treatment has risen from 400 to 32,000 in London alone over these last few months and some will choose to use private healthcare facilities rather than wait.  

Harnessing technology 

Many aspects of life have been fast-forwarded by years in this crisis. Changes that were due to be trialled have already become the standard and practices that were thinking about the future have rapidly progressed. 

Greater utilisation of tele­medicine, for example, has been a great success both in terms of Covid-safety, but also in terms of convenience for patients and time efficiency for clinicians.

Working with a partner who similarly embraces new technology to adapt to the current situation should also be a key consideration for those looking to expand their services. 

Collaboration is the future 

A time of national crisis has taught us that we are better working together than as individuals and that adaptable and forward-thinking organisations, where actions speak louder than words, will thrive. 

Perhaps more than ever, it has emphasised that the clear, logical and agile thinking that makes a clinician good at managing one patient is also necessary when delivering healthcare to large groups of patients. 

As a consultant, a major component in both being able to plan strategically and adapt quickly is by establishing a collaborative relationship with a private healthcare provider. 

One that treats doctors as individuals, not numbers, that encourages and listens to consultants’ feedback and adapts as their practices adapt – improving their own professional development and the care they can offer patients.

We all hope that 2020 will not be repeated and that the lessons learned from this crisis will help us be more resilient as a society. Similarly, those of us who are charged with providing good healthcare have learned that working together within those agile, decisive and responsive organisations will find their services are required more than ever before. 

As usual, those providing the highest quality of care will be most in demand.