Challenges in Healthcare

We all know the challenges in healthcare that COVID-19 raised, in almost every industry and sector, globally. Many of which are still facing such challenges several years down the line.

COVID-19

The healthcare sector already faced enormous challenges in healthcare before the pandemic – longstanding financial pressures, a precarious and narrow provider market, limited choice and control for people in many areas, a struggle to scale innovation and engage community assets, an undervalued workforce and increasing workforce shortages. The crisis has magnified these issues and local authorities are taking a huge financial hit.

Despite that, social care has continued to function. Overall, people were not left without care, though waiting lists are now growing. Community mobilisation ensured people received vital food and medicine. Some providers responded flexibly to meet needs in creative and positive ways. The provision of care, however, came at a terrible cost for people living in care homes, their families and care workers. Those using and providing other forms of support also faced considerable challenges in healthcare. People missing out on healthcare may have reduced their independence or suffered damage to their mental health as a result. The same is true for the millions of people awaiting surgery and the estimated 1.9% of the population experiencing long COVID-19. The longer-term impacts of these on people’s needs and the workforce are still to be understood.

Things to consider

Healthcare officials and government bodies had to be quick to react and quickly develop strategies and tactics to put into action the expected surge in patients and also the potential risk to the healthcare workers themselves.

Communities rallied together and local authorities supported such organisations, helping those most vulnerable in their local areas. It became a time of community and bringing people together with their neighbours. There was a collaboration with local health partners to ensure the health and dedication of care staff, and unpaid carers were looked after properly and showed the resilience of individuals.

Prevention

Some local authorities have taken proactive steps to engage with people, develop innovative solutions or take positive measures to ensure social care providers can continue operating. Future planning, though, must be based on what people want. If it’s propping up a market that doesn’t give real choice, it’s time to think again. Plans must address the risk of future outbreaks and the multiplying impact of winter pressures, increasing needs, limited availability of some services and dire staff shortages to avoid what may be experienced by some who use social care as a ‘permanent lockdown’.

Care homes

Across the healthcare sector, there were already pre-existing problems before the pandemic and these are still felt in 2023. There is still a lack of funding across the board and many facilities and healthcare provisions are seriously underfunded and lacking basic equipment and facilities. Staff challenges in healthcare were a large part of the problem, staff were in some cases, unable to work due to their own risk to health or their families as these were the staff in the face of COVID-19 every day. Shortages due to staff falling ill due to the virus were a difficulty faced by all healthcare providers. Waiting times increased across all areas, and GPs, and hospitals were all affected by reduced staffing numbers. Care homes were particularly affected and are still recovering from the aftereffects of Covid-19.

• During the two peak periods of COVID-19, April to September 2020 and October 2020 to March 2021, 39,350 deaths in care homes were attributed to COVID-19.
• Around 40 per cent of all care homes reported an outbreak in the first four months of the pandemic.
• The transmission was accelerated by the nature of homes, residents with COVID-19 moving in, lack of testing and lack of PPE.
• Lack of specialist healthcare going into care homes has resulted in people suffering a range of health complications – not just COVID-19.
• Providers faced rising costs of more than 30 per cent higher than usual – largely due to PPE inflated costs, sick pay, retaining higher staffing ratios and backfilling with more expensive agency staff.
• Two-thirds of providers reported delays in receiving additional funding as this took time to pass through via local authorities.
• Residents – many of whom have dementia – experienced distress, confined to their rooms with no outside visitors.
• Poor or rushed assessments made it hard for staff to understand the needs of new residents.
• Since the start of the pandemic, occupancy levels in care homes have fallen from 86% to 76% in care homes with nursing and from 87% to 81% in residential care (August 2021).
• Staff vacancies in care homes present a big risk to viability rising from 6% in April 2021 to 11.5% in December 2021.
• New waves of COVID-19 have caused additional pressures. Lack of staff plus COVID-19-related worker absence and infection rates in homes, resulted in many care homes not accepting new referrals in December 2021. This has a significant impact on hospital discharge too.

What next?

From these challenges in healthcare that the services face, many things can be taken away from it and steps to be implemented going forward.

Knowing and understanding what works and what the public wants. People’s efforts must result in positive impacts on people. Working well together may show great endeavour, but if people themselves have little say, choice or control, then effort needs to be refocused. Numbers are important but it is outcomes and the impact as defined by people themselves that matter.

Increase choice and promote equality. Be clear about the purpose of support. How will it help people live in the way they want to?
Begin to scale things that are working well. Innovative and more personalised approaches, such as Shared Lives and community enterprises have delivered good outcomes throughout.

Are you finding the post-COVID world a difficult one in your role? Looking for a new role in healthcare? Chat with our team at Cucumber for more information.