Treading Gently

Samantha Horwill
December 21, 2020

The pandemic has driven rapid and often radical change in systems across the NHS, and in Wales this has been no different.

Although the switch to virtual working was something that I had been grappling with for years prior to the big shift in the spring of 2020. Being based in Mid Wales with team members in Cardiff and Brighton, I was accustomed to spending most of my days on back-to-back video conferences. In a way, suddenly my work was easier, as previously I was often the only one on Zoom, and this meant at best I was faced with a room full of people I couldn’t hear or see (and missed out on the communal chat and office cake); and at worse I was left waiting for what felt like hours while various technical difficulties were dealt with in a meeting room somewhere.

Now, everyone was on their own screen and we were all in the same virtual boat.

Similarly, for as long as I had been working in Wales, I had been asking the question “What conditions need to be present for people in primary care to choose to collaborate?”. The pandemic has shown that necessity pushes us to consider doing things in ways we would have dismissed or discounted in normal times.

When the reality of delivering care in a pandemic started to become clearer, one of the challenges faced by the NHS was workforce planning and logistics.

I could see how Health Boards were grappling with ways to ensure existing hospitals and new field hospitals were suitably staffed. This was (and continues to be) a huge undertaking, however there was an ability to “switch off” new demand in some parts of the secondary care system, to ease the pressure on hospital teams operating under extremely difficult conditions.

The ability to ‘manage’ demand in primary care is much more difficult. Primary care was open, and having to redesign service models in unprecedented ways. Some groups of practices were looking to respond to the pandemic by leaning into established or new collaborative partnerships, and this way of working could be helped by having an easy way of flexing resources across settings to meet the demand where it was needed.

Yma, in partnership with Here, offered the GP Networks Workforce tool to the NHS Wales for free during the first wave. The tool is designed to enable a mixed workforce to be scheduled across an unlimited number of locations, auto-matching practitioner availability to rota requirements, handling all logic and financial calculations, where needed.

Pen Y Bont Health took up our offer.

I had supported the delivery of the Practice Unbound Workflow Network programme to the federation earlier in the year and I remember being inspired by their leadership and energy for innovation. It was a privilege to be invited in again, this time to work with the practice managers from the five practices to see how the Workforce tool could be used as part of their COVID preparations. Their vision was create the infrastructure that would enable them to shift from business as usual to a hot, cold and administration hubs should this be needed. We supported the practices to ensure the system was fully set up in a matters of weeks and fortunately there was no need to implement the approach during the first wave as capacity within the members practices was maintained despite the added pressures.

The federation has since decided to invest in ongoing access to this tool for a year, supporting their ability to mobilise themselves as a group of practices should the need arise in future times of excess demand and reduced capacity.

I made a choice quite early on in the pandemic to tread gently, to find ways to help that were small and valued. I am so happy that we could play some part in supporting primary care in Wales to respond to the challenges of the pandemic.

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