At last, we may be able to plan for a post-pandemic era, albeit with a watchful eye for the re-emergence of mutated versions of SARS-CoV-2 now and in the years to come, with particular vigilance during the winter months, when coronaviruses spread more easily. To date, the mass vaccination programme has demonstrated what can be achieved with good information about the benefits of vaccination and efficient scheduling of appointments with outreach vaccination arrangements for the housebound. Retaining high COVID-19 vaccination uptake across the whole population, beyond the nine priority groups and among the vaccine hesitant, will require continued effort as the UK returns to normality, with increased social distractions and lower risk perceptions of COVID-19. Over the years, much has been learnt from influenza vaccine hesitancy (Larson et al, 2014), and it will be especially important to maintain consistent public health messaging about the personal and societal value of COVID-19 and influenza vaccinations and other protective measures.
The British Geriatrics Society (BGS) (2020) has summarised 10 beneficial healthcare innovations that were introduced during the COVID-19 pandemic, which its members believe should be retained: (1) proactive anticipatory care for those with frailty (identified using validated tools and professional judgement); (2) urgent primary care response, which enables people to remain at home; (3) specialist-led assessment and treatment in the home, as delivered by Hospital at Home schemes; (4) coordinated support for care homes, including nursing support; (5) person-centred advance care planning (ACP); (6) age-attuned acute care to minimise delirium and its consequences; (7) safe, effective and timely transfers of care with avoidance of re-admissions; (8) optimising rehabilitation and recovery to minimise long-term disability; (9) virtual clinics and visits to enable consultations in the home; and (10) digitally enabled care characterised by remote and mobile health monitoring. The report provides case studies of the innovations, together with reflections on the benefits of the innovations and BGS resources. The BGS argues that the pandemic has provided the impetus to improve care quality, resulting in unimaginable service transformation within 6 months with substantial cost savings through avoidance of unnecessary outpatient appointments (BGS, 2020).
Perceptions of digital health technologies have changed over the pandemic because of their rapid deployment as health services found effective means of offering ongoing care (Patient Coalition for AI, Data and Digital Tech in Health (Patient Coalition), 2021). In November 2020, an online survey (n=120) confirmed the findings of others (Patients Association, 2020), namely, that the uptake of digital health technology varies and there is ambivalence about whether its use improves care experiences. Three-quarters of the sample supported its use in the NHS, but the participants had concerns about data collection and sharing, its accessibility and reinforcement of the existing digital divide, and they wanted the choice to use technology rather than technology, replacing clinicians. Case studies illustrate good practice, namely, digital health helping to meet patient needs; ensuring that the technology is easy to use; recognition that different solutions rather than ‘one-size-fits all’ ones may enable access; and digital health strengthening, rather than undermining patient-clinician relationships. A consistent thread in the Patient Coalition (2021) report was the importance of involving patients throughout service transformation, including in the policy-making process.
‘… it will be especially important to maintain consistent public health messaging about the personal and societal value of COVID-19 and influenza vaccinations and other protective measures'.