Reflections on IMPOWER’s Virtual Care Webinar

At IMPOWER we are always thinking with our clients about how to act innovatively to improve outcomes. The pandemic has forced everyone in public services to innovate at pace – to take positive risks with new solutions in order to secure the outcomes that matter.

Virtual care is a good example of this, and we recently held an online Q&A to reflect on recent developments in the UK and Australia. In both countries, system leaders responded to the Covid outbreak by rolling out virtual care at an unprecedented pace and scale.

We were very fortunate to have three expert speakers:

• Miranda Shaw (General Manager, Royal Prince Alfred Virtual Hospital) who led the set-up of a virtual hospital in New South Wales, Australia
• John Skidmore (Director of Adults, Health and Customer Services, East Riding of Yorkshire Council) who led a system-wide response to developing virtual care support tools for care homes and their residents
• Jonathan Steel (GP, Social Care Fellow for the Royal College of Physicians, and Director at Clinical Panel) providing expert reflections from the UK and internationally

In the Q&A, both Miranda and John reflected that the outbreak of Covid had accelerated conversations about virtual care that had been going on for some time. Virtual and digitally-supported health and social care were already in use, but the pandemic changed the risk profile of service delivery almost overnight. As a result, virtual tools suddenly became pragmatic enablers of care delivery. An example of the pace of change is that the Royal Prince Alfred Virtual Hospital went from having 69 patients at launch in February 2020 to supporting over 2,000 patients just two months later.

It was also striking that in both Australia and the UK there had been a strong emphasis on monitoring impact. In the context of a rapidly evolving situation, it was important to do this – recognising that impact should be considered from care recipient and provider perspectives – both in terms of outcomes and experience. In both cases impact measurements were data driven, but also focused on qualitative indicators of how users experienced this new model of care. John’s teams in East Riding started daily conference calls with all their care homes to make sure the virtual care was accessible and supportive.

Some of the other key discussion points included:

• The need to ensure equality, especially for those with low digital literacy or no internet access
• How consumer involvement can support developing better models of care and increased person centricity
• Workforce impact – the fact that we can have the best technology in the world, but genuinely shifting the way things are done must be underpinned by behavioural change
• Considerations of data use, including interoperability (connection with other data sets), longitudinal and predictive analytics – moving from lag to lead indicators and responding accordingly
• Whole ‘system of system’ approaches – recognising that support to keep people well and at home requires outcomes-based and multi-disciplinary interventions

Looking to the future, the challenge is to build on the learning from the UK and Australian examples, and others like them. The pandemic accelerated change, but it is now down to all of us to continue this spirit of innovation and grow the adoption of virtual health and social care. Jonathan asked us all to be prepared for failures as we increase virtual care, and to use failure as an opportunity to learn. He also pointed out that the evidence base for virtual care is growing – but is not complete yet. We need to support systems to use virtual care and learn about it in real time.

At IMPOWER we are inspired by how health and care systems have stood up to the challenge of the moment and embraced virtual care in the face of the pandemic. Now is the time to embrace and expand upon what has been achieved over the last year.