Professor Helen Stokes-Lampard
Chair, Academy of Medical Royal Colleges
The Covid-19 pandemic has put the NHS under the most extraordinary pressure in the last 18 months. We’ve all seen it and many of us have felt it day after day. Whether we are patients waiting for tests or treatments or we are NHS staff doing our utmost to deliver in difficult and distressing circumstances, it has not been easy and much of the time it has been incredibly tough. Further to that, we all know that it is not going to get easier any time soon. Resources are more in demand than ever, with extra space and time required for each patient to ensure their ongoing safety, further reducing NHS capacity.
This pressure is just one reason why I am proud to be part of the Evidence-based Interventions programme, which the Academy is now leading. For me, there has never been a more appropriate time to review the ineffective and inappropriate tests, treatments or procedures we had previously used in good faith. There is a wealth of high quality evidence available to help us define which these are and help shape our EBI guidelines so that clinicians can reduce their use and target them more appropriately. As healthcare professionals, we want to do the best we possibly can for our patients and use our resources as wisely as possible – the EBI programme makes that so much more straightforward.
The national NHS backlog of people needing tests or treatment is now in excess of 5 million, so it is essential that not only do we treat the most urgent cases first, but that we also focus resources on interventions that are known to be appropriate and effective. The NHS has, for the last year or so, been painstakingly working through waiting lists, checking that patients still need the treatment they were due to have. Teams of clinicians have also been using the EBI lists and associated guidance to ensure resources are used most effectively and treatment is appropriate – that means ensuring the right patient is receiving the right treatment at the right time, to optimally improve their health and wellbeing. Patients on waiting lists deserve to have investigations or treatments that will improve their situation, to offer them anything less is a disservice to them and waste of valuable time and resources.
We know this will take time to bed in with both patients and doctors, good news initiatives always do, but we’ve developed a digital tool that may help clinicians assess whether a chosen treatment fits with the EBI guidelines. Along with waiting list validation, this continued assessment of recommended treatments will focus our resources in areas with the most significant impact, helping the greatest number of patients in the most effective way.
Some say it will take years for the NHS to truly recover from the pandemic. Indeed I suspect that it may never go back to how things were, but EBI gives us a chance to ensure that we do take some good from the crisis we’ve all fought so hard to overcome.