Covid-19 and its impact on health and care: a view from Wales

A guest blog from Dr Angela Parry PhD; PFHEA; RN, Interim Director of Nursing, Health Education and Improvement Wales (HEIW). This is the second in our series of guest blogs looking at the impact of the Coronvirus pandemic across the four nations of the UK.

How has the pandemic affected education and training?

Our healthcare workforce did not falter to meet the healthcare needs of the people of Wales during the recent pandemic.

It is no secret that here in Wales we rely heavily on a locally grown workforce drawn in high numbers from the communities that they serve. This seemed to reinforce the passion to contribute and to get this right for the 3.2 million people of Wales.

Working within the regulatory emergency standards programme, plans were adjusted and risk assessments were completed by students and trainees, enabling all those who stepped forward to participate in health and social care to do so whilst keeping themselves and their patients safe.

Inevitably in this fast-paced situation, with restrictions on movement and recalibrated healthcare priorities, the consequence is minor delays and disruption to some education courses to student recruitment processes and to assessments.

However, the close working partnership between Welsh Government and HEIW, together with the Health Boards, Social Care and education providers enabled changes to be achieved through clear messaging to students and trainees alongside the Once for Wales principles which underpins many of our initiatives in usual times.

Has there been a greater impact on particular professions or areas of patient care?

Whilst most professions would probably identify with the impact on them being greatest, it is likely that the students and trainees in their final few months of education felt this most keenly.

The emergency regulatory standards resulted in students undertaking roles more closely aligned to that of a registrant several months prior to expecting that to happen. The support of supervisors and colleagues was essential in enabling this transition and providing support during these challenging times. Furthermore, as many of the workforce in Wales are local, the support of their family and local community in enabling them to step up in this way merits acknowledgement.

Opportunities to work in chosen fields on registering has also needed to be rethought with many routine services put on hold to focus on patients who were acutely unwell or requiring support out of the hospital environment in primary and social care.

The pandemic also provided the opportunity for some professions to develop in new and emerging ways to keep people out of hospital, for example in Optometry, and to interface with other disciplines in ways that previously had been considered but not necessarily actioned. The pandemic has therefore provided an impetus to change within and across professions to ensure that patient care remained of the highest standard.

What have been the challenges, and where have opportunities for positive change arisen?

Wales has seven Health Boards with many education programmes offered on a Once for Wales approach. Effective working across Wales is therefore critical to business as usual, not solely business during pandemic times.

The numbers of healthcare professional students and trainee doctors continues to grow year-on-year in Wales in line with initiatives by both the Welsh Government and Health Education and Improvement Wales to encourage aspiring health professionals to come to Wales alongside a locally grown workforce.

The greatest challenge remains around placement capacity to ensure students on registration have the necessary skills and competence to perform as high-quality registrants.

A further challenge was to make decisions that are correct for the people of Wales, and the students and trainees of Wales balancing the needs of the current cohort of completing students and trainees, whilst mindful of the students following behind to ensure that workforce pipeline was not disrupted.

How do you think things will be different in the ‘new normal’ or a post-Covid health system?

To work in healthcare, be involved in the care of people either directly or indirectly – at often either the best or worse times of their lives – is a privilege. Whilst this has not changed, the routes to achieving this safely and sustainably may have changed forever.

Covid-19 has revealed the need for a responsive and agile regulatory framework – one that supports a workforce able to work across disciplines and sectors. A regulatory approach that delivers the workforce we need, and not the workforce we are given.

We need to modernise a number of processes. For example, opportunities to undertake recruitment to professional courses virtually rather than face-to-face provides additional benefits of a greener and more sustainable impact on the environment.

Furthermore, there is an opportunity to deliver teaching and assessment differently, increasing the use of digital and simulated methods involving more multi-professional opportunities.

Finally, the pandemic has led to greater recognition of, and interest in, the varied careers available in healthcare resulting in a resurgence of interest and hopefully a buoyant recruitment period.

Read our guest blog in this series from Danny Mortimer, Chief Executive of NHS Confederation who writes about how The Covid-19 crisis presents challenge and opportunity for health and care in England. 

Find out more about our approach to working during Covid-19 here.

Notes to editors 

Health Education and Improvement Wales (HEIW) is a special health authority within NHS Wales. Sitting alongside health boards and trusts, HEIW has a leading role in the education, training, development, and shaping of the healthcare workforce in Wales. Its key functions include: education and training, workforce development and modernisation, leadership development, strategic workforce planning, workforce intelligence, careers, and widening access.