Healthcare lessons from previous crises

At the start of 2020 I embarked on my Churchill Fellowship to research international advanced practice in physiotherapy. My investigations took me to Christchurch, New Zealand, where I spoke with clinicians and clinical leaders who lived and worked in healthcare through the most traumatic years of Christchurch’s recent past. 

The city of Christchurch has had its fair share of crises in the past decade, namely the earthquakes in 2011 and the terrorist attack in 2019. There are similarities between the effects of the disasters that Christchurch has experienced and the situation we find ourselves in during the Covid-19 pandemic. In any crisis there can be a huge loss of life and a high number of casualties. There are also difficulties in managing supplies and maintaining non-emergency services, along with dealing with the long-term impact that a crisis can have on the health system and society.

Emergency plans tend to lack foresight of long-term impacts, especially psychological impacts. In Christchurch they were dealing for years post-earthquake with its psychological and emotional effects, including grief, loss, fear, low confidence and lack of self-determination. There are similar mental health implications from Covid-19, including post-traumatic stress disorder (PTSD), anxiety and depression.

Although many health services are still dealing with the acute need of Covid-19 patients, we should be planning for the long term physical and mental recovery needs of our communities. In Christchurch, clinicians and leaders repeatedly highlighted some key principles which they saw as successful elements of their health system’s response. These included collective responsibility, collaborating with other services, and being citizen-focused.

At the NHS Trust I work for in Gloucestershire, we are collaborating closely with community and hospital teams to ensure people have access to recovery services. We are also involving our local citizens contributors by asking them what their communities and families need from us.

If you work in the NHS or public services, please keep dialogue open with your local citizens and colleagues across different organisations. Think about who you can be collaborating with in other organisations and in the communities you service. Collective responsibility and collaboration are a positive approach to changing services and will help us respond to the long term needs of our communities post Covid-19.