Recovery, Renewal, Resilience

A recent UN policy brief identified the significant gap in health coverage as a core reason for COVID-19 having such devastating impacts on people's lives. Universal health coverages means that all people and communities can access the health services that they need, with three key priorities; "equity in access, sufficient quality and no undue financial risk". Consider:

• Establish universal provision for "COVID-19 testing, isolating, contact tracing" and treatment
• Ensure protection of essential health services during the critical phases of the pandemic (e.g. services for sexual and reproductive health)
• Through international partnerships, ensure future COVID-19 vaccines are a "global public good with equitable access for everyone, everywhere"
• Protect and invest in core health systems functions that are critical to protecting and promoting health and well-being, known as "Common goods for health"
• Suspend user fees for COVID-19 and other essential health care; reduce financial barriers to service use
• Strengthen local, national and global pandemic preparedness and aim for healthy societies for the future through a whole-of-society approach

Consider:

• That systems are not always focused on all the needs of people but rather on specific health conditions. Support for people and their overall health is vital rather than the restoration of specific services.
• That there will be challenges about aligning all the different health and care activities that are required in each place. Central government organisation may mean a lack of alignment at a place level depending on the department. For example, health systems, local resilience forums and environmental infrastructure are all different in England. We have learned that effective partnerships need to be developed 'bottom up' at place level, and many of these have worked well during COVID-19 response.
• Partnerships between organisations and between and in communities have worked well because of relaxation of information governance, financial constraints, central guidance and regulation. Careful consideration must be given to the extent to which these are reinstated and the timing of this.
• New processes that have been established during response, and the extent to which they can and should be continued. IN particular, remote consultations between health care providers, both in hospital and primary care, currently comprise the vast majority of interaction. Reverting to the pre-COVID method of primarily face to face will have both positive and negative consequences, which will differ across society. Careful thought needs to be given to the equality impact of retaining these changes.
• The power of each part of the health system - including that of the large health service providers (hospitals) but also the power of the people who live in each place. The longer-term consequences of e.g. establishing COVID-free (cold) hospital sties must be considered from a population perspective.

TMB Issue 10 brings together the reflections of our learning from the first 10 weeks of gathering lessons on recovery and renewal from COVID-19. Follow the source link below to read all of the reflections from our team (p.9-15).