Coronavirus is the gravest global health emergency for a century but the NHS, and its brilliant staff, have responded magnificently to the greatest challenge in its history. Staff – present, past and future – have had to come together as never before, supported by volunteers and the public. I have been immensely proud of the work done across the health and care system to meet the demands of the first peak of the pandemic while maintaining essential services.

On January 30, NHS England and NHS Improvement declared a level four incident in response to the coronavirus outbreak in China. Since then teams across the country have worked tirelessly to redesign services, transforming areas used for elective operations into ICUs, transferring a huge proportion of our face-to-face consultations to telephone or video and building seven Nightingale hospitals from scratch. It worked. While many people have, sadly, lost their lives, we did not see the scenes from Italy and elsewhere that so shocked us all of health systems being overwhelmed. It is now as great a challenge to restore and recover service delivery in a world with COVID-19.

One of the key elements of meeting the challenges of the pandemic was innovating at pace and working differently. Time and time again the NHS has demonstrated its ability to do this, from Leicestershire Partnership NHS Trust who set up a mental health urgent care hub for patients in crisis to the clinical staff to the engineers and physicists at Leeds Teaching Hospitals Trust who have begun to convert sleep apnoea machines into ventilators to treat COVID-19 patients. The NHS has shown creativity, commitment and determination in its approach.

We have also seen brilliant examples of collaborative working, without which we could not have met the challenges of the pandemic. Some of this was between NHS organisations, especially in ICSs and STPs. Much of it was also between NHS providers and local partners, such as local authorities and the voluntary sector.

Not all the change we have seen has been about technology, much of it has been about working more flexibly. As we see from the example at Countess of Chester Hospital NHS Foundation Trust this has required staff to retrain at pace to meet the scale of demand from COVID-19. This has often involved a blurring of traditional role boundaries and testing what different clinical professionals could contribute.

That didn’t happen because it was centrally mandated. It happened because professionals in NHS organisations did the right thing to best meet the challenges of the national emergency.

Some of the innovation we have seen is a rapid acceleration of changes we had already intended as part of the long term plan. There have been plans to use telephone and video for remote consultations for more than twenty years. This year the NHS moved very quickly to using these technologies for appointments. Remote consultation will not be right in all circumstances, but we must retain the benefits we and patients have realised from it.

Meeting the challenges of COVID-19 has come at great cost to the country. Many, including NHS staff, have lost their lives. NHS staff have given their all, sometimes at a cost to them and their families. A small ray of light in this otherwise dark time has been the flourishing and sharing of new ways of working.

As this report illustrates, many of the examples we have seen of all these types of innovations have come from NHS providers. It is to the credit of trust leaders that they fostered an environment in which that could happen and supported their staff in making the changes quickly.

We need to find ways to not only keep the changes that have helped us to care for patients safely, but to keep the focus on doing the right thing that enabled the change to happen at scale and pace and to see collaboration within and across organisations in a way that would almost have been unimaginable before.

To have come so far in such a short space of time is something to be proud of – thank you to everyone who has played a part in making this possible.​


Amanda Pritchard

Chief operating officer,  NHS England and NHS Improvement