NICE’s support for rebuilding capacity in non-COVID health services

Director of our Centre for Guidelines, Paul Chrisp, discusses how NICE can help the NHS and wider care sector restore services most affected by the COVID-19 pandemic

Dr Paul Chrisp

When the COVID-19 pandemic hit the UK’s shores earlier this year, the NHS responded quickly, diverting and devoting resources to make sure patients facing this new and unknown pathogen received the best possible care.

But in doing so, many other health services were reduced or paused. Far fewer people consulted their family doctor or used urgent and emergency care services in the spring and summer. Cancer screening programmes were suspended, and the number of people coming forward with suspected cancer symptoms fell dramatically too. 

Now the pressure is on to accelerate a return to near-normal levels of non-COVID service provision, and to encourage people to re-engage with health services in a safe and appropriate way. And now is the time to do it: while COVID hospitalisation numbers remain low – despite a significant uptick in the number of diagnoses in recent days – and before winter pressures come into play.

NHS England and NHS Improvement has urged clinical teams, providers and CCGs to redouble their focus on the needs of non-COVID patients in certain key areas including cancer, mental health, general practice and other community services.   

This is where NICE comes in. We have a large suite of relevant guidance products that will prove extremely useful as the system rises to the challenge of restoring priority non-COVID services. 

GPs, for example, might find it useful to refer to our cancer recognition and referral guideline, which includes recommendations on the symptoms that warrant investigation and referral for suspected cancer.

GPs also play a vital role in preventing and detecting long term conditions like cardiovascular disease, hypertension, diabetes and obesity in those at greatest risk of poor health outcomes.   

In addition, our guidance on supporting people with learning disabilities includes recommendations on offering annual health checks, which are an NHS England priority for the autumn. Similarly, GPs have been urged to begin a programme of structured medication reviews for care home residents – our guideline on managing medicines in care homes outlines what the reviews should cover.

Immunisations are, of course, a key part of preventing ill health. There is a backlog of routine childhood vaccinations caused by COVID-19, and priority groups must be encouraged to have their flu jab this winter. Our immunisation guidelines contain recommendations that can help raise awareness among at-risk groups.

Finally, technology has an important part to play in the UK’s response to the pandemic and NICE is ideally placed to recommend innovative solutions to the challenges we’re facing. For example, we’ve carried out assessments of digital therapies for depression, anxiety and other common mental health conditions treated by IAPT services. The therapies we’ve reviewed support remote, socially-distanced care and allow therapists to manage bigger caseloads.

And we’ve produced innovation briefings on technologies to support self-management of chronic COPD and to manage cystic fibrosis during the pandemic.

For specific advice on how NICE guidance can support service restoration in your local area, contact your local NICE field team representative.

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