Building health and care system resilience and recovery

Niamh Lennox-Chhugani, Edelweiss Aldasoro and Alejandro Gil Salmeron

In April 2020, one month after many countries across the world went into lockdown and health and care systems in many countries were dealing with the consequences of the pandemic, the International Foundation for Integrated Care launched a webinar series over five months. We convened integrated care practitioners from across the world to share their immediate experience of coping with this challenge and the effect it was having on care and outcomes.

Over two years have elapsed since our last webinar in that series and the World Health Organization (WHO) published its report “World Health Statistics 2022: Monitoring health for the SDGs” in May 2022. This report is WHO’s annual compilation of the most recent available data on health and health-related indicators for its 194 Member States, featuring the latest data for indicators from the Sustainable Development Goals (SDGs). And it makes for sobering reading.

The report highlights that continuity of care has been severely disrupted in every country providing data, with the biggest impact being felt in low income countries. In high and middle income countries, the distribution of impact has been most felt by people living in poverty, people living with long term conditions and older people. Reduced access to essential services during the pandemic has effected these populations more than others. Some of the data contained in the report was collected in 2020, some even earlier, so it difficult to draw definitive conclusions, however there are some early indicators from the third round of the WHO Global Pulse Survey conducted in late 2021, that will need to be tracked.

Looking at the data from the survey, over 92% of the 127 countries surveyed in November 2021 reported continuing disruption to one or more essential health service. Primary care, community services and rehabilitation were amongst the most likely to be disrupted. On top of this, it is the increasing disruption to elective care, including delayed treatment for non-communicable diseases and long term conditions, that is likely to have significant negative effects on health outcomes over the next decade.

Countries health systems have responded to the pandemic by modifying how services are delivered, for example using remote consultations. But WHO’s report also highlights the effect of a decreasing health and care workforce, exhausted by the demands of the pandemic and the decrease in care seeking behaviours from the population in many countries. To address these challenges, 70% of the countries surveyed are reporting investment in longer term preparedness and resilience. It is likely this investment will only get countries ‘back on track’ to pre-pandemic trajectories unless governments are encouraged to think differently about how health and care is organised.

As we proposed in the webinar series back in 2020, integrated care is a fundamental design principle that helps us cope with some of the worst effects of service disruption. There are some excellent examples from across the world of how people and community centred integrated models of care emerged or were scaled up during the pandemic, some technology enabled, others rooted firmly in an asset-based community approach.

The International Foundation for Integrated Care will be revisiting some of the webinars in the original series in the Autumn 2022. We will be bringing together international panels to explore the experience of integrated care in the context of the pandemic response, what we learnt and are taking forward to build health and care system resilience and recovery in different countries and what still needs to be learnt. We will link this to the Foundation’s 9 pillars of integrated care with a particular focus on workforce, communities and digitalisation.

We look forward to welcoming you to one or all of the webinars.