EHS-COVID (549) Policies to address the health care backlog beyond COVID-19 (2)

12 September, 2022

European Observatory on Health Systems and Policies webinar – “Beyond the COVID-19 pandemic: policies to address the health care backlog” Thursday, 8

September 12:00–13:00 CET

“The COVID-19 pandemic caused health systems to postpone non-emergency procedures, and now health systems in almost all countries are facing care backlogs. Delays in diagnosis and treatment are causing significant barriers to access.

“Health systems have been using a wide range of policies to reduce backlogs. Policies must carefully balance the need to catch up on care as

quickly as possible in the near term, with strategies that build sustainable capacity over the long term.

“How can we improve health workforce availability while protecting health workers? How can we rationalize healthcare delivery without worsening inequalities? Join us to find out!

Keynote speaker:

Sarah Reed, Nuffield Trust, London, UK

Patrick Jeurissen, Radboudumc in Nijmegen, the Netherlands

Marie-Camille Lenormand, Ministry of Health and Prevention, France

Tomas Zapata, WHO Regional Office for Europe


Ewout van Ginneken & Erica Richardson (European Observatory on Health Systems and Policies)

I listened to much of this (We had a loss of satellite broadband for at least 15 minutes).

These are my notes:

Sarah Reed said that the Nuffield Trust were looking to benchmark what has happened to non covid services, identifying lessons that can be applied to health care delivery policy generally. Every country examined has had disrupted services. Backlogs are dynamic and are now challenged even more by costs of living inflations and raised energy prices. The UK waiting list which was 4 million is now 6 million patients. Missing patients are not coming forward and patients may be changing their presentations or presenting later.

Three major policies to respond to post covid were becoming apparent:

- Increasing the size of the workforce with increased recruitment and better retention (free car parking, free child health, mental health support at work. One example of employment change is that of anaesthetists in Spain. Shortages are being dealt with by employing three anaesthetic nurse assistants to do the anaesthetic work under the supervision of the anaesthetist. Better recruitment forward planning as required in most countries. Burnout is a major problem across Europe. 60% of hospitals are not working at full capacity and no countries are keeping adequate figures of how many healthcare staff wish to leave their posts. Stress and poor mental health are problems everywhere. High workload, inadequate work conditions.

- Improving productivity, capacity and demand management through balancing private and public care, extended hours and checking waiting lists to see whether procedures are still necessary and through the use of patient initiated care.

- Investing in capital, infrastructure and ne community-based models of care, expanding digital infrastructure and investing in primary care, community and home based facilities.

It was considered important to be sure that policies to recover backlog do not inadvertently increase inequalities or undermine progress made before the pandemic.

Ayder Tajahmady, France.

France had an initial 2 months state of crisis before working back to original workload management. Regulations had been loosened to allow telemedicine and teleconsultations and to allow reviews to take place without face-to-face consultations.

Silos of health care often disappeared and care became pan-health team care with more efficient team working. The doctors’ contracts in France are reviewed every five years and will be reviewed in October. It is envisaged that the new contract will include much more pan-health care.

Rural areas will need new skills, education and workforce planning.

Will we ever catch up? Will we ever catch up? Less certain now that the inflation and energy crisis has emerged. Extra hospital reimbursements might be necessary and support systems for people who are on waiting lists.

Young people need to be brought into a conversation about the importance of health working as employment.

How to support patients on long waiting lists? More support through physiotherapy, checking whether procedures are still necessary and more

information to patients on waiting lists.

The next European Laboratory of Health webinar will be at 12.30 CEST on 12 09 2022 and at 12,00 CEST on “Measuring backlogs”

HIFA profile: Richard Fitton is a retired family doctor - GP. Professional interests: Health literacy, patient partnership of trust and implementation of healthcare with professionals, family and public involvement in the prevention of modern lifestyle diseases, patients using access to professional records to overcome confidentiality barriers to care, patients as part of the policing of the use of their patient data Email address: richardpeterfitton7 AT