Context:
In March 2020, NHS Wales enlisted the expertise of ICST to establish standardised clinical practices for treating COVID-19 across the country. Given the limited evidence on managing the pandemic, it was crucial to create a flexible, nationwide approach that could adapt to evolving circumstances and new findings.
The solution needed to encompass various stages of care, from initial assessment to intensive care unit (ITU) treatment and palliative care, and to be concise, rooted in fundamental principles, and accessible to healthcare staff via mobile devices or computers.
Clinical leads from across Wales were engaged to promote its adoption and facilitate implementation. The Welsh Government’s Chief Medical Officer endorsed the guideline by encouraging its use in all health boards through correspondence with Chief Operating Officers in late March 2020.
Solution:
COVID Response
The toolkit provides digital support for both patients and practitioners, promoting practices and behaviour change principles that result in improved outcomes and ultimately reduce the burden on the health system.
Implementation 1:
Supporting hospital healthcare teams–through implementing the dynamic NHS Wales COVID-19 Hospital Guideline.
Implementation 2:
Supporting primary care – through implementing the dynamic NHS Wales COVID-19 primary care Guideline and NHS Wales Long COVID Guideline.
Implementation 3:
Supporting the public – through implementing the NHS Wales COVID Recovery App.
Implementation 4:
Supporting decision-makers–through implementing the NHS Wales COVID audits.
By using emergency implementation science and individual behavioural science methodologies, the COVID response ensured reach and adoption whilst achieving outcomes. This approach ensures seamless system installation without the need for additional resources or staffing. By practically supporting existing services, rather than imposing fundamental change, the toolkit minimises resistance, ensures sustainability, and achieves population-level reach and scalability.
Outcomes:
COVID Response
From frontline teams managing patients presenting with acute COVID, to practitioners supporting recovery and return to normal services, and people living with long-term COVID, there were solutions created for everyone.
Reduced mortality rates
Implementation of the programme has coincided with Wales having the lowest mortality rates from COVID during the first wave of the pandemic compared to England.
Data informing service provision
Data outputs from these innovations (e.g. symptom prevalence), have informed service provision across Wales.
“We are the consultant holistic practitioners, based in the community. We need to make sure everybody receives the support they need on their long COVID journey. We are constantly learning about COVID and how is evolves and develops. What this [guideline] does is gives us the additional knowledge and opportunity to support our patients to the best of our ability.”
Dr Mark Walker
Senior Medical Officer, Co-author of the Long COVID Management Guideline
“I managed to download this and think it is a positive step towards managing recovery from Covid -solution focussed therapy. The app is good and sure it will be really useful. Thank you”
Long COVID patient
Using the COVID Recovery app
“The team at ICST likewise worked tirelessly to film, edit and animate the videos over weekends to ensure there were no delays to their publication. “The data presented in this report speaks for itself. More than 50% of all consultants of any speciality in Wales, signed into the system and excellent feedback about its relevance and quality. I’m not aware that anyone has created a national guideline like this, anywhere else in the world, and certainly not at such speed and reach.“
Dr Simon Barry
Respiratory Consultant and National Respiratory Clinical Lead