Date published: 23 May 2022

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It’s been hard in recent times to escape headlines and analysis of where the NHS stands now we are free of lockdowns and are facing a new future of learning to live with the COVID-19 virus. Other events may have overtaken the pandemic as the main news items, but it’s clear the virus, and its impact on health services, remains an ongoing challenge.

I’ve written before about my admiration for the sacrifices NHS workers have made in recent years, but what happens now to our health services and those that work within it? Pausing services temporarily while we battled with the virus has caused inevitable backlogs that is putting the system and its workforce under immense pressure.

According to analysis of the 2021 British Social Attitudes survey (BSA) published by The King’s Fund several weeks ago, public satisfaction with the NHS has fallen to its lowest level in 25 years. It should be said that the survey is not critical of those who work for the NHS or the incredible efforts they have put in over the last few years. An illustration of those findings are below buyt the main complaints were:

  • Concerns over long waiting times (65 percent of those surveyed)
  • NHS staff shortages (46 percent)
  • Inadequate Government funding (40 percent).


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So how does Mersey Care, and the wider healthcare system, address those issues? How do we find a new way of approaching these challenges while maintaining the highest standards of healthcare for our population?

You may have heard politicians and healthcare leaders using the phrase ‘The New Normal’ as we plot a different way of helping our patients, service users, carers and workforce through these challenging times. Put simply it’s a conversation that needs to be had to ensure we continue providing healthcare safely so it meets the demands of our population and was very well explained by NHS Providers recently.

In addition to the backlog of services that were temporarily suspended during the pandemic, we also know that mental health has surged and finding a balance for that will be difficult. The risk is that we end up trying to confront the challenges of demand using all the tools we’ve always used,

To use a football analogy, as the game changes we need to think about different tactics. Mersey Care is working on those new approaches by talking to colleagues and service users and I’ll go into greater detail of what that will look like in a future blog.

The big challenge, not just for Mersey Care but for all health care providers, is how do we make sure this notion of new normal is not just the same as we’ve always done? I’m not alone in thinking this needs a radical new approach rather than just a reset of what we did before the COVID-19 pandemic took hold.

Sometimes there’s a temptation to think by working harder and faster things will turn out differently. Eminent judges like Albert Einstein worked out the folly in that many years ago when he said: “The definition of insanity is doing the same thing over and over again and expecting different results.”

What we must do is really explain the detail of what is going to be ‘new’ so we can clearly demonstrate how the NHS has learnt and developed. Here at Mersey Care we’re still developing those plans in partnership with our workforce, but once they are finalised it will be important to demonstrate that the ‘New Normal’ is not the same as old normal.

In Cheshire and Merseyside, we’ve been working on this idea of ‘System P’, which is superbly explained in the animation below. Mersey Care is the host of the programme, which aims to take a more predictive, preventative and crucially, precise approach to population, people and person health. In short focussing far more on two-way conversations between health providers and those they care for and you can find more information about it on our website.


There will be a lot of different ideas of what the new normal looks like but I’d envisage it to look very like System P, where different partners share knowledge and learn from each other so we can really provide the services our population needs.

I don’t believe we can keep talking about prevention without looking at using some of the finance currently used for treatment to spend on prevention. System P is a way to begin to formulate a framework that allows us to do that in a common sense way.

Those of you who have time to watch the video will learn System P is broken down to four components:

  • Data – bringing together separate local health and care resources into a single data library
  • Analytics – using additional capacity to analyse the collated data sets to make predictions based on that data
  • Care – Using these insights to develop new models of care focussing on people’s wider needs
  • Payment – mechanisms and approaches can respond to the new way of working to help remove the barriers to person centred care.

Sometimes smalls changes in approaches can make a huge difference to the overall system – just look what the impact technology has had on how we care for our population during the COVID-19 pandemic with virtual consultations and remote monitoring.

We hope System P will help simplify healthcare for a population that is increasingly presenting with complex needs. By partners sharing resources and expertise, we believe we can work together to simplify how the people we care for can access the services we need. I think that’s an NHS we’d all like to see in the future.

Prof Joe Rafferty CBE

Chief Executive