Executive summary

As Victoria prepares to face an increased influx of COVID-positive cases in its health system, the VHA has looked at four case studies (UK, Canada, Sweden and South Korea) to identify some potential lessons to support Victoria’s readiness.

 

Based on these experiences, this analysis has identified that:

  • there will be increased demand beyond the last ‘peak’ and that past performance does not ensure future success
  • data and modelling support preparation
  • community health and other health and care settings need to be utilised to decrease non-COVID demand on the hospital sector
  • additional workforce capacity, from within and beyond the sector, needs to be added
  • there needs to be a coordinated approach
  • changes need to be made before the system is under pressure
  • health services need to be supported and enabled to be ready.

 

With over 220 million confirmed cases of coronavirus (COVID-19) globally, including at least 4.5 million deaths, the global pandemic has put health systems around the world under stress. In particular, health systems have struggled to treat the number of cases that have required hospitalisation, which has impacted care for COVID and non-COVID patients.

While Victoria’s health system has faced a myriad of challenges in the last 18 months, it has, in comparison to other health systems, not had to face the same level of hospitalisations stemming from COVID-19. However, despite largely ensuring that COVID-19 demand did not exceed health system capacity, the Victorian public health sector has been under severe pressure that has tested the workforce and infrastructure. The VHA has, during this period, advocated across a range of issues to reduce the burden on Victorian health services, and supports a whole-of-system response to the pandemic.

As Victoria plans for the next stage of its response to COVID-19, with an expected increase in cases and hospitalisations as the state opens up, the VHA has taken the opportunity to review how other countries have attempted to prepare their health sectors for increased demand, as well as what the outcomes have been. This has identified interesting case studies, with relevant aspects of the response that could inform Victoria’s next steps.

 

Read the supporting case studies

 

Analysis

These case studies, while not exhaustive or illustrative of the global experience, do highlight some important steps and lessons that Victoria should be cognisant of as it prepares its own health system:

  • There will be increased demand beyond the last ‘peak’ of cases and past performance does not ensure future success. While most of these jurisdictions initially prepared for and dealt with their first COVID-19 ‘wave’, some were later overwhelmed as cases and hospitalisations increased due to the development of Variants of Concern; for example, the ‘delta’ strain currently in Victoria. Managing these developments, and increases in hospitalisations, requires providing further support and resources.
  • Data and modelling support preparation. Enabling services to understand local potential demand means they know what steps to take to be ready for increased demand, which should lead to increased resilience during difficult periods.
  • Community health and other health and care settings need to be utilised to decrease non-COVID demand on the hospital These different case studies all demonstrate the need to utilise the entire healthcare system, or there is a risk of reduced capacity and overwhelming the acute care system. This also cannot be a ‘one-off’ event to increase hospital capacity, but a concerted effort to ensure patients are treated in appropriate locations to support the pandemic response.
  • Additional workforce capacity, from within and beyond the sector, needs to be added. All these examples experienced workforce pressures, with varying success in mitigating this issue. It is clear, however, that this capacity is essential to ensure that a health system can meet its COVID-19 demand.
  • There needs to be a coordinated approach. Where systems were effective in withstanding the increased demand, there appeared to be a level of coordination to ensure the health system stayed strong, particularly when the pressure was acute. With Victoria’s decentralised health system, this coordination across the system is even more important.
  • Changes need to be made before the system is under pressure. These case studies particularly highlight the need to implement changes to support health system preparedness and readiness before the health system is under pressure; changes that are made too late are less effective.
  • Health services need to be supported and enabled to be ready. These jurisdictions demonstrate the value in being prepared – while Victoria has faced many impacts stemming from the pandemic, higher rates of hospitalisations will be a new experience. Services need to be funded and encouraged, through reduced restrictions, to do what is necessary to be prepared.

 

Next steps

The VHA is hosting a member forum on Victoria’s health system readiness on 28 October 2021.

Health and community health service CEOs, executives and Board Directors are encouraged to attend the ‘Navigating COVID Peak’ forum. Please register via this link.

The forum will focus on system readiness – how the Victorian public health system can be supported to manage the expected increase in demand stemming from the COVID-19 pandemic and its impacts. At the forum, the VHA will seek member experiences and ideas and feedback on solutions.

Members can contact us via vha@vha.org.au if they have any questions or concerns ahead of the forum.

The VHA will continue to monitor developments and advocate on behalf of members during this difficult period, and is committed to supporting members as required.

 

Download the entire article and case studies as a PDF