Health service capacities, responses and practice

The vast majority of scholars who focus on health services explore ‘normal’ times, with long-standing issues which often change rather slowly. Much used words such as ‘crisis’ and ‘disaster’ are arguably overused and often do not fit academic definitions. Very few scholars explore huge and fast-moving ‘external shocks’ such as COVID-19, which does fit these definitions and has implications for health services capacities, responses and practice. First, capacities vary within high-income nations and hugely between high- and low-income nations. Nevertheless, the fringe field of ‘surge capacity’ will become more important. Second, responses varied significantly both in terms of speed and content, resulting in different outcomes, for example, the numbers of deaths between the UK and Germany. This will have implications for the neglected topic of intra- and inter-crisis learning related to pandemics. Third, the rapid changes to work environments, for example, eye surgeons working in ICUs, may lead to a greater focus on the future on issues of practice such as clinicians’ reflections on their work environment and skill mix.