In the first few months of 2020, we watched on as ‘coronavirus’ took hold in China. It felt a long way away and seemed unbelievable that our country could come under lockdown restrictions. Then we witnessed the impact in Italy and the enormous pressure faced by health services there. Suddenly the threat was much closer to home.

I remember the first cases in Greater Manchester so clearly. I was pulled out of meetings to take calls, with news of the first case in a care home, another person very unwell at Wythenshawe Hospital and then tragically the first death in our region. Suddenly the strict restrictions seen in other countries didn’t seem so unlikely after all. A year tomorrow, 23 March 2020 – our own lockdown began.

Early on, one of the biggest challenges was that we were dealing with something largely unknown. Any emergency response will always be reactive initially but in this instance, we really didn’t know what to expect. We moved rapidly to free up beds in our hospitals, protect care homes as best we could, source supplies of PPE and stand up testing facilities for key workers. We now know more about transmission and have learnt from earlier waves meaning planning is a little easier.

I chair Greater Manchester’s community coordination cell (CCC). This is part of a multi- agency incident management structure set up early in the outbreak to ensure that our response was coordinated and joined up across the patch. CCC looks at all elements of health and care at a community level including primary care, adult social care, and mental health. It reports into the high-level strategic coordination and other cells feed into it, such as the primary care cell.

The new cell structure built on a strong history of partnership working in Greater Manchester and established collaboration between different partners put us in a good position for what was to come. We address problems together, with few arguments over roles or formation of silos. I believe the pandemic experience has strengthened and expanded joint working – both on the ground and as an ethos that shapes how we do things right across the board.

At the heart of our plans, set out when health and social care was first devolved to Greater Manchester, was an acknowledgement that health is not just about good physical and mental health and the absence of disease or illness. Education, housing, work, the ability to get on and a wealth of other factors also determine our state of health. The Covid-19 pandemic has laid this bare, highlighting the impact of health inequalities in our city region. We must now step up and do more – to build back fairer.

Our response to the pandemic has seen many health services adapt rapidly to changed circumstances. In just two weeks, GP practices switched to carrying out around 90% of patient contact virtually – a dramatic increase from around 10% previously. We have seen similar moves in outpatient clinics too. These changes were in progress before Covid-19, but the outbreak accelerated this process significantly. There are more things I could mention, in fact wherever you look, fantastic things are going on now. It makes you proud.

Our hospital teams have done an amazing job over the past 12 months under immense pressure.  To manage increased demand, trusts had to reprioritise patients who needed urgent care and treatment – of which there were many. As we know, this now means there is significant backlog in the system and a worry that patients will be waiting longer. This is challenging but I know there is a willingness to do things differently, such as developing new care pathways and diagnostics in the community. While patients are waiting, we can monitor their condition to help prevent suffering and deterioration, with the flexibility to move them up the ‘queue’ if needed.

I have felt humbled by the continued hard work and level of dedication we have seen from our health and care workforce over the past 12 months. From care home staff, to nurses in intensive care, cleaners, bereavement professionals, laboratory staff, GPs in our communities, volunteers and of course Partnership colleagues supporting the vaccine roll out– we have all pulled together to do something immense. Thank you everyone, for all that you do.

Despite all efforts, the most tragic and harrowing thing we will all remember in years to come is the loss of life. Every single person who has died from Covid-19 is one too many. It’s impossible to say anything here that will do justice to this loss but suffice to say  my thoughts are with everyone affected. One of the hardest things to bear during the first wave was the tragic loss of life in our care homes – some of the most vulnerable members of our communities.

We now have vaccines that offer safe and effective protection against Covid-19 and I am pleased that we were able to roll this out to care home residents and staff early on. I have had my vaccine and I encourage everyone to do the same when their turn comes. Ultimately, it can save lives – your own, and those around you.

12 months to develop a safe and effective vaccine. Sounds fast when you put it like that. A year like no other. It has been an incredible journey with memorable successes and unforgettable lows. As hospital admissions fall and the number of those vaccinated rises it feels like we have reached a real turning point. Of course, significant challenges still lie ahead. But in adversity, Greater Manchester has really shown its mettle. The years of ever closer partnership working, collaboration and integration have paid off and I believe we still have more to give.

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