Impact of COVID-19 on NHS Business Sustainability and Continuity

This report examines the profound impact of the COVID-19 pandemic on the National Health Service (NHS) in the UK, focusing on its business sustainability and continuity. It explores the research questions regarding the pandemic's effects, sustainability measures, and innovations implemented. The report delves into the literature on sustainability during crises, ESG factors, and business continuity, particularly within the healthcare sector. It highlights the challenges faced by the NHS, including the need to redefine profit and sustainability, adapt to new reimbursement models, and innovate in education and training. The study, based on secondary and primary data, including interviews with NHS management, investigates the effects of COVID-19 on NHS's sustainability strategy and responsible investment, emphasizing the role of innovation and creativity in business operations. The report also addresses the limitations of the research, such as data availability and time constraints, while emphasizing the importance of sustainability principles and community engagement in the post-pandemic recovery of the NHS. The findings suggest that the pandemic has highlighted the flexibility and resilience of the NHS, while also underscoring the need for digital advancements and coordinated support to achieve sustainability goals. The report concludes by emphasizing the NHS's potential to strategically develop sustainably, creating value for all stakeholders.

THE IMPACT AND THE ROLE OF
COVID ON THE SUSTAINABILITY AND
CONTINUITY OF BUSINESS. NHS CASE

Contents
Introduction.................................................................................................................................................3
RESEARCH QUESTIONS................................................................................................................................3
THEORY AND LITERATURE...........................................................................................................................4
BACKGROUND & PROBLEM DEFINITION....................................................................................................5
PROBLEMS AND LIMITATIONS.....................................................................................................................5
References...................................................................................................................................................8

Introduction
The rapid evolution of society is largely due to the cultivation of the capacity for permanent
reinvention of man. The recent crisis has created uncertainties in all aspects of life as well as
development opportunities. Although uncertainty requires innovation, being the norm of work in
various fields of industry or business, in terms of health systems, adaptability to the
unpredictable and rapid reinvention are not exactly assets. However, the emergence of new
business models in health and the current needs of patients obliges doctors, insurers, healthcare
providers and the state to reconfigure the way we perceive health and health systems.
The definition of profit generated by any medical system, whether public or private, must remain
the health of the patient. Profit is the result of successful treatment. The way in which "added
value" is generated, which results in health, is characterised by sustainability. Constantly
improved over the years, the contemporary medical system has become a hard-to-shake and
hard-to-fund. The crisis situation reveals more or less serious inadequacies that were dragging
into the eternal paradigm of health reform (Grima, Dalli Gonzi and Thalassinos, 2020). The
current period of turbulence and uncertainty can be considered a learning experience for the
political environment, providers, the medical industry and patients, making it an ideal
opportunity to reimagine the model of the functioning of the health care system.
Taking in consideration the master’s degree department and my research topic, in the rows below
I share some thoughts on some changes that can have a permanent impact in NHS:
 redefining profit and sustainability in a competitive medical environment
 the emergence of new models for reimbursement of the costs of medical services, of a
global settlement type, on performance criteria, for the final outcome of treatment and not
uniform, for services provided
 moving niche specialized medicine to dedicated centres
 innovation in education and training
 stimulating high value generating centres in a sustainable healthcare system.
RESEARCH QUESTIONS
◦ In which why the unexpected pandemic affected the business part of NHS?
◦ What was the actions taken to maintain the sustainability?
◦ Innovation and creativity, actions taken?
The outbreak of the COVID-19 pandemic mobilized an impressive number of companies in UK,
which reacted quickly to the call of the authorities and supported in various ways the public
health system in UK (Jones and Comfort, 2020). COVID-19 crisis has had a strong impact on
the work of private companies, generating numerous changes in their communication strategy,
supply chains, employee safety and health and more. Even before the pandemic, sustainability
was a topic in the UK corporate discourse. In the context of COVID-19, this research aims to

analyse the impact of this unprecedented crisis on NHS' sustainability strategy and responsible
investment.
The role that sustainability plays in the company development strategy is becoming more and
better defined at the management level, whether it is managing the overall impact of the
company's business or creating long-term value for stakeholders. According to the literature the
integration of sustainability into decision-making has a long-term impact on operational
performance.
RESEARCH OBJECTIVES
◦ To know how integration of sustainability into decision-making has a long term impact
on operational performance.
◦ How sustainability is related to continuity of business.
◦ To know is there any difference between in the role of COVID on the sustainability in
NHS and other sectors.
◦ Is the impact of COVID on NHS business positive or negative?
NHS associations have been instrumental in providing a rapid response to COVID-19 and also
play a vital role in recovery. This includes their broader influence as leaders, purchasers,
custodians of real resources and network resources in neighbouring health economies. Gradually,
the business of money is evolving beyond the realm of a corporate custodian to capture the work
of a worthy creator, exerting a shared impact on dynamic circles like never before. Furthermore,
it is here, in the dynamic circle, that the difference between classification methods for dealing
with environmental change is greatest. Those who lead the path towards sustainable progress are
clearly identified as a key component of their courses of action and awareness. The devastating
effects of the pandemic have been aggravated and exacerbated by the unreasonable globalization
of money which is responsible for the neoliberal destruction of state capacities for industrial
sectors. . A flow of monetary influences has long stimulated the breakdown of stocks and
interest, reflecting the differences within a nation and the information produced by neoliberal
labor market management systems. .
Worldwide, shortages in personal protective equipment (PPE) have emerged. The lack of sources
for their use in pandemic diseases has emerged from the neoliberal "moment-to-save" cost-
saving methods. The pandemic has exposed the limitations of physically controlled global
vertical investment chains, as illustrated below. High-wage countries found it difficult to secure
basic equipment (guards, protective clothing, and air conditioners) because they were heavily
controlled by imports. The absence of PPE has put many healthcare workers at risk due to the
inevitable nature of COVID-19. In the overall picture of wellness workers struggling without
accessible PPE there are high rates of depression among medical clinic wardens, nurses and
specialist specialists.
Similarly, there has been an increase in the use of environmentally dangerous medicines, such as
inhalers. NHS confidence changes, for example, by switching to dry powder inhalers, reducing
unstable sedative gas, and reuse reducing the natural side effects of this type of product. In fact,
the research also suggests that up to 33% of asthma cases can be kept at a strategic pace from
trying to reduce emanations. There are many positive things to draw from the NHS COVID-19

response. The pandemic has highlighted the great flexibility of the NHS, as well as its resilience
- there is no doubt that both will be important for the NHS based on meeting the net zero outflow
targets. However, the product of digital consideration is essential and optional at scale, an
example of this flexibility. Recently expected to take several years of searching, the NHS made it
possible to think fast. Such digital support will take a huge toll on the NHS by meeting the zero
target. While innovation and progressive development will play an important role in supporting
the NHS at the ‘zero point’, the continued activity of the NHS 1.3 million employees and
millions of additional patients will also be crucial. to achieve this goal. Support should be co-
ordinated in the NHS lifestyle and structure with the aim of delivering key NHS exercises for
both individuals and the planet.
THEORY AND LITERATURE
◦ Sustainability in business during the crisis
◦ ESG factors
◦ Continuity during the crisis
◦ COVID effects and changes
However, with regard to responsible investments based on criteria related to environmental,
social or corporate governance factors (environmental, social and governance - ESG factors),
business representatives do not, however, foresee a substantial change for the UK market.
ESG factors and long-term value can be considered two sides of the same coin, are
interdependent. The world is changing, and these changes can quickly affect the business
environment, as we have recently observed (Dwivedi and et. al., 2020). In my opinion, it is
important for companies, in my research for NHS, to understand that the inclusion of
sustainability principles in decision-making processes can help create a advantage while
responding to pressure from stakeholders to adopt social responsibility practices. Accepting this
trend will require a number of changes in organizational culture, existing processes and
technologies, but in the long term, these efforts can lead to the creation of new opportunities,
improved performance, as well as the company's reputation.
The study is based on secondary data and primary data – 2 interviews, members of management
NHS teams, collected between November 2020 and June 2021. The study aims to highlight
trends that can then be validated by extensive market research on representative samples. This
material will be developed on the basis of the information held at the time of writing - it will be
informative.
◦ The literature review divided in order to be able to independently study the main concepts
as well as it’s the typology.
◦ Academic articles, press, magazines, specialized blogs and studies, from both from
professional associations – as well as from international publishers.
◦ All sources of information will the object of a careful selection, with the aim of providing
a logical, complete, attractive and interesting text.

◦ Finally, the conclusions will be reached through reasoning and elaborate logic been based
on my personal experience and the one of the authors, who have carried out a detailed
study of the business, the crisis and analyzed the different pieces of information.
◦ The NHS case study will be carried out from an impersonal and neutral perspective and
trying to preserve objectivity.
With the introduction of new rules and legislation on the protection of the environment, the
safety and protection of employees and communities, as well as the obligation of non-financial
reporting, the concept of sustainability has become increasingly popular, in tune with the global
dialogue on sustainable development.
According to surveys and literature, the majority of respondents argue that integrating
sustainability principles into business strategy and operations management is a priority for the
companies they represent (Sarkodie and Owusu, 2020).
In the context of the new pandemic, the most important ESG factor taken into account is 'health
and safety at work', being a priority for almost all of decision-making professionals in
companies.
BACKGROUND & PROBLEM DEFINITION
◦ I`m part of NHS
◦ The “NHS Business” aspect changed in the last year
◦ Unexpected COVID pandemic
◦ COVID effects and changes
◦ Sustainability and continuity
The role of innovation and creativity in the way of doing business during pandemic.
It is still uncertain to what extent sustainability will play a central role in the post pandemic
economic recovery and what sustainability principles NHS will consider for future investments.
But at the operational level, sustainability seems to be becoming an increasingly important the
COVID-19 pandemic can be an important moment for NHS, where they can understand the
atypical challenges of the present and retreat strategically to develop sustainably, creating value
for all stakeholders.
Community engagement projects are one of the ways in which companies can integrate
sustainability into their work, thus having a positive social impact and generating long-term
value. The volume of community engagement activities of private companies is, however,
largely determined by the annual budget allocated to CSR projects, directly influenced by each
company's annual profit.

Sustainable investments also play a role in the sustainable development strategy of companies
and may vary. In this regard, the COVID-19 pandemic has led to an increase in sustainability
budgets, especially for companies that direct more of the annual budget into community
engagement activities and responsible investment (Mukherjee and et. al., 2020).
PROBLEMS AND LIMITATIONS
◦ Interview and direct information from NHS managers - refusing or not adequate to my
research
◦ Lack of time for the research
◦ Not enough relevant literature based on the COVID pandemic and its effects on the
business part of NHS
Moments of systematic reset of the global business environment, such as the pandemic with the
new coronavirus, are ideal for reconsidering the business model and an opportunity for
innovation in health that should not be missed. We are presented on the tray models of good
practice and even examples of failure, classified by categories, only well served enough to
understand that it is not necessary to repeat the mistakes of others.
Moreover, we also received money from the EU for strategic investments. The correct evaluation
of the current medical system, without hiding behind the finger, the definition of the problem
without missing any details, the definitive elimination of conflicts of interest and any elements
that do not serve the patient's good and the concentration of the main activity in the field of
expertise of each are mandatory steps to get closer to the starting line. The race is long. But the
start is mandatory, it would be a shame to lose it.
There is no better time to reorient and organize activities based on their ability to create plus
value. It is okay not to have an opinion on something that we do not know well, but we thus
retain resources for innovation and performance, strictly in the field in which we have expertise.
The opportunity is to educate all those involved and their orientation towards what is relevant
and effective in their areas of expertise (Mukherjee and et. al., 2020). Quality people have
always defined successful organizations and high-performing businesses. They must be more
involved, and the well-known "rotation of professionals" eliminated anyway from all aspects of
society.
Effective management will be confirmed by keeping specialists who add value by engaging them
in an environment that is appropriate to professional growth and the business itself. The strength
and sustainability of a healthcare system is measured by activities that add value to patients.
Summary of relevant theory / literature

◦ https://www.cdc.gov/mmwr/Novel_Coronavirus_Reports.html
◦ https://www.nejm.org/coronavirus
◦ https://jamanetwork.com/journals/jama/pages/coronavirus-alert
◦ https://www.thelancet.com/coronavirus
◦ https://www.cell.com/COVID-19
◦ https://www.bmj.com/coronavirus
◦ https://academic.oup.com/journals/pages/coronavirus
◦ https://www.elsevier.com/connect/coronavirus-information-center
◦ https://www.sciencemag.org/collections/coronavirus
◦ https://www.sciencedirect.com/science/article/pii/S0268401220309890
◦ https://www.pnas.org/content/117/30/17656.short
◦ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7280091/
◦ https://journals.aom.org/doi/abs/10.5465/amp.2019.0053
◦ https://www.nber.org/papers/w27362
◦ https://www.nber.org/papers/w27309
◦ Accad M.Accad M. BMJ. 2016 Mar 15;352
◦ Loder E, Groves T, Schroter S, Merino JG, Weber W.Loder E, et al. BMJ. 2016 Feb
10;352:i641.
◦ Royal National Orthopaedic hospital, Business continuity plan(2020)-Silvana Iuliano
◦ Orosun et al. Heliyon June 27, 2020
◦ Pettigrew LM, Kumpunen S, Rosen R, Posaner R, Mays N.Pettigrew LM, et al. Health
Policy. 2019 Jan;123(1):51-61. doi: 10.1016/j.healthpol.2018.10.017. Epub 2018 Nov
10.
◦ Loder E, Groves T, Schroter S, Merino JG, Weber W.Loder E, et al. BMJ. 2016 Feb
10;352:i641.
◦ The New England Journal of Medicine,2020
https://academic.oup.com/journals/pages/coronavir

References
Grima, S., Dalli Gonzi, R. and Thalassinos, E.I., 2020. The impact of COVID-19 on Malta and
its Economy and Sustainable Strategies. Available at SSRN 3644833.
Jones, P. and Comfort, D., 2020. The COVID-19 crisis and sustainability in the hospitality
industry. International journal of contemporary hospitality management.
Dwivedi, Y.K. and et. al., 2020. Impact of COVID-19 pandemic on information management
research and practice: Transforming education, work and life. International Journal of
Information Management, 55, p.102211.
Sarkodie, S.A. and Owusu, P.A., 2020. Impact of COVID-19 pandemic on waste
management. Environment, development and sustainability, pp.1-10.
Mukherjee, M. and et. al., 2020. Ecosystem-centric business continuity planning (eco-centric
BCP): A post COVID19 new normal. Progress in Disaster Science, 7, p.100117.