It can be difficult to find the words to adequately describe the last 12 months. It has been without question the most challenging period in the history of the NHS and, by now, every one of us will have been affected by this terrible disease in one way or another. We will know people who have and continue to suffer from it, we will know people whom we have lost to it. Each of our own lives has been radically altered in ways no one could have accurately predicted a mere year ago.

How can things ever go back to the way they were before? How can we collectively recover from the darkness that has touched all of lives? A new day will dawn and the shadow of COVID will pass. But the scars of this pandemic will mark all of us for the rest of our lives. We will need time to take a breath, to pause and reflect of what we achieved, together, in the face of this challenge.

Imagine your life beyond the pandemic; imagine watching Wales score the match-winning try in a packed Cardiff pub, imagine live music and singing at the top of your lungs in a group of total strangers, imagine embracing your friends and family after only seeing them for Zoom quizzes for months. If you worked in the NHS, wherever you worked in the NHS, all of these things will one day be possible because of you.

In 2018 we, like many other health organisations, celebrated the 70th Anniversary of the NHS and were inundated with stories of just how much the service meant to people, how, in many ways, it is foundation of the society we live in. Three short years later and this sentiment has increased 100 fold. The darkness of COVID-19 has forced the best of us in the NHS to shine even brighter. Despite the uncertainty, despite the danger, despite the suffering and the loss, we have stood firm; what we have achieved by working together, driving innovation and challenging the status quo was unthinkable in the system we has before the pandemic. It is now incumbent on us to capture any positives we can from the tragedy we have faced, and take that first step into a new world.

All of what comes next is, of course, predicated on the success of the COVID-19 mass vaccination rollout. It is hard to believe the speed at which these vaccines were developed and as hospitalisations and deaths continue to fall, it is a testament to the experts involved in their development that we now have at our disposal our best hope at a future beyond COVID-19. Of course, once it was approved for use, there was an incredible amount of work involved in delivering the vaccine to the people we serve. Teams have worked around the clock to achieve the most efficient way of getting this vaccine to the people who need it most.

Now, the vaccine programme is running like a well-oiled machine and as a Health Board, we are making excellent progress in working our way through the priority groups as set out by the UK’s Joint Committee on Vaccination and Immunisation (JCVI). In just three months or so, we have offered a first dose to well over a third of the total adult population in Cardiff and the Vale of Glamorgan, and it will not be long to wait until every adult has received some form of immunisation against COVID-19 with many already having received their second dose as well. 

In the immediate aftermath of the pandemic, we will need to address the effect it has had on the health service as a whole, as well as the individuals it is comprised of. It is a challenge that we are already facing up to as it becomes ever clearer that we in the NHS will nave simply be able to go back to how things were. Much was learnt throughout the pandemic, but the main lesson is that we cannot simply continue to do things the way that they have always been done. In fact, we have a responsibility not to.

The health system will need to reset and recover. We are currently dealing with challenges such as those posed by the climate crisis, a rapidly changing population and ever-growing waiting lists, deepening health inequity, and an exhausted workforce to deal with them. Work is ongoing to tackle all of these things but the organisation that exists at the end of solving them will be radically different than the one we have today.

We will need a new model of care: one which prioritises patients based on risk, one which is more technologically advanced and digitally capable, and one in which staff members are not afraid to take risks and innovate for the benefit of their patients.

All of this work is already underpinned by and outlined in our Shaping Our Future Wellbeing strategy, which was published all the way back in 2015. The COVID-19 pandemic has given us the impetus to not only achieve but exceed the goals we set out in that document and do so with an even greater sense of urgency. 

However, we want the future of our clinical services to be a product of collective leadership and co-production. We want to bring care closer to home by developing our community and digital services, making it as convenient as possible for people to access the care they need. The University Hospital of Wales could be enhanced as a centre for emergency and specialised care, focused on research and innovation, providing care for the sickest patients, while University Hospital Llandough will specialise in care for ill but stable patients who are not dependent on critical care during their stay. Routine and planned operations would take place at this site, as well as rehabilitation care and inpatient mental health services.

This is our vision for the future of healthcare in Cardiff and the Vale of Glamorgan, one which will in fact affect the whole of Wales, and we want your opinions on it. That is why we are working in partnership with the South Glamorgan Community Health Council, inviting members of the public to learn more about the proposed transformations and provide feedback.

But questions remain. How do we put in place an infrastructure to support staff with their projects and innovations? How do we ensure that the traditional barriers and organisational boundaries that crumbled as a result of the COVID-19 pandemic are not put back up again in the way of those who want to make meaningful change? How do we ensure that our staff have everything they need to deliver the best outcomes for the people we serve: the right tools, the right skills, connections with partners in industry and academia? How do we ignite the spirit of radical ideas, collaboration, and collective leadership that was kindled by the pandemic?

To achieve all of this, the Health Board has established the Dragon’s Heart Institute. It will drive transformation from within but also spearhead innovation and change across public services to deliver the best outcomes for the people we serve and to tackle the most enduring problems we currently and will continue to face in a post-COVID world.

The COVID-19 reminded the world why the NHS is something to which to aspire. It reminded us all just how amazing the people that staff it are and showed us that there is no limit to what we can achieve when we challenge the way things have always been done.

As we move into the future, accepting that we can no longer go back, The Dragon’s Heart Institute will be there to, time and again, bring out the best of our NHS.