Catching up on the most urgent essential health services without risking patient | Western Cape Government


Catching up on the most urgent essential health services without risking patient

17 August 2020

While the health service platform must remain geared to deal with COVID-19 pandemic (including a possible second wave of infections), the Department of Health wants to scale up essential health services in a balanced manner.   

The Department’s risk and impact based approach is guiding the services to be reintroduced identifying those services which have low risk yet high impact (such as immunisation services). These services which had reduced significantly during the COVID pandemic, will have a significant long term impact for those clients who had missed immunisations, follow-up appointments and scheduled non-emergency treatment.   

When comparing April 2020 to April 2019:  

  • A 68% less persons visiting primary health care facilities in the Metro and 37% in the Rural   
  • A 51% reduction in elective surgical procedures in the Metro and 42% in the Rural   
  • A 48% reduction in emergency visits in the Metro and 40% in the Rural   
  • 46% less outpatient visits in the Metro and 52% less in the Rural   

The Department is particularly concerned about a reduction in essential and basic primary healthcare services including: 

  • A 22% reduction in immunisations   
  • A 36% reduction in screening for TB   

Chronic disease management (Diabetes, Hypertension, etc.), HIV and TB management, Child and Women’s health (including immunizations) have seen significant reduction in uptake and will be scaled up systematically. These scaled up activities will not only take place in our health facilities, but will also be undertaken as part of community oriented primary care (COPC). This approach is marked by community healthcare workers visiting patients in their neighbourhoods and homes and undertaking screening activities (which will include COVID-19 screening). Despite the fact that COVID-19 will be a factor for hospitals in the coming months, a systematic scale-up of elective surgery is being planned at many hospitals, as possible. 

A major by-product of the lock down period was the decongesting of the health service platform. Whilst some non-emergency services were scaled down, alternative innovative measures such as increased home deliveries of chronic medication took preference, ensuring these patients continued to receive their medication. This development has been positively experienced by many patients, and is one of the positive innovations the Department wishes to sustain and expand going forward. 

A phased approach will be adopted to return the comprehensive health service platform back to a new normal and will be considered in short, medium and long terms.