Guide for Health Services

This page provides adaptable recommendations to prepare and support continuity of healthcare during public health emergencies by enabling the rapid adaptation of healthcare service delivery. The recommendations are organised into five implementation phases, structured around three key stages: before, during, and after public health emergency with clearly defined agents responsible for implementation.

Summarised version can be found here

STAGE 1: Prior to public health emergency

Phase 1: Preparation and planning

Recommendations included in this phase focuses on the preparation and planning for public health emergencies.

Responsible agents: Policy makers and service providers


1. Be pragmatic, adapt and tailor to context	Need to embed contingency plans into healthcare service plan by developing and incorporating rapid adaptation strategies that are pragmatic, tailored to address local capabilities, specific challenges, and healthcare needs.
2. Designate a leader	Prior to crises, appoint a public health response lead at organisational level to oversee the rapid implementation of emergency response strategies. This role would facilitate top-down collaboration, resource allocation, supply/equipment sourcing and dissemination, also enhancing communication across the system. This has been found to promote uniformity and ensure a coordinated approach to public health emergencies.
3. Set a time frame	In a case of public health emergency events, evidence suggests that adaptation is considered rapid when it occurs within three months, especially for a large-scale crisis. Based on this, a three-month timeframe is proposed for implementing contingency plans and strategies. It is important to note that the implementation of contingency plans and strategies can begin as soon as a crisis emerges if plans are already in place and there is succession planning to ensure business continuity.
4. Train staff and managers	Provide staff/managers training on public health emergency response coordination, risk assessment (i.e., when to act (adapt) or not), mitigation and rapid adaptation skills, to enhance clinical and service delivery decision making.
5. Fund public health emergency	Ensure health services are accounted for in public health emergency budget.
6. Assess the need for personnels	Prior to public health emergency, identify the service demand for staff role and develop strategies (i.e. training, or recruitment for effective response when need arises).
7. Expand	Expand healthcare services where evidence indicates a clear need.
8. Review and adopt available evidence-based recommendations	Promote the adoption of evidence based rapid adaptation recommendations to support healthcare services decision-making and continuity of care.
9. Prepare patients for contingencies	Promote the dissemination of information to guide patients’ safe care-seeking behaviour and to ready them for potential changes in service delivery platforms during crises. This could be a national level campaign, through leaflets, newsletters and social media, where feasible, explore during routine consultation.

Phase 2: Assessing Needs and Engaging

Recommendations included in this phase focus on developing priorities and strategies that support equitable care.

Responsible agents: Service providers and implementers


10. Prioritise care and platform	Consider developing a priority plan. Triage patients based on risk. Identify suitable treatment platforms and tailored self-management interventions to address these needs. Address equity, acceptability challenges and the unique needs of vulnerable and marginalised populations (i.e. older adults, ethic minority groups).
11. Strengthen communication strategies	Establish a clear communication pathway among healthcare providers, leadership, team members, and patients.

STAGE 2: During public health emergency

Phase 3: Executing

Recommendations included in this phase focus on actionable interventions for rapid adaptation during public health emergencies.

Responsible agents: Service providers and implementers


12. Rapidly conduct risk assessment/analysis	Quickly perform a risk assessment to evaluate the threats public health emergency posed on health services, staff and patients, guiding decisions on when to act/adapt or not.
13. Promptly request funding allocation	Evaluate the funding required for service continuity and submit timely requests to support its rapid adaptation.
14. Adapt to changing context	Adapt to evolving contextual needs by implementing comprehensive risk mitigation measures such as PPE use, hand hygiene, restructuring (e.g., demarcations, removing waiting areas) and vaccination programs.
15. Optimise workforce	Identify the demand for healthcare services during public health emergency, provide resources and develop business strategies to boost employee and service efficiency and improve performance. For instance, part-time staff may expand their hours.
16. Optimise service delivery settings and platforms	Maintain the provision of self-management advice and consider redirection of service delivery such as signposting and specific referrals to community and specialist services for continued care.
17. Use digital technology	Where applicable, establish or utilise existing digital platforms at the health facility to enable care delivery, strengthen communication strategies and initiate rapid in-service training. Hybrid mode of care (virtual and in-person) may be considered where applicable. Follow established guidance telehealth regulation, considering accessibility, liability, safety and privacy.
18. Prioritise staff wellbeing	Provide accessible, ongoing and timely occupational health assessments and staff safety measures including mental health care, psychosocial support and promote self-care strategies to cope and recover from burn out during the time of crisis. It is important for management to receive training focused on supporting staff wellbeing.

Phase 4: Reflecting and Evaluating

The recommendation included in this phase focus on the rapid assessment and evaluation of adapted strategies

Responsible agents: Service providers and implementers


19. Incorporate rapid assessment and evaluation	Monitor healthcare services by facilitating continuous learning through rapid evaluations of adapted strategies. Utilise routine data and collect feedback from users and providers to drive ongoing and successive improvements.

STAGE 3: Commence during and beyond public health emergency

Phase 5: Evolution and Maintenance

Recommendations in this phase emphasis the potential for sustaining implemented strategies.

Responsible agents: Service providers and implementers


20. Identify the short, medium or long-term use of adapted strategies	Document effective, sustainable strategies for integration into routine practice while distinguishing temporary contingency measures for future crisis use. Continue to adapt sustained strategies to context through continuous improvement.
21. Create a roadmap for restoring healthcare services	Establish a clear plan for recovery gradually restoring modifications made to healthcare services where necessary as public health pressure ease.
	Note that some modifications may be carried into the future following assessment and with continuous improvement.