NHS

Government Wants to Make Covid Vaccination Mandatory for All Frontline NHS Staff

Reports suggest that Sajid Javid, who recently expressed hesitancy about “taking away people’s freedom” with vaccine passports, is keen to force all frontline NHS staff to get vaccinated against Covid. A decision on whether NHS staff, like care home workers, should be told to “get jabbed or get another job” is expected to be made later this month. i news has the story.

A formal consultation on making Covid and flu vaccination a condition of employment in the NHS is due to end on October 22nd, and the Health Secretary is ready to act swiftly to implement the change, i has been told.

Following a change in the law enacted this summer, staff in care homes have until November 11th to get double jabbed for Covid, after which point they will be legally barred from work without vaccination.

The Department for Health and Social Care (DHSC) has separate but similar plans to require all NHS frontline staff to be fully vaccinated – unless they have a medical exemption.

Javid is privately furious with the risk that unjabbed NHS staff pose to vulnerable patients when working in both hospital and in community settings. [Privatley? He seems to be fairly open about this.] …

He is understood to want to be “even more hardline” with health service staff than with care home staff, not least as they are directly employed by the state rather than by private providers.

While no one in Government wants to publicly pre-empt the consultation, it is understood that Boris Johnson is fully behind Javid’s belief that unjabbed health staff pose a risk to the most vulnerable

Javid also wants to offer extra reassurance to vulnerable patients that they can enter hospital and be sure that all those around them are double jabbed.

There is also a concern in government that unjabbed care home staff, who are barred from working with patients from next month, have been moving into the NHS.

The vast majority of NHS staff have been double jabbed. Latest weekly figures for England show 1,326,000 have had a first jab (92%), 1,277,000 (89%) have had a second jab. But 8% have not had any jab at all.

Worth reading in full.

More than 10 Million NHS GP Appointments a Month Still Not Taking Place Face-to-Face

More than 40% (10.2 million) of the GP appointments held in England in August did not take place face-to-face, according to the latest NHS data, despite continued demands for patients to receive the treatment they need and deserve. The Telegraph has the story.

According to NHS Digital data, 57.7% of the 23.9 million GP appointments in England took place in person in the first full month following the ending of coronavirus restrictions, a total of 13.7 million.

This means that a total 10.2 million appointments did not take place face-to-face.

Before the pandemic, the number of in person appointments stood at 80%.

The figures come despite Boris Johnson saying in September that patients are entitled to see a GP in person, amid mounting concern about access to face-to-face care.

Patients’ groups and campaigners have said many vulnerable people have been unable to access care, with coroners linking a string of deaths to remote appointments.

During the first lockdown last spring the percentage of face to face appointments dropped below 50%, and has been hovering between 50 and 60% ever since. …

Total number of appointments fell in August by almost 2 million,  leaving the proportion seen face-to-face barely changed since July, when it was 56.9%. 

The problems have started to have a knock-on effect on A&Es, with emergency care doctors saying a lack of GP access is a major factor in the high numbers of people turning up at hospitals.

Worth reading in full.

Vaccine Passports Back on Table as U.K. Government Seeks Public Views on Winter Plan

The U.K. Government is asking for public feedback on the use of domestic vaccine passports in indoor and outdoor venues if cases threaten to overwhelm the NHS this winter. The “Plan B” proposals could see nightclubs, concert halls, sporting events and outdoor festivals require proof of Covid vaccination status, with the opportunity to add more venues if necessary. The Telegraph has the story.

Ministers last night insisted the Government needed to be prepared to “act swiftly” and adopt measures such as vaccine passports “at short notice” if there were “unsustainable pressures” on the NHS as a result of the COVID-19 pandemic.

Health Minister Maggie Troup said: “While we are totally confident the careful steps we are taking will help rule out the need for mandatory vaccine certificates, we need to be prepared for all scenarios.

“We know these kinds of contingency plans will only work if businesses and the public get to have their say and I’m urging everyone who could have to use certification: give us your views, give us your ideas.”

Industry and the public have been given until October 11th to respond to the planned vaccine passports, which would be mandatory for all adults over 18 attending the prescribed venues, and will require legislation.

Under the plan, only double-vaccinated people would be certified by the passports. Negative Covid tests and proof of natural immunity after recently recovering from the virus would no longer be permitted.

Worth reading in full.

If you don’t want to see vaccine passports introduced this Winter, please respond to the Government’s consultation here.

English Hospitals Told They Can Drop Some Covid Measures to Help Reduce Backlog

In a move aimed at helping to cut down long and ever-growing treatment waiting lists, English hospitals have been told they can scrap some of the ‘anti-Covid’ measures they were forced to introduce during lockdown, including testing and isolating patients before planned operations. BBC News has the story.

The changes, recommended by the U.K. Health Security Agency (UKHSA), are aimed at easing pressure on the NHS.

It says testing and isolating patients before planned operations can be dropped and hospitals can return to normal cleaning procedures.

Social distancing can also be reduced from 2m to 1m in some areas.

More than five million people are waiting for NHS hospital treatment in England and hundreds of thousands have been waiting more than a year.

Although the Government has announced an extra £5.4 billion over the next six months to respond to the backlog caused by the pandemic, ministers have warned waiting lists could get worse before they get better, as more people come forward.

UKHSA Chief Executive Dr. Jenny Harries said the new recommendations would help local hospitals plan more elective care.

“This is a first step to help the NHS treat more patients more quickly, while ensuring their safety and balancing their different needs for care,” she said. …

Local hospitals will be left to decide when and how these changes are introduced.

Guidance on which measures can be relaxed in GP surgeries, dentists and for ambulance trusts are still being considered.

The recommendations were based on reviews of evidence and broad agreement from experts in infection prevention and control, the UKHSA said.

Worth reading in full.

People in Poor Regions Almost Twice as Likely to Wait More than 12 Months for Hospital Treatment

People living in some of England’s poorer regions are more likely to be forced to wait longer to receive routine treatment on the NHS, according to a new analysis. Waiting lists are also growing at a faster rate in these areas, where people are less likely to be able to afford private healthcare. The Telegraph has the story.

Data from The King’s Trust and Healthwatch England found that 7% of people waiting for treatment in the poorest regions will wait more than 12 months. 

However, for the most affluent areas, this figure is just 4%. …

From April 2020 to July 2021, waiting lists have swelled by 55%, on average, in the most deprived parts of the country compared with 36% in the richest areas.

Despite the efforts of NHS staff during the pandemic, the backlog has grown to 5.61 million people – almost one in every 10 people in England.

The NHS has now been told by the watchdog to ensure people have “interim support” in place while it tackles the record backlog of untreated patients. 

The analysis comes as a poll Healthwatch England exposed the toll the waiting list is having on people’s physical and mental health.

A survey of 1,600 people who were either on the waiting list themselves or had a loved one in need of treatment, found that 54% said it was affecting their mental health while 57% said the wait was affecting their physical health.

And 48% did not have any support to manage their condition during their wait.

Almost one in five (18%) have already gone private for treatment or are considering it, but 47% said that paying for private treatment “was not an option”.

Worth reading in full.

NHS Cancer Patient Backlog Could Take Over a Decade to Clear

Almost every day brings more bad news on the cancer patient backlog in the NHS, caused in large part by the “stay at home, protect the NHS” drive. New research suggests that the waiting list could take more than a decade to clear, and backs up a study released earlier this week showing that thousands more will die along the way because of delayed treatment. The Telegraph has the story.

The analysis of NHS statistics by the Institute of Public Policy Research (IPPR) estimates that around 20,000 cancer diagnoses have been missed during the pandemic.

Waiting lists have reached a record high of 5.5 million, with fears they could reach 13 million, as patients come forward after struggling to access services, or from fear of being a burden on the NHS during the pandemic.

It comes amid growing concern about access to face-to-face appointments with GPs.

The Prime Minister said on Wednesday that patients were entitled to see their doctor in person, raising concerns that without the option, deadly symptoms could be missed. 

Before the pandemic, around 80% of consultations took place in a doctor’s surgery – but in July the figure was just 57%.

The new study by the IPPR and CF, a data analytics consultancy, says it could take until 2033 to clear the backlog – and come too late for many of those whose diagnosis was missed or delayed. 

Even this timetable would require a 5% increase in cancer care activity levels above pre-pandemic levels, it says.

However, boosting this to 15%, with a major expansion in diagnostics and staffing, could clear the backlog by next year, the analysis suggests. …

The research shows that in the year following the first lockdown, 369,000 fewer people than expected were referred to a specialist with suspected cancer. …

Concerns about the spread of Covid, and efforts to free hospitals for patients with the virus, resulted in a major reduction in access to diagnostic tests. …

The report said: “Behind these statistics are thousands of people for whom it will now be too late to cure their cancer.”

Worth reading in full.

Record Numbers of Children Seeking Access to Mental Health Services

A new analysis by the Royal College of Psychiatrists has underlined the damaging impact of long months of school closures and general lockdowns on children’s mental health, showing that record numbers of young people are seeking – and are having to wait for – access to mental health services. The Guardian has the story.

In just three months, nearly 200,000 young people have been referred to mental health services – almost double pre-pandemic levels, according to the report by the Royal College of Psychiatrists.

Experts say the figures show the true scale of the impact of the last 18 months on children and young people across the country.

“These alarming figures reflect what I and many other frontline psychiatrists are seeing in our clinics on a daily basis,” said Dr. Elaine Lockhart, the college’s Child and Adolescent Faculty Chair. “The pandemic has had a devastating effect on the nation’s mental health, but it’s becoming increasingly clear that children and young people are suffering terribly.”

The college analysed NHS Digital data on mental health referrals for children and young people aged 18 and under. It found that between April and June this year, 190,271 children aged 18 and under were referred to children and young people’s mental health services – almost twice the number (97,342) referred during the same period in 2019.

Urgent referrals had also risen steeply. From April to June in 2019, 5,219 children and young people were referred for urgent care. This rose to 8,552 in 2021, the college said.

At the end of June, 340,694 people were in contact with children and young people’s mental health services, up from 225,480 in June 2019. …

Eating disorder treatment services were seeing more patients than ever, the college said, but it also warned of an “unprecedented” number of children still waiting for care.

Worth reading in full.

The Staggering Inadequacy of NHS Scotland

by Montgomery Scott

It happened quickly and out of the blue. We’ve three young children – a six year-old, three year-old and our six month-old ‘lockdown baby’. Any parent with children in an education or nursery setting will tell you that from September to June they spend 80% of that time with a cold, cough, sneeze or sniffle. On occasion, it can be much worse. Our eldest once had scarlet fever and had to be rushed to hospital while he was having a sleepover at his grandparents. He was fine but they’ve never quite recovered. After your first sprog, you tend to roll with the punches and are able to tell if something is seriously wrong and make plans accordingly.

We were not, however, prepared for the events of this week. Having inherited a lurgy from his siblings, the baby hacked his way through the past seven days. His temperature soared now and then but we brought it down with sleep, Calpol and Ibuprofen.

On Monday we realised it was getting worse. His breath came in short gasps; he was managing only every third inhalation to get oxygen into his tiny lungs. We live in Scotland so it was also the September holiday weekend, meaning the older children were around our feet until the babysitter arrived. By evening, we decided that if the baby could get a long sleep it might nail whatever he was struggling with internally. He didn’t. When he refused to eat, drink and had a dry nappy we knew the game was up.

I’m 40 now but when I was a child I had bad asthma – meaning regular visits to Ninewells Hospital in Dundee. I grew up in a town 15 miles from Ninewells and when anyone in our household became ill we could telephone our local GP who would – if required – visit our house. It didn’t matter whether it was day or night. This was the case for both adults and children; my father when he crumpled with appendicitis and we children when suffering a fever.

As a rule, I have a soft spot for things from the past. I like old cars with roaring petrol engines. I admire the quality craftsmanship of Edwardian and Victorian furniture. I love gothic fiction. Yet I am also a progressive in its true sense. I’m receptive to new ideas and fascinated by technology. I listen to others’ opinions even if inside I’m thinking “what total crap”.

My experience this week, however, has confirmed that the health service in Scotland is gasping its last breath. Rather like my son could have done had we not taken matters into our own hands.

I looked online to remind myself what options were available for out-of-hours GP advice. I checked our local practice first and their pages directed me to NHS 24, or ‘111’. On their website, there are so many options – probably to confuse the time wasters – that I thought perhaps there was no alternative to calling 111 other than by an online contact form. I gave up and just called 111.

The phone line proved infuriating. I’ve worked in some senior roles in my time and as I listened to the repeated messages about Covid symptoms I had an increasing sense that NHS Scotland is grinding to a halt – with management either disincentivising those without coronavirus symptoms from getting in touch at all, or trying to process what (I thought) must be thousands of people with Covid symptoms through the NHS.

I heard midnight chime in the village steeple. It took 10 minutes to speak to a call handler. Our baby’s breathing was at its worst. Barely there at all. He was gulping in air but seemed unable to get it down. We put the call on speaker. After going through patient details we read the symptoms out. The telephonist was polite and clear and asked straightforward queries. He brought in a second person – a nurse – to ask specific medical questions about our boy’s pallor and the movement of his chest and stomach. As soon as we answered she said: “Okay, I’m going to get an ambulance to you.”

Of all the things I’d waited for her to say, I didn’t expect that. My wife was upset. She felt it was her fault. A ridiculous notion but mothers are hardest on themselves.

We leapt to action and packed a hospital bag for baby and one for mummy. It took us 10 minutes.

I put the lights on downstairs and in the hall and opened the curtains so we would be a spotlight in the midst of the village – drawing the ambulance to us. If lucky, my wife would manage a cup of coffee before she went in the back with the baby.

We discussed the possibility that she and our son might get separated – either by the ambulance or at the hospital – but thought we were only applying our worst fears from the past 18 months, and if such a question were to arise she would dig her heels in and refuse any intervention which cited Covid rules.

My wife and I are what I’d describe as “informed sceptics”. We take precautions, don’t believe in lizard rulers, stick to the rules like wearing masks in heaving crowds, don’t wear them in the school playground (as we ought in Scotland) but do our research. We dithered over the vaccine, skipping our appointments only to then attend the drop-in clinic when vaccine passports were brought in in France. We also know that children and babies without life-threatening conditions statistically are safe from Covid harm.

To drive from our village to the new Edinburgh Sick Kid’s Hospital takes around 30 minutes on quiet roads. We also have smaller community hospitals on each point of the compass around us. I’d figured on the shortest time for an ambulance to get to us as 15 minutes, and the longest half an hour.

Our baby continued to gasp like a fish on a ship’s deck.

After 45 minutes of waiting the clock read 1am. My phone rang. A telephonist from the Scottish Ambulance Service on a Glasgow number cheerfully opened up the conversation. He was sorry to bother us. He’d been given limited information from NHS 24. Could we describe the symptoms. Has our baby suffered a seizure or convulsion yet. “No,” we said, thinking, “Why on earth would we wait for that to happen before doing anything?” I mean, for Christ’s sake, our son can barely breath.

The conversation came to an unusual impasse. We were informed that unless our six month-old suffered any of the above we wouldn’t be deemed a critical case and the ambulance would come in 12 hours time. “What?” I heard my wife say from the middle of the room. “12 hours?” Immediately my wife put on a jacket and grabbed the car keys. “We’ll drive him in ourselves.”

On arrival at Edinburgh Sick Kid’s Hospital matters dissolved into farce. Nurses took vitals in the waiting area and we waited. We were informed that no rooms were free. This is a £1 billion flagship Scottish hospital in our capital city that’s just opened. My wife waited for four and a half hours for a room. The mother next to her had a wheezing toddler, who had had convulsions and arrived by ambulance – only to wait two and a half hours to be taken to a room. In the course of the night, the waiting room filled up with coughing, gasping children.

Our family’s fears about Covid restrictions proved unfounded. Neither our baby nor my wife was tested for coronavirus and no sign of that happened with the other children present.

Instead, we received an outburst of frankness from an NHS nurse after the four-and-a-half-hour wait. She told us that cases of serious chest infections – such as acute bronchitis – which our six month-old had contracted, were exploding. The reason? Not enough exposure to minor ailments and infections to boost their developing immune systems due to the lockdowns.

NHS Scotland is the mids of a crisis. The Scottish Government has borne considerable public wrath in recent days over ambulance waiting times. Some people have had to wait 40 hours for an emergency vehicle only to die anyway. Based on our experience, this fury is earned.

My wife drove home with our son at 7am. Ninety per cent of the time spent waiting, half an hour to decide it would be best fixed by waiting it out – to try another day to see if he suffers a convulsion and therefore could be close to death.

Work often takes me to London. I could have taken the Edinburgh to London journey three times before an ambulance reached our house from a brand new hospital 30 minutes from our home.

We have come a very long way from the days of GP home visits. Centralisation of the health service, closure of local acute care facilities across Scotland with more on the way, and the main centres of healthcare simply unable to cope. Add to this a hesitancy from the Government to acknowledge that children and young people are now not only the sufferers in terms of their education but their actual health – weak immune systems coupled with paralysis from many terrified parents to expose them to ‘normal’ life – and you have the perfect storm.

I hope there are better days ahead. We as a family, however, will be taking the Scottish Health Secretary’s advice. We’ll neither call 999 or 111. We will ourselves operate an ambulance service and drive our children to A&E. Woe betide those poor people with no money and no transport.

It truly is a matter of life and death. Only the privileged ones who can drive to hospital themselves will be safe. Shame on you, NHS Scotland.

Montgomery Scott is a pseudonym.

Extra 10,000 Brits Likely to Die of Cancer Due to Drop in Emergency Referrals during Lockdown, According to New Study

A drop in emergency referrals for cancer over the past year of lockdowns is likely to result in an extra 10,000 deaths from the disease, according to a new study. In particular, the “stay at home, protect the NHS” message is believed to have put people off coming forward and ‘burdening’ the health service for check-ups, meaning their symptoms were not investigated. MailOnline has the story.

University College London researchers said a drop in emergency referrals from GPs last year across the U.K. resulted in around 40,000 late diagnoses of the disease.

These delays and longer waits for NHS treatment – fuelled by the pandemic – mean thousands will die “significantly earlier” from the disease than would have been the case pre-pandemic.

The study of more than 2,000 adults found nearly two thirds of people worried about bothering family doctors with “minor health problems” because of Covid.

And during the first lockdown last year, the NHS moved GP appointments to online and telephone to limit face-to-face consultations. Number 10’s “stay at home, protect the NHS, save lives” messaging put people off coming forward, meaning their symptoms were never investigated. …

Just 57% of GP appointments are now in person compared with 80% before the pandemic. 

A senior coroner in Manchester earlier this month concluded a lack of face-to-face care contributed to at least five deaths in the area during the pandemic. …

23 million appointments, whether face-to-face or otherwise, were also “lost” during the pandemic.

Out of the 2,000 people polled by UCL, those above 65 – the group who require the most healthcare – were the least likely to want to see their doctor remotely.

Some 56% in that age group opposed having more telephone and online consultations, while 24% were in favour of them.

And only 46% of people aged 18 to 24 wanted more remote appointments, with more than a quarter (28%) against them.

Worth reading in full.

A Doctor Writes: The NHS Is Concealing Important Information from the Public

We’re republishing a post from our in-house doctor, formerly a senior medic in the NHS, on the unreliability of official figures on ‘Covid inpatients’ . This was first published in July and only now has the mainstream media finally cottoned on to the fact that the NHS’s Covid inpatient figures are unreliable. Since we published this, there have been at least three updates to the ‘primary diagnosis schedule’, all showing a consistent overstatement of 25%.

On Thursdays, the NHS release the weekly summary data in relation to Covid patients. Normally this is a more granular version of the daily summaries – it has some hospital level detail and figures on non-Covid workload for comparison. Usually interesting but not especially informative.

Yesterday was an exception. Placed down at the bottom of the page, almost like a footnote, was a “Primary Diagnosis” Supplement. Graph One shows the information contained in that spreadsheet. I find it astonishing. In essence, it shows that since June 18th, the NHS has known its daily figures in relation to ‘Covid inpatients’ were unreliable at best and deliberately untrue at worst.

The Yellow bars are what the NHS has been informing the nation were Covid inpatients. The Blue bars are the numbers of inpatients actually suffering from Covid symptoms – the difference between the two are patients in hospital who tested positive for Covid but were being treated for something different – where Covid was effectively an incidental finding but not clinically relevant.

For example, on July 27th, the total number of beds occupied by Covid patients was reported as 5,021. However, until today, we were not permitted to know that only 3,855 of those were actually admitted with Covid as the primary diagnosis. There has been a fairly consistent overestimate of the true number by about 25% running back to mid June – figures before that date are ‘not available’.

Why does this matter?

Well in one way it doesn’t matter very much. Whether the burden of Covid inpatients is 5% of the available beds or 3.5%, isn’t massively significant – it’s still a relatively small proportion. NHS managers are already arguing that even patients with Covid being treated for another condition still need isolation procedures and present an extra burden on the system. They may argue that the NHS is still under strain from staff absences, stress levels and the waiting list backlog – so it doesn’t really matter if the published figures are somewhat inaccurate.

But it matters hugely.