Good afternoon and welcome to my latest patient safety update in which we look at the lifting of Covid restrictions, the new CQC Chair, the scrapping of ‘natural birth’ targets, a new taskforce on maternity disparities and an interesting report on social care from Camilla Cavendish.

FREEDOM (AGAIN) The Prime Minister confirmed that all remaining domestic Covid restrictions will be removed at the end of this week as he set out his plan for living with Covid. Few people really disagreed with the approach but there was some concern that the abolishing of free testing and funding the ONS study going forward will leave a big hole in the DHSC budget. There were also concerns from the NHS Confederation about NHS staff having to fund their own tests. A bigger concern is whether we really have learned the lessons about NHS capacity if we are going to get through future pandemics without switching off vital services. No sign the message has got through according to this exchange between me and the Prime Minister. It won’t do to say we have ‘more’ doctors and nurses when the question is whether we have ‘enough.’

KEEP JABBING Also part of the new plan there was welcome news that over 75s, care home residents and those who are immunosuppressed are to be offered a fourth booster jab. This follows the news that children aged 5-11 will also be offered a first vaccination, something that even hesitant parents may consider if they want to take their children on holiday to Italy. All this feels sensible even if some of us are asking why it is taking the JCVI so long compared to their earlier fleetness of foot.  

CQC LEADERSHIP On Tuesday the Select Committee held a pre-appointment hearing with the government’s preferred candidate to be the new Chair of the CQC. Ian Dilks had previously been Chair of NHS Resolution where he did a pretty good job, inheriting what was then the NHS Litigation Authority and really turning it round to focus on reducing the long term drivers of our £2.2 bn annual litigation bill, namely reducing incidents of patient harm. I pushed him on how the CQC will assess ICSs and the importance of CQC independence. There were some complaints from my fellow committee members about his lack of knowledge of social care (something he was in fairness quite honest about) but we approved his appointment.

MATERNITY TARGETS Check out this really important story from Shaun Lintern at the weekend about how NHS Trusts have been told to stop using caesarean rates to monitor performance as they encourage the pursuit of vaginal births over safety. My Select Committee called for the end of the use of such targets in our maternity safety report last summer, echoing campaigners like James Titcombe who have been pressing for it for years. In a letter seen by Shaun, Jacqueline Dunkley-Bent and Dr Matthew Jolly write that they are worried “by the potential for services to pursue targets that may be clinically inappropriate and unsafe in individual cases”. Safety has finally trumped ideology in this case - but what about all the other targets? The NHS has more targets than any other healthcare system in the world - perhaps it’s time we asked why.

DISPARITIES TASKFORCE Another potentially important maternity safety development was the announcement by the government of a new taskforce to tackle the disparities in care received by women belong to ethnic minorities and those living in deprived areas. The taskforce will be co-chaired by Maria Caulfield, the Minister for Women’s Health and the Chief Midwifery Officer, Professor Jacqueline Dunkley-Bent. It will meet for the first time on 8th March. If you want to hear the best reason why this matters, listen to this evidence from campaigners Clotilde and Tinuke from last year’s select committee hearings.

TWO MORE MATERNITY SAFETY GEMS  (if such things exist) are the latest HSIB report on the safety risks associated with maternity pre-arrival instructions by 999 call handlers and tonight’s Panorama report on the failures at the Shrewsbury and Telford NHS Trust - 9 pm on BBC1 for that small minority of you who still watch terrestrial TV. The programme was featured on the Today programme this morning where I spoke to Justin Webb about the dangers of thinking this is just a Shrewsbury and Telford issue (1 hour and 54 minutes in).

SOCIAL CARE REPORT On Monday, with zero fanfare the government published Baroness Cavendish’s independent review of social care. Camilla is one of our most thoughtful commentators on the challenges of an ageing population and if you haven’t read it her new book is well worth a read. The question what will happen to her report given the government has already published its White Paper - it contains a lot of original thinking that could really have improved a white paper that was rather rushed out.

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Jeremy Hunt