Good afternoon. Today how confidence is replacing caution around COVID and whether that is wise; what is really happening with the social care delays; and the big things that need to change in the provision of mental health for young people. Please remember to get your friends and colleagues to sign up if they are enjoying this email which they can do here.

COVID COURAGE? The general sense I’m now getting is that the government is confident they’ll be able to lift pretty much all of the restrictions on 19th July including allowing those who have been double jabbed to avoid quarantine when travelling back from certain countries abroad. This confidence is fueled by a slowing down of the growth in cases and the fact that daily hospital admissions have remained below 200 and seem to be heading downwards. As someone who has generally advocated a more cautious approach I find myself torn. Only a few days ago we seemed a long way from a ‘big bang’ reopening but with less than 1% of hospital beds occupied by Covid patients and 80% of adults vaccinated by 19 July, I now think -subject to data - we need to start trying to get back to normal. But I would feel more relaxed doing so if we fixed some of the issues in test and trace, namely the disincentives that still exist to people self-isolating when they are asked to.

WINTER WORRIES The other caveat, as a veteran of them myself, is NHS winter pressures. NHS leaders are warning about how an additional surge of COVID patients plus the normal winter pressures will severely hamper their ability to clear the backlog and the key point, as Saffron Cordery says, is that whilst the vaccines are clearly breaking the link between infections and hospitalisation, “the reality on the frontline is that even a small increase in COVID-19 admissions or emergency care pressures could affect our ability to deliver non-COVID services.” Many A&E departments are already really under the cosh but a more generalised move to call before you walk could make a big difference.

SOCIAL CARE DELAYED…AGAIN It may seem strange how the postponement of a simple meeting came to summarise all that is wrong in our approach to social care but that’s how the sector felt when  a crunch meeting between the PM, Chancellor and Health Secretary was put off. As I wrote on Monday, rarely were so many hopes pinned on a single, behind the scenes meeting so we have more delay and lots of anger and frustration. None less my sources tell me the issue is ‘very live’ with plans being bandied around Whitehall with a Dilnot-style cap very much on the table. Listen to my question to Helen Whately about this at today’s urgent question in the House.

MENTAL HEALTH BOOST… In better news NHS England announced £40m was being invested to address the impact of COVID on children’s and young people’s mental health. £10m of this is being spent on additional beds and there is a very welcome focus on eating disorders where referrals are up by a quarter since the pandemic. I asked Nadine Dorries at the Select Committee how we could do more to help young girls in particular come forward for treatment earlier.

…BUT STILL A MAMMOTH TASK to improve children and young people’s mental health overall, given Nadine Dorries’s confirmation yesterday that 60% of young people are not getting the treatment they need.  We had a very thorough Select Committee with her, Professor Tim Kendall and Claire Murdoch covering whether we should adopt the Trieste model here and stop all long term admission of mentally-ill young people; what funding streams need to change to get more resources into community provision and the whole approach to suicide prevention. However the reforms in the mental health green paper of 2017 (which I oversaw) seem to be on track, with a third of school children due to get access to new mental health support teams within the next two years.

MATERNITY INFO As part of the Select Committee’s inquiry into maternity services our Independent Expert Panel is now assessing the government’s performance against its own ambitions. To do so they asked the Department for a whole host of information. This exchange of correspondence has now been published and there’s some interesting snippets in there: confirmation that the Department is funding the RCOG and HEE to develop a framework for calculating safe staffing levels similar to Birthrate Plus alongside Midwife and Doctor attrition rates for the last ten years; well worth a skim. The next year is going to be huge for maternity safety: the Ockenden Report into Shrewsbury and Telford, the Kirkup review into East Kent and a year of focus on the issue by the World Health Organisation who say there are 7,000 newborn deaths every day across the world. All will kick off next month with the select committee report which I have seen although my lips are of course sealed until it is formally approved and published.

SAFETY CONFERENCE Don’t forget you can sign up now to HSIB’s second Healthcare Safety Investigations Conference which is taking place this September.

Jeremy Hunt