Good afternoon and welcome to another patient safety weekly update. Our new time slot made no discernible difference to our read rates (what loyal readers you are) so we’re going to stick with it for now as it is more timely. This week I look at our continued progress in tackling COVID-19, a few concerns with the vaccine programme, preventable suicides, maternity training and more.  

COVID-19 LATEST Daily cases still seem to be stuck around the 4,000 mark with the ONS survey reporting a levelling off of community cases at around 160,000 in England and a slight uptick in the number of cases in the 35-49 age group. Daily hospitalisations seem to have plateaued too at about 300 new admissions a day. But more positively daily deaths have continued to decrease and according to the ONS are in fact below the five year average for the second week in a row. My conclusion (and Matt Hancock’s new slogan): don’t blow it now. 

VACCINE GOOD NEWS More than 30 million people have had a first dose and over 3 million a second with the ONS reporting that 90% of 70+ year olds in England have received at least one dose. Analysis by Public Health England states that the vaccination programme prevented 6,000 deaths in the over 70s up to the end of February. Also from the ONS more than half of people in England (54%) and Wales (50.5%) now have antibodies - a stunning result also largely thanks to the vaccine rollout. The figures are slightly lower for Northern Ireland (49%) and Scotland (43%). 

VACCINE BAD NEWS Germany has once again flip flopped on the AZ jab banning its use for the under 60s. I sense a lot of DPhil research projects in the next few years called ‘Can the precautionary principle kill?’ In the UK we have our own issues though with uptake from some minority ethnic communities remaining worryingly low. The lowest vaccination rates were from people identifying as Black African (59%) and Black Caribbean (69%). Fewer people from Bangladeshi (73%) and Pakistani (74.0%) backgrounds have also been vaccinated. Thank you to Lenny Henry and others for a new campaign to try and address this.

GLOBAL PANDEMIC TREATY Finally on COVID related news world leaders and the WHO have come together to call for a new global treaty to better prepare us for future pandemics. The mad dash for PPE at the start of the pandemic and recent vaccine wars show why we need this. But we also need more transparency when new pathogens arise - not least from China. Even the WHO has criticised China for a lack of data meaning they cannot rule out the virus originating from a research lab in Wuhan.  

PREVENTABLE SUICIDES Following last week’s select committee session on mental health the Independent has reported on the inquest into Azra Parveen Hussain’s suicide whilst under the care of Birmingham and Solihull Mental Health NHS Foundation Trust. The coroner found that multiple opportunities were missed that would have kept her safe. They also highlighted a lack of national regulation or guidance on the risks presented by internal doors in patients’ bedrooms. We don’t know how many of the 5691 suicides registered in England and Wales in 2019 could have been prevented (and in fairness in patient suicides have been coming down) but let’s hope the NHS does commission quantitative research on the scale of the issue as Tim Kendall hinted might happen last week.

PREVENTING SUICIDE FIFTH PROGRESS REPORT Also timely is the release by the DHSC of the latest progress report on reducing suicide. Although rates increased in 2018 and 2019 the early indicators are that there doesn’t appear to have been a rise in 2020 despite numerous lockdown mental health issues (e.g. a doubling of eating disorder referrals according to Claire Murdoch). The report also highlighted the additional £500m recently announced to address waiting times for mental health services. 

MATERNITY TRAINING FUNDING NHS England announced last week that they will be spending nearly £100m on training and recruitment. This is fantastic news because - being recurrent - it means nearly 1000 midwives will be permanently added to staffing levels, meaning we should start to meet the Birthrate Plus standard. As Simon Stevens said as part of the announcement there is more to do but this is a big achievement for Chief Nurse Ruth May in particular who by all accounts played a blinder in her negotiations with NHSE.

SAFE DISCHARGING Last week the CQC published an update regarding its work helping create designated settings within care homes that hospital patients with COVID an be discharged safely into. We all know how badly this issue can go wrong so the CQC has set out some of the reassurances they will be looking for, making clear that there are now 155 places across 108 different local authorities that meet the required standards.

FIVE X MORE CAMPAIGNERS NOMINATED Atinuke and Clotilde the founders behind the Five X More campaign have been nominated by the House of Commons for ‘petition of the year’. Not only did their petition get nearly 200,000 signatories but their evidence to the Health and Care Select Committee was incredibly powerful. Congratulations to them both for being such effective campaigners.

PUBLIC HEALTH REFORMS The government has published more details of its plan to reform public health. The main structural change is the creation of the Office for Health Promotion that will pick up the prevention side of Public Health England’s work. This will sit within the Department of Health and Social Care and be led by the Chief Medical Officer.

HAPPY EASTER I must be feeling better from my Covid as I have just spent an exorbitant amount buying Easter eggs online. I hope you have a lovely Easter weekend. We’re taking a break next week so the next update will be on 14th April.

Jeremy Hunt