Good afternoon and welcome to my patient safety update which this week stays well clear of birthday parties and police investigations (sorry!) and instead looks at COVID, an important Select Committee session with the Health Secretary, what’s gone wrong at HSIB, and the House of Lords debate on the Health and Care Bill.

COVID The picture is starting to look really quite encouraging. ONS data shows a decrease in case numbers (1 in 20 people had the virus in the week ending 15th January compared to 1 in 15 in the previous week) and that trend is continuing with more recent data showing a 3% decrease in cases in the last 7 days. There’s good news on the hospital admissions front too with those down 15% in the last week. We’re also seeing the start of a tailing off of the actual number of patients in hospital with covid. With 37m people having been boosted I would hope these numbers will continue to head in that direction even with the lifting of the Plan B restrictions - and in each previous wave the lifting of restrictions has not stopped the decline, something which I have yet to find an epidemiologist who can explain. It is surely now time to start planning for further boosters as we learn to ‘live with Covid,’ particularly as Israel is already going down that route.

HEALTH SECRETARY EVIDENCE SESSION It won’t surprise you to know that I focused my questions on workforce issues where the lack of urgency was summed up aptly by former NHS CEO Lord Stevens as ‘wilful blindness' in his speech to the House of Lords on Monday. What does that mean in practice? No response to the report on burnout six months ago; Health Education England still without a budget even though the financial year starts in April; no workforce plan to deal with the backlog; no long term workforce plan; and of course independent verifying of training numbers voted down. So I tried a new approach with Sajid: given that the government has already used Birthrate Plus to provide an independent estimate of the number of additional midwives we need - and funded the shortfall with £95m - why not do the same for the rest of the NHS? In fairness something like that does happen for nurses (currently a shortfall of around 36,000) but there is nothing for doctors where there are shortages in nearly every specialty except neurosurgery. Finally, one longer term benefit of resolving the workforce issues would be that we could go back to GPs having their own list of patients to ensure continuity of care for us all, a question prompted by yesterday’s report in the British Journal of General Practice that people with dementia are 35% less likely to have delirium if they see the same doctor regularly. There was also a strong hint, not widely picked up, that he might delay the February deadline for NHS to be double vaxxed on the basis that omicron is milder than delta so less of a patient safety risk.

LORDS ON THE HEALTH AND CARE BILL On Tuesday the House of Lords debated the workforce planning amendment tabled by Baroness Cumberlege. This is the same amendment I moved in the House of Commons which would introduce independently verified workforce projections every two years. Julia spoke to it brilliantly. I’ve mentioned Lord Stevens’ ‘wilful blindness’ quote already but it is well worth spending two minutes reading his whole speech.. The Minister, Lord Kamal responded for the government and largely repeated the same arguments we’ve heard against this amendment – namely that their 15 year framework is coming, as is the elective recovery plan, and we’re already recruiting more staff. Interestingly he also said that “there is a concern that publication in a two-year cycle could be seen as too rapid given the long lead times for many health professionals”. Perhaps there’s a chink of light here? Could we persuade the government to do one of these reports once every 4 or 5 years? He ended by hinting more work and discussions were needed on this issue. Let’s hope so.

TROUBLE AT HSIB In an extraordinary and deeply troubling story Shaun Lintern has exposed big issues at HSIB. There was obviously something very wrong with the culture of the organisation and its management with widespread bullying, sexism and racism. Hopefully new leadership can start creating the right culture as the work HSIB does is extremely important and independent safety reports are vital given what we are about to hear in the Ockenden and Kirkup maternity reports. Things need to change and change quickly. Shaun has also heard that the DHSC is considering stripping HSIB of its maternity services investigations but surely any issues there can be sorted out by new leadership without the upheaval of setting up yet another independent body to do these vital reports.

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Jeremy Hunt