Good afternoon and welcome to my latest patient safety update in which we cover stark warnings about the future of general practice at the select committee, worrying signs on Covid at home and abroad, the latest on the Ockenden Review, and the Public Accounts Committee report on the NHS.

A MASSIVE CRISIS IN GENERAL PRACTICE  was the stark message from Martin Marshall during the first evidence session of the Health and Social Care Select Committee’s inquiry into the future of general practice. He warned that 34% of GPs had indicated that they would retire in the next five years which would mean we’re set to lose around 14,000 – more than we are planning to recruit over the same period. You should all know what my long-term solution to this problem is by now (independent projections of workforce needs for those not paying attention at the back) but Martin had a few other areas we need to focus on. So alongside increasing the size of the workforce he suggested we should be encouraging GPs to work differently to cope with the additional workload they are facing, and manage demand by ensuring patients know when to go to their GP and when to go elsewhere. As he ended by saying, there are no real short term or easy fixes to this but plenty that government could be doing. Watch this short video on why we’ve started the inquiry itself for more background info and why it matters for patient safety.

PAYING TO WORK The Committee also heard from Dr Kieran Sharrock from the BMA on how the tax treatment of pensions was encouraging people to retire early. He described how GPs coming to the ends of their careers were essentially paying to work. He suggested we should look at the way judicial pensions have been reformed to address this anomaly. With retention being such an issue I think this is something the government should seriously look at.

SPARE TRAINEES In the latest sign that our current system of workforce planning isn’t working there are nearly 800 medical graduates who haven’t got a training place. This is the highest number for six years and up 300 on last year. Given the shortages virtually all specialties are facing better planning would arguably have ensured funding was available for these places. Let’s see how many of them do eventually get spots but either way this doesn’t seem a sensible or practical way to plan the pipeline of future doctors.

OCKENDEN PUBLICATION After the disappointment of last week’s delay the Department of Health and Social Care has confirmed that the Ockenden Review final report will now be published on 30th March. Good news the government has managed to find time before the Easter Recess but it is surely essential that Sajid presents the report himself to Parliament.

PAC ATTACK The Public Accounts Committee has a report out this morning stating that the government has “overseen years of decline in cancer care and non-urgent hospital services in England”. It also highlighted the problems facing a workforce exhausted after two years of the pandemic. Themes we will return to in our forthcoming cancer report.

COVID AT HOME Speaking of which sadly as we feared the ONS is now picking up the increase in Covid cases as it reports that 1 in 25 people in England had the virus in the first week of March. This is up from 1 in 30 in the last week of February. With the dashboard showing cases have risen by over 50% in the last 7 days and hospitalisations by 18% we really do need to start on those fourth shots, particularly for those who are more vulnerable.

AND ABROAD Yet more evidence of the life saving impact that the vaccines have had comes in this fascinating thread by John Burn-Murdoch at the FT on the situation in Hong Kong. Sadly vaccination rates for the elderly in Hong Kong are still very low (2/3s of over 80s are unvaccinated!) and this is leading to around 1 in 20 people who get the virus dying. That is higher than the early months of the pandemic in the UK. John compares Hong Kong with New Zealand which is experiencing a similar wave of Omicron but thanks to much higher vaccination rates is doing so with a far, far lower fatality rate. More reasons to cheer our vaccination programme but a reminder we can’t be complacent. 

THE ADMIN As ever you can sign up to receive this update via our website here and please tell any friends you think might enjoy it. Patient safety matters - and step by step we are making sure the world realises!

Jeremy Hunt