Good afternoon and welcome to my patient safety update which this week despite all the other issues swirling around looks at some really important NHS issues including COVID, the role of national targets, potential new reforms, the government’s preferred candidate for Chair of NHS England and social care vacancies.

COVID LATEST It really does look like we are past the peak with the latest ONS numbers which estimate that 1 in 15 people had the virus in England which is no change from the week before - but given the two week time lag a pretty significant flattening of the sombrero. More recent new case numbers show even better news as the seven day average is down nearly 40%. Patients being admitted to hospital with covid is also down and the overall number of patients in hospital is steady. All of which is largely thanks to vaccine immunity which has now seen 4 in 5 eligible adults boosted. Unless something dramatic changes the government is expected to remove some of the restrictions later today or tomorrow.

TARGETING SAFETY I used the latest Health Oral Questions to ask the Secretary of State about what may seem a small issue in the grander scheme of things but actually something that defines NHS culture - the role of national targets. We use targets more than any other health large health system in the world and I have long worried they focus attention on numbers rather than people, so prompted by reports he is looking to learn from the academy model in our education system (more below) I urged him to look closely at the distorting impact targets can sometimes have on quality and safety of care. Encouragingly the SoS said all national targets should be reviewed. Labour will scream this is because the government is not hitting them, but behind the fireworks I hope we can have a sensible debate on the best way to preserve hard accountability for politicians without compromising a patient-centred focus in the system.

MORE NHS REFORMS? The Health and Care Bill hasn’t finished making its way through Parliament but the Health Secretary is already looking at what further reforms might be needed to get to grips with the backlog. According to the Times he’s considering giving well run hospitals more freedoms, introducing ‘reform trusts’ and chains of hospitals to be run by leading NHS managers. These proposals are expected to feature in a future White Paper and there is no doubt a lot can be learned from the regulatory structures in education which have transformed state schools over the last 20 years or so. But the more immediate challenge is surely workforce reform upon which my views are well known - and backed up by more data this week saying one in four doctors are reportedly so tired their care of patients is impaired.

NHS ENGLAND CHAIR Which is why I asked the government’s preferred candidate for the position of Chair of NHS England whether workforce would be one of his priorities. This was part of the Health and Social Care Select Committee’s pre-appointment hearing with Richard Meddings which you can watch in full here. He answered a range of questions and in the end we approved his appointment despite his lack of health experience. His answers on social care were not great but he is understandably on a learning curve - and most significantly he said he would back the NHS over the Treasury on workforce issues, a not insignificant point given he was until recently a non-Exec director at that very same Treasury. Our report on his approval his here.

SOCIAL CARE VACANCIES Are in many ways even more of a concern than those in the NHS with CQC figures showing they nearly doubled during 2021 from 6% to 11.5%. London has the highest vacancy rate at 12.5% but the East of England actually experienced the fastest growth in vacancies last year going from 5.3% to 12.1%. The government’s ‘Made with Care’ campaign is very welcome but we need much more than an advertising blitz to fill these vacancies.

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.

Jeremy Hunt