Good afternoon and welcome to my regular patient safety update. Even though Westminster is convulsed with stories about parties, much worse stories of patient harm are just not going away. This week we heard really concerning news about a potential cover up at the North East Ambulance Service, a really frustrating stonewalling on workforce issues at the select committee and two reports highlighting just how badly maternity services let down black and mixed ethnicity women. The only silver lining is that Covid continues to decline - who would have thought we would be taking comfort from that?

HERE WE GO AGAIN The Sunday Times is showing how inspired it was to take on Shaun Lintern as Health Editor after he uncovered a horrible cover up this time from the North East Ambulance Service. As I told the House of Commons, it isn’t the mistakes that are the real cause of concern, but the cultural and legal context that mean people think it is better - and potentially safer - to cover things up than be honest and seek to understand what went wrong. Paramedics do a brilliant job under huge pressure and are going to make mistakes - but how easy do we make it for them to say so? On this particular instance it is welcome to see that the government is going to investigate exactly what happened - but would it have happened without investigative journalism? Surely we need a systems that self-corrects by being hungry to learn from mistakes without prompting from the media.

WORKFORCE WOES In the latest Select Committee evidence session for our inquiry into NHS and social care workforce we heard from the dentistry, pharmaceutical, nursing and midwifery sectors on the challenges they are each facing. The main concerns from the British Dental Association was that only half of the population has access to NHS dentistry and there is a migration of dentists to the private sector - with the dental register going up but NHS dentists down by 3000. Depressingly despite a report nearly a year ago from the Select Committee arguing for 2000 more midwives their numbers too have continued to decline. Worst of all was some revelations about the much-trumpeted ‘Framework 15’ which was what the government said it would do instead of the independent workforce projections we unsuccessfully argued for in the new Health and Care Act. Apparently Framework 15 will not after all tell us how many doctors, nurses and midwives we are likely to need in 15 years, nor whether we are training enough for the future. So why chop down trees and waste of all of our time producing it? See my very frustrating exchange with the head of Health Education England.

BIRTHRIGHTS AND FIVEXMORE REPORTS Two reports out this week really shine a light on another issue the Select Committee looked at last year – the significantly worse outcomes experienced by black and ethnic minority women using maternity services. The Birth Rights report calls for change on issues ranging from education, training, and the need to see better representation in leadership positions. The Fivexmore inquiry found very similar negative experiences grouped into three areas of offensive attitudes, poor knowledge, and racially based assumptions.  It feels like there is a double whammy here: a higher likelihood that minority ethic mothers will have higher risk pregnancies for socio-economic reasons and prejudice such as believing black women will have higher pain thresholds. The former can be mitigated but not solved by the NHS on its own but the latter should surely be stamped out immediately.

NOTTINGHAM LATEST The families have reiterated their calls for Donna Ockenden to lead the review into the maternity services at Nottingham after she seemed to confirm she would be free in July. If that is the case and the families are happy to wait until then I can’t see any other barriers to appointing her but it sounds like she still won’t be. For some reason the Department of Health appears to think she is too independent - which of course is precisely why Nottingham families do have confidence in her. It feels like another own goal. I am meeting the families tomorrow.

COVID LATEST Some interesting analysis by the ONS comparing Covid as an underlying cause of deaths to flu and pneumonia. This found that Covid was an underlying cause in four times as many deaths as flu and pneumonia since March 2020. The government has also signed the G7 Pact for Pandemic Readiness which will see the signatory countries share what worked during the Covid outbreak and ensure we are better prepared in the event of another one. In terms of our usual update the ONS Survey shows yet another fall in new cases with 1 in 55 people in England in the community having the virus in the week ending 14th May compared to 1 in 45 in the previous week.  The dashboard also sees cases (15%%), hospitalisations (18%) and deaths (37%) all dropping. There is also a big drop in the number of patients in hospital with Covid falling from 7613 which we reported in last week’s update to 4639 now.

THE ADMIN AND A PLUG Lots going on again so please do sign up to receive this update via our website here. You may also have heard that an excellent new book on patient safety has been published, available on Amazon and in all good bookshops. Generally positive reviews - here is my personal favourite (but not entirely comfortable) review from Dr Rachel Clarke. And here is my favourite tweet from someone who manned the barricades against me.

Jeremy Hunt