Good afternoon welcome to my weekly rant in which I look at the week’s health news through a patient safety lens. If you are enjoying these emails please forward them to a friend - and if you have been forwarded it, you can sign up here. This week I look at mental health (it being MH awareness week), the new NHS Bill and the big disappointment of the week namely…

SOCIAL CARE REFORM FLUNKED Blink and you would have missed the briefest of possible mentions on social care in the Queen’s Speech yesterday which was a huge disappointment to me, many other MPs and the social care sector. The Mail front page summed up what many felt and I don't pull my punches in an op-ed later in the paper. I wasn’t expecting massive detail from Her Majesty but the briefings that go alongside the speech were as vacuously empty as the mention itself, suggesting the battle is still raging between No 10 and No 11. Philip Johnston has a good description of the issues in the Telegraph - his main insight is that it isn’t a lack of consensus between political parties blocking reform, but a lack of it inside the government about how much money they are prepared to commit. That said, social care was mentioned and the Health Secretary and the Prime Minister’s Spokesman and the PM himself all reiterated that plans would be brought forward this year. They had better do so because from my own bitter experience I know NHS reforms will fail if a desperate care system continues to export its most vulnerable patients to hospitals, often the worst place for them. Ongoing Treasury resistance seems to be the issue and the crunch will now come in the autumn spending review.

WHY WE NEED REFORM Needless to say I see it as a critical patient safety issue if vulnerable people are not given the support they need to live safely at home, something Age UK thinks is happening to up to 1.4 million people. Without getting into esoteric debates about the role of the state vs the individual I would also like incentives to encourage people to save for at least some of their care costs as part of their pension - but that is only ever going to help in the long term, and there is a crisis now. The King’s Fund’s Social Care 360 finds that in the last five years 120,000 more people requested social care, but 14,000 fewer actually received support. Age UK has found that the pandemic has increased people’s needs with 1 in 4 older people reporting their ability to do everyday things has worsened. The Daily Mail has crunched the numbers and finds that 17,000 were forced to sell their home to pay for care costs in the last year, up nearly half in the last two decades. Like me, Sir Andrew Dilnot himself says the Prime Minister cannot duck the issue any longer but since his pledge on the steps of Downing Street, Age UK estimate that 10,000 people have had their savings wiped out to pay for care.

BETTER NEWS FOR THE NHS was the inclusion of the long-awaited Bill to put ICSs on a statutory footing, to ensure patients get “more tailored and preventative care, closer to home”. This follows the White Paper which the Select Committee will be publishing its verdict on later this week. My lips are sealed but the tone of our evidence sessions has been a cautious welcome to the proposals. NHS Providers responded thoughtfully to the proposals as ever in a good summary of where the NHS establishment stands on them.

WORKFORCE ‘SLAP IN THE FACE’ Worrying story from Shaun Lintern who reports that “hundreds of doctors… have been told they won’t have jobs in the NHS training scheme from August”. Due to a lack of training places nearly 700 doctors with four years training are now going to have to find non-training jobs within the NHS. This is yet more evidence that we aren’t getting workforce planning at all right. All the more reason for the NHS Bill mentioned above to include a new duty on HEE to publish independent projections. Alongside social care the absence of a workforce planning overhaul remains the biggest gap in the plans. Which is why I was pleased to hear that the Prime Minister agreed with me that his needed to change if we are to ensure we train enough doctors and nurses. Something to watch for when the Bill is published.

CONNECT WITH NATURE As we are currently in Mental Health Awareness Week worth checking out the campaign to encourage us all to connect with nature to help improve our mental health. Gone are the days when Prince Charles was ridiculed for tree-hugging - the benefits of nature on mental health are now ‘mainstream’ as these tips show. 

HUGS ALL ROUND (SORT OF) Big COVID news of the week is that the Prime Minister confirmed we are moving to the next stage of the government’s roadmap. The UK’s Chief Medical Officers also moved us from alert level 4 to 3. Although that means we are now allowed to hug our loved ones again it is worth listening to the Prime Minister when he warns that this “does not mean we can suddenly throw caution to the winds.” He was also right to announce that a full public inquiry into the coronavirus pandemic would be held, starting in the Spring of 2022. This should mean that everyone can continue to focus on managing the virus through the next months rather than be distracted by an inquiry starting too soon.

COVID STAT ATTACK Daily cases dipped back below the 2000 mark a few days ago (although have crept back up again), there are just over 1100 people in hospital with the virus, and no one died from it on Sunday. All very encouraging news.  

PATIENT SAFETY CONGRESS PROGRAMME has been launched and you can take a look here. Yet again a great programme with lots to enjoy.

IND2021 Finally, happy International Nurses Day and THANK YOU to all my nursing readers for all the brilliant work you’ve done over the last year. I think it is fair to say it has been noticed!

Jeremy Hunt