Good afternoon and welcome to the latest edition of our patient safety update. This week we look at the government’s winter covid plan, the latest on the health and social care levy, the select committee’s session on cancer services and events on World Patient Safety Day this Friday. As ever you can sign up to receive this update via our website here.

THE VACCINE PLATEAU There seems to be a steadying off in case numbers over the last week or so and the first slide from the Number 10 press conference yesterday shows the seven day average of new cases has even started to decline. Hospitalisations also seem to be holding at around 1,000 new admissions a day. Although it seems weird to have a plateau when we are used to exponential growth rates, the number of those actually in hospital with COVID is still rising and now at nearly 8,500. We will also see case numbers tick up from next week as the impact of the schools and offices returning feeds in. But here is a stunning fact from the ONS:  99% of those who died from COVID between January and July of this year had not received two doses of vaccine. PHE stats also state that 143,600 hospitalisations, 112,300 deaths and 24,702,000 infections have been prevented as a result of the vaccination programme.

WINTER IS COMING so the government has published its plan and finally we have both a vaccine booster programme and vaccinations for 12-15s (see next para). Test and Trace will remain an important tool in keeping cases under control and this new modelling has found that it has in fact reduced transmission contrary to what some sceptics have been saying. The government is surely wise to hold measures such as mandatory face masks and covid status passports in reserve as nobody quite knows what will happen, not least SAGE who warn that hospitalisations could jump very sharply to between 2-7,000 a day. Ideally we would have started the two new vaccination programmes at the beginning of this month but you can sympathise with ministers wanting cover from JCVI/CMOs before making some momentous decisions.

CHILD VACCINATIONS We have also - finally - made the right decision on the vaccination of 12-15 year olds. As I told the House of Commons on Monday night the direct health benefits of doing so are marginal but the wider benefits are significant. The mental health impact of school disruption played a part in the decision, sensibly, but equally wise was the decision not to factor in the health impact on adults - no parent is going to agree to sacrifice a child’s interest for wider societal benefit and scientists and politicians are wise not to try.

HEALTH AND SOCIAL CARE LEVY This was debated yesterday and I had a pop at the opposition parties for not supporting it. I normally avoid doing so on the basis that we have enough Punch and Judy in the Commons but for people who have been arguing for over a decade that the NHS is underfunded it just seems ridiculous to vote against a £12bn rise. But my main concern is that the money ends up being wasted because we do not expand the workforce fast enough to deliver the extra care  as I argue in this thread. We also need to make sure that we don’t end up with a targets culture as we did the last time there was a huge backlog, leading amongst other things to Mid Staffs.

MENTAL HEALTH PARITY It looks like the government/NHS may have inadvertently forgotten the Mental Health Investment Standard when they announced the £12 bn. That vital commitment, dating from my and Simon Stevens’s time, commits the NHS to increasing mental health spending at a faster rate than overall NHS spend but appears to have been overlooked in the way the NHS’s £8 bn share of the pot is allocated. I asked Sajid Javid about the issue yesterday and received a helpful - but non-committal - reply. To be continued.

CANCER CATCH UP In another very emotional session the Select Committee heard yesterday about what needs to be done to improve cancer outcomes in the UK. We started with a powerful testimony from a lady from Hertfordshire called Andrea who lost her daughter Jessica due to repeated missed diagnosis (including no fewer than 20 conversations with her local GP surgery). Her suggestion to reintroduce named GPs for every patient to help reduce the chances of this happening was well received and her whole testimony is worth a listen. Once again issues of workforce featured prominently, this time because of the risk it poses to stopping us meeting our ambitions to diagnose 3/4s of cancers at the early stages by 2028.

TED BAKER After nearly five years as Chief Inspector of Hospitals Ted Baker has announced that he will retire in March next year. I thoroughly enjoyed working with Ted and think he can look back on his time at the CQC with pride – he had big shoes to fill after Mike Richards but did so brilliantly and was passionate about getting culture right so people are able to learn from mistakes. Mike and Ted’s legacy is 4 million more people using good or outstanding hospitals every year - not a bad starter for ten.

WORLD PATIENT SAFETY DAY The reminder that you won’t need is that this Friday is the third World Patient Safety Day. This year is focusing on safe maternal and newborn care something I’ve been passionate about for a number of years and that the Select Committee recently published a report on. I’ll be speaking at a number of events throughout the day including those hosted by the WHO, Imperial College and Patient Safety Movement Foundation.

SPEAKING OF EVENTS I couldn’t do an update on patient safety without mentioning Baby Lifeline’s amazing maternity conference last Thursday. It was great to do it in person again after such an extended break and well done to Judy and all the team for putting on such a fantastic conference.

Jeremy Hunt