News from Nowhere 103 November 2021

Watch out for the eek! in geek

The public perception of Test and Trace is “incredibly negative” says the new head of NHS Digital Simon Bolton. He describes the way the NHS collects and uses data as “not logical”, with innovative efforts by trusts, ICSs and NHS centre “overlapping considerably”. Providers often have “no idea” what the data they spend “time and effort to provide” to the centre is used for. His priority is to stop the NHS creating “two solutions to the same problem”.

This reminds NfN of Connecting for Health, launched in 2002 and closed in 2009 after a series of IT melt downs. The Connecting for Health project began at a meeting between computer experts and a Prime Minister who knew little about computers. It was overambitious, far from essential, and seems not to have had any robust economic analysis. Millions of pounds were wasted, for little if any benefit. Wish Simon Bolton well, please. 

Sources:  Daily Insight: The other side of the Test and Trace story  HSJ 23/10/21 and Anthony King & Ivor Crewe The Blunders of Our Governments  OneWorld  2013 pages 196-200 

Cancer backlogs

If hospitals can maintain activity levels 5 per cent above pre-pandemic levels, it will take until 2033 to clear the cancer treatment backlog caused by the pandemic. However, if activity levels can be increased to 15 per cent above pre-pandemic levels, backlogs across the cancer care pathway could be cleared by next year.

Source: https://www.ippr.org/research/publications/building-back-cancer-services

Access to general practice: storm in teacup?

The Daily Mail and the Telegraph have been horrid to GPs, who are peeved and threatening to strike, retire early or emigrate. The Nuffield have done some work on current public attitudes towards general practice, and the news is relatively good. Based on data from 850,000 patients, the independent GP Patient Survey 2021 showed increases in overall patient satisfaction with general practice, satisfaction in being able to make an appointment; and satisfaction with the appointment times offered. 

On the other hand, Healthwatch and the Care Quality Commission are recording rising number of concerns and complaints, typically about appointment availability, waiting times, and in particular, the ability to see a GP, especially face-to-face. Access to GPs has been a problem for some time – since the start of the NHS, according to some ancient NfN moles – so there will be no quick fixes, but some appreciative words and some extra investment would help.

Sources:  NHS Our plan for improving access for patients and supporting general practice 14 October 2021 and Rosen R and Paddison C  “The new GP plan is much better than the headlines suggest – but it’s only the beginning”, Nuffield Trust 2021

Not bad for a three-day week

Although the number of GPs has increased in the last year, many are working part-time, and locums are in demand. Here’s an example of what locums are offered in South London

  • Six sessions starting ASAP
  • Clinic hours 0830 – 17:30 (Nine hour working day) 
  • 15 appointments in both the morning and afternoon, including telephone triage and some-face-to face consultations. Also self-generated administrative work 
  • Minimum pay £775 per day (£2325 per week or, assuming 6 weeks holiday a year, £106,950 per year)

Source: NfN moles, no names no pack drill


Command & Control, at last?

Operation Rescript is the ongoing military operation to help contain the COVID-19 pandemic, and is the UK’s biggest ever homeland military operation in peacetime. It has involved up to 23,000 personnel deployed in a Covid Support Force (CSF) and must have come as a surprise to NHS management. When the military is asked to jump, it asks ‘how high’, but when the NHS is urged to act it seeks guidance from above and takes soundings from stakeholders.

Launched in March 2020, at the start of the pandemic’s first wave, the operation began with the airlifting of critical COVID-19 patients, logistical support, planning support and the formation of a helicopter task force. From April 2020, the CSF began helping plan, construct and staff several temporary critical care (Nightingale) hospitals across the UK and also provided drivers and call handlers to reinforce ambulance services. In May 2020, the CSF helped with mass COVID-19 testing across the country to help reach a government target for 100,000 tests per day. These tests were largely carried out at mobile testing units which had been set up by the CSF in areas such as police stations, fire stations, care homes, prisons and benefit centres. 

During the pandemic’s second wave, from September 2020, the CSF assisted with more mass testing and, from December 2020, began assisting with the UK’s vaccination rollout through providing planning support, medical staff and constructing vaccination centres — a task unparalleled in its scale and complexity. 

Other support provided by the armed forces has included the testing of the NHS’ contact tracing phone application, NHS Test and Trace, the manufacturing of personal protective equipment (PPE), the creation of disinfectants, including the Virusend formula, and countering COVID-19 misinformation. The military’s responses to Covid-19 demonstrate how to contain an emergency, and how weak the NHS’s emergency response was at the level of planning and logistics.

Sources: https://www.army.mod.uk/news-and-events/news/2021/03/a-year-of-supporting-covid/ and https://en.wikipedia.org/wiki/Operation_Rescript

Is buying better healthcare morally wrong?

Politically, Scotland is sometimes pictured as closer to Scandinavian social democracy than it is to English neoliberalism. The latest British Social Attitudes report tested this hypothesis by asking whether buying better healthcare was morally wrong. It looks as if Scotland lies between England and the Nordic countries in its attitude towards buying healthcare

  • 42% of people in Scotland say that it is wrong for people to buy better healthcare. In England the equivalent figure is 32%.
  • In Norway 65% feel that is wrong to buy better healthcare. The figures in Finland (51%) and Denmark (50%) are also higher than in Scotland.

Source: https://bsa.natcen.ac.uk/latest-report/british-social-attitudes-38/social-inequality.

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