Debi Evans Blog: 27 September 2022

September 2022 has been a tumultuous and turbulent month for many reasons. Since being released from an official state of mourning, the UK Government has steamed ahead with both NHS plans and a maxi-budget that isn’t really a budget. Earthquakes, volcanoes, hurricanes, typhoons and floods are continuing to wreak havoc all over the world, with the latest casualty being Canada, which has declared a state of emergency as a hurricane became a tropical storm in Ottawa. Thousands are without power. Keep an eye on Europe. 

With the geopolitical situation becoming tenser by the day and the cost of living crisis escalating, one might be forgiven for thinking that Brave New World is jumping off the page. This week’s blog is slightly shorter because of the MHRA board meeting held last week. Exclusive footage of the full Board meeting with accompanying timestamped gist is now up at that link. 

As well as all things health, I like to keep my eyes on the planet. Large earthquakes continue across the globe, with Mexico being doubly hit by earthquakes and a tsunami alert. Similarly, Taiwan has been hit by a typhoon and a large earthquake. The tail end of Hurricane Fiona is expected to head for the UK from the USA.

So let’s catch a glimpse of what is to come in the foreseeable future; stories that you may have missed. 

 

Europe preparing for the third emergency 

As we appear to be launched into another state of ‘emergency’, Europe is warning to prepare itself for yet more restrictions, mask mandates and injections. The plan appears to be set in stone. The quotation beneath is from the EU plan for 2022/2023:

While the evolution of the pandemic is unpredictable, the EU needs to prepare itself – for the third time in a row – for a challenging autumn and winter. But the future of the pandemic does not only depend on new variants that may emerge and out-compete older strains. It is also greatly determined by human behaviour and how much immunity can be built up in the population. 

Minimising the number of new cases also decreases the chances of new variants appearing. These are factors that can be influenced, and Member States’ healthcare systems and society must continue to adapt their collective response to this virus until the threat of COVID-19 is no longer acute.

As we have seen during the peaks of the COVID-19 pandemic, working together is essential. Now that a political agreement has been reached on the new EU regulation on serious cross-border threats to health, which is the final legislative piece of the European Health Union Package53, the Union will soon have a new set of tools to finish the revision of the EU health security framework and to strengthen the required infrastructure and processes for implementing COVID-19 preparedness and response measure.

The pandemic has reminded us very clearly of the importance of collaboration. Through working together, we can make a real difference and strengthen the EU’s capacity to prevent, prepare and respond to health crises – in the upcoming months as well as in the future. We are stronger, more resilient and more effective when we work together on a sustained management of the pandemic

 

NHS 

The Health Secretary, Thérèse Coffey, has announced the package of help that she believes will save the NHS: the ABCD strategy, which stands for Ambulances, Backlogs, Care, Doctors and Dentists.

£500 million has been earmarked from the NHS Budget to get medically fit patients out of hospital as soon as possible. Has the 100 Day Challenge launched on 1 July failed? As the NHS is braced to receive an overwhelming number of sick patients this winter, one cannot help but wonder why this winter should be any different to other winters historically. More than 13,000 of the 100,000 NHS general and acute hospitals beds are filled with ‘delayed’ discharge, which has led to Accident & Emergency units at hospitals becoming snarled up, and long delays in ambulance handovers. We have reported many times on ambulance delays of up to 24 hours to get patient into A&E. 

Currently, many care homes are shutting their doors permanently, unable to meet the cost of energy bills. Many say they cannot keep their elderly warm this winter, so have no choice. So where will this £500 million go? We have been struggling for decades with a shortage of social care. Theresa May, when she was 'crowned' Prime Minister, did away with the portfolio of Social Care Minister—a big mistake. The amount of money allocated is to be taken from the NHS budget and in reality is a drop in the ocean compared to what is really required to keep our care homes and carers in work. 

Thérèse Coffey appears to be living in a dream state if she thinks she can achieve her ambition. Reducing A&E times to discharge, transfer or admit within 4 hours appears unachievable; her plans to magic up an extra 7,000 beds is nothing more than wand-waving. Or will you be biosensored or electronically tagged and cared for in a ‘virtual ward’? 

Driven to desperation, many are having to borrow funds from family, friends and loved ones, or go without, in order to access surgery or treatment privately, just to end the pain and to restore their lives to some form of normality. For those who cannot afford to go private, inequalities will only increase. Do we need any more evidence that the NHS is broken beyond repair? Perhaps we change the word ‘National’ for ‘New’? I prefer the old. 

 

Gold star medals for NHS staff 

The Covid Star medal is the creation of Cambridge artist Harry Gray, who was inspired by healthcare staff while in hospital. He said he received excellent care, but could already see the strain on NHS staff. Whilst on the wards, Harry often heard the phrase ‘they deserve a medal’, so he decided to design one. It has already been adopted by many hospitals and NHS trusts across England and Wales. Consider the medal shown in the above link. Does the star look like a Maltese cross to you? Are you seeing darker connections?

 

MHRA

The monthly MHRA board meeting was held on 20 September 2022 by live video link. On the agenda was patient safety, delivery, science and innovation, and there was much discussion of staff vacancies. It would appear that the MHRA has a severe staffing problem. Retaining staff is proving difficult, and whilst junior members of staff are being promoted to more senior roles with some success, there is a gap at the bottom. It also appears that the MHRA is actively tracking the whereabouts of their staff—to ensure efficiency, of course. Perhaps that is why many are leaving?

The UK Column has exclusive footage of the board meeting, accompanied by timestamps to help navigate the two and a half hours of the meeting. Whilst the MHRA has appeared to obfuscate and delay in replying to Freedom of Information requests and complaints, I can confirm that I have received a very comprehensive reply from Dr Alison Cave with regard to most of my questions. Watch UK Column News and the home page for more on this in the coming days and weeks. 

 

Prescriptions 

The UK Column has been forewarning of rising prescription charges to £13 per item combined with a raised eligibility criteria. This appears to be an inexorable process so that any day now, those over 60, who are normally exempt from prescription charges, will pay them until they reach the grand old age of 66, when they are eligible to claim their state pension. To save GPs’ time, it will now be your pharmacist that you speak to when you need a prescription. 

 

Burnout in doctors impacts patient safety

A new study shows that doctors across both hospitals and general practices who are experiencing burnout are twice as likely to be involved in a patient safety incident and three times as likely to leave their jobs. 

The pressures that many clinicians face in the NHS is impacting on their ability to deliver safe and effective care. In relation to general practice, the impact of this stress is causing doctors to experience burnout so they become despondent and think about leaving the profession (either by retiring early or leaving the NHS). This also impacts on how they deliver care to patients, with doctors who experience burnout more likely to make errors that result in patient harm. By addressing burnout, this research helps to show that care could be safer

Professor Aneez Esmail

 

General Practitioners 

Thérèse Coffey isn’t making many friends with her latest aspirations and plans for the NHS, which take aim at GPs. Community pharmacists will become far more accessible (UK Column has been covering this for many months). Anyone requiring an ‘urgent’ appointment with their GP will be seen the same day, whilst everyone else must be given an appointment within two weeks. Could this be the age of telemedicine and virtual appointments in the medical metaverse? Meanwhile, Ms Coffey tells patients simply to switch to another GP if they can’t access a quick appointment. With doctors being threatened with naming and shaming if they don’t meet their targets, it appears GPs are being attacked on all fronts. 

 

Staff safety in the NHS

Despite there being no accurate picture or data, there appears to be big concerns over the safety of staff. Being subjected to malicious violence is not something that I experienced as a nurse in all my years of working in the NHS. Of course there would be patients who were mentally ill, confused or suffering from dementia, who could became agitated or anxious. Now, hospitals appear to be secure institutions and security guards man the doors instead of patients being greeted with smiles and a bouquet of flowers.

Any mental health patient who was at risk of harming themselves or others used to be looked after in purpose-designed secure facilities. Roger Ringham, Chair of the National Association for Healthcare Security, appears to suggest assaults on NHS staff is a big problem—but says so without any evidence to substantiate it. Is patient behaviour being lined up to take the blame for the mass exodus of doctors and nurses?

 

Flu

The scares continue and the word ‘twindemic’ is being heard more often. At the July NHS Improvement Board meeting, Stephen Powys warned of a ‘twindemic’ of Covid and Flu which would put our NHS at serious risk of collapse. Australia has been reporting of an earlier and larger surge of flu, which appears to have flown all the way to the shores of the UK. Even the late Queen’s recent funeral has been disparaged as an environment where massive crowds could fuel the spread of ‘the virus’.

 

Medication without harm — World Health Organisation 

The World Health Organisation’s third World Patient Safety Day took place on 17 September. This year’s theme was medication safety. Globally, medication errors and poor medication practice are some of the leading causes of avoidable patient harm. Prescribing errors. and human factors like stress and high workloads, are often at the root of mistakes. The report Medication Without Harm proposes solutions to address many of the obstacles the world faces to ensure the safety of medication practices.

 

Sinovac for six-month-old babies — Hong Kong

China appears to be continuing with its zero Covid policy and extending it to Hong Kong. Worryingly, babies are now to be injected, despite all the evidence to demonstrate that babies and children are not at risk from Covid and therefore do not need any preventive interventions for it, least of all an experimental novel ‘vaccine’.

Hong Kong has reduced the minimum age for getting vaccinated with China's Sinovac Covid-19 shot from 3 years to six months after several young children became infected with the virus.

Adults and children in the Asian financial hub, which retains some of the world's toughest Covid precautions, are required to have at least three coronavirus vaccine shots.

 

Natural News reports that lawsuits claim hospitals specifically targeted unvaccinated patients with forced Remdesivir and respirator “treatment”—a death sentence. The decision to administer Remdesivir to Covid patients and smother them with a ventilator—a plandemic “treatment” protocol that we now know has killed many—was done not according to any kind of science, new lawsuits allege. Hospitals selectively targeted the unvaccinated for this deadly protocol, according to the legal arguments made. Unvaccinated patients were forced to take Remdesivir and breathe with a ventilator almost as a type of punishment for their non-compliance with government protocols.

 

Articles that may be of interest 

Italian Data Used to Shut Down the World in Spring 2020 Shows Excess Deaths Were Not Caused by the Spread of a VirusThe Exposé

 

UK spends 10 Days mourning death of one person but remains silent over 607,000 deaths following Covid Vaccination—The Exposé

 

Is Gender Dysphoria contagious? Find out here.

 

Genetically-engineered herpes virus can beat cancer—Daily Mail

 

 

Jeremy Hunt: Patient Safety Newsletter 

I reproduce below Jeremy Hunt's latest blog.

Good afternoon and welcome back to my patient safety weekly update. We paused during the mourning period for her Majesty but back this week with a look at World Patient Safety Day, Therese Coffey’s first statement to parliament, a powerful report from the Academy of Medical Royal Colleges, more evidence on the crisis in maternity services as well as the launch of our new patient safety blog.

SOS NHS: Thérèse Coffey today published ‘Our Plan for Patients’, the government’s big statement of intent as to how it plans to fix the crisis in the NHS. It promises same day GP appointments when needed and a pledge that no one will have to wait more than two weeks for a routine appointment. The proposals will see a greater role for pharmacists to help free up appointments and more freedoms for GPs to hire extra staff, more money for social care to free up hospital beds, pension tax reform to stop doctors retiring early and use of volunteers as during the pandemic.

I like Thérèse and wish her well, but as I write in this Telegraph article. I am worried we are not doing the fundamental reforms the service really need. If the answer to quicker appointments was more targets, we would have the fastest appointments anywhere because the NHS have more targets than any other healthcare system. It’s not more targets the NHS needs but more doctors, as I responded in parliament earlier today and my more detailed response as Chair of the Health and Social Care Select Committee is here.

Fixing the NHS 

The Academy of Medical Royal College has launched a powerful report on how to do just that this week. Starkly highlighting the crisis we are currently in the report is a very persuasive cry for help. It focuses on addressing the workforce challenges, reforming social care, making use of digital, valuing staff, revitalizing primary care and much else that we agree with. I really hope the government pays attention as the Academy doesn’t often make such determined public interventions but this one is well worth a read.

World Patient Safety Day

Celebrations for this year’s World Patient Safety Day in the UK were obviously somewhat muted given the national mourning period. But it was great to see that there were many events around the world to mark the occasion and highlight this year’s theme of medication error. This is a great way to reaffirm the objectives of the WHO Global Patient Safety Challenge for this year which focuses on medication – Medication Without Harm was launched by the WHO in 2017, coincidentally the same year I commissioned the University of York to analyse the extent of the issue in the NHS. They concluded medication error directly caused directly caused 700 deaths a year and indirectly contributed to 22,000 deaths a year in England alone.

Maternity Madness

More troubling evidence of the extent to which maternity services are in crisis from the BBC. They have found that more than half of maternity unites in England consistently fail to meet safety standards. The CQC rates 7% of units as posing a high risk of avoidable harm and 48% as requiring improvement. We really do need that timetable for the implementation of Ockenden. We’ve had countless reports about what needs doing (and with the Kirkup Review into East Kent and Donna’s next review into Nottingham we are likely to see more reports with the same or similar recommendations) so we just need to get on and do it. 

Covid

Covid seems to be on the wane as cases continue to fall, with rates now down to just 1:75 people the community. The dashboard data for the last 7 days is looking good too as cases have decreased by 1.4%, hospitalisations by 5.3% and deaths by 30.7%.

As if the world needs another blogger

But it is about patient safety, so please indulge me! In my inaugural post for my new patient safety blog. I set out what I hoped to see from Therese’s first statement including a workforce strategy, individual GP lists, a timetable for the implementation of the Ockenden Review, scrapping national targets, reform to the litigation system, and a revamping of the learning from deaths programme. I’ll try to post every week but we’ll also host guest pieces every so often so do get in touch if you would like to contribute. And please help spread the word about patient safety by forwarding this email to a friend and getting them to sign up.

[Jeremy Hunt's blog ends]