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Long Covid: Major study into the long term impact launched in Scotland

Every adult who has tested positive for COVID-19 in Scotland is to be invited to take part in a major new study into the effects of long Covid.

Researchers hope to identify how many people in Scotland continue to be unwell after having the virus.

The Covid in Scotland Study (CISS) will ask people what their symptoms are and how it affects their lives. Those taking part will be asked to use a phone app to answer questions about their health before and after Covid.

Early estimates suggest as many as 6,000 people in Scotland were experiencing long term symptoms after the first wave of the pandemic but it is not known what that tally is now.

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Source: BBC News, 12 May 2021

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Having minimum nurse to patient ratios cuts risk of death, new study claims

New research examining the effect of minimum nurse-to-patient ratios has found it reduces the risks of those in care dying by up to 11%. 

The study, published in The Lancet, also said fewer patients were readmitted and they had shorter stays in hospital.

It compared 400,000 patients and 17,000 nurses working in 27 hospitals in Queensland, Australia to 28 other hospitals. The state has a policy of just one nurse to every four patients during the day and one to seven at night, in a bid to improve safety and standards of care.

The research said savings made from patients having a shorter length of stay, which fell 9%, and less readmissions were double the cost of hiring the extra nurses needed to achieve the ratios.

NHS England has resisted moves towards minimum nurse to patient ratios, suspended work by the National Institute for Health and Care Excellence (NICE) on safe nurse staffing in 2015. This came as the watchdog was preparing to call for minimum ratios in accident and emergency departments. It has advised that eight or more patients to one nurse is the point at which harm can start to occur.

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Source: The Independent, 12 May 2021

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New law to dissolve CCGs and curtail the internal market confirmed

The government has confirmed its commitment to bring in new health legislation during this Parliament, but social care reform has again been ‘kicked into the long grass’.

Today’s Queen’s Speech confirmed that planned, radical changes to the Health and Social Care Bill 2012 will be laid before Parliament this year.

The changes, first outlined in the government’s proposals this February, will put integrated care systems on a statutory footing, dissolve clinical commissioning groups, water down the internal market within the NHS and increase the powers the health secretary has over NHS England and the service. 

Today’s Queen’s Speech said these changes meant “patients will receive more tailored and preventative care, closer to home [and will] empower the NHS to innovate and embrace technology”.

However, it did not add any further information to the government’s already stated plans to “bring forward proposals in 2021” for social care reform. The 2019 Queen’s Speech, the first delivered during Boris Johnson’s tenure as prime minister, promised to bring in ”legislation for long-term social care reform in England”. To date, the government has failed to act on this promise.

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Source: HSJ, 11 May 2021

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Families launch court case in bid for public inquiry into deaths

The Department of Health and Social Care (DHSC) is facing being taken to court over an inquiry it launched into the deaths of dozens of mental health patients in Essex.

Last year, the government said it would commission an independent inquiry into at least 36 inpatient deaths in Essex, which had taken place over the last two decades.

However, more than 70 families are calling for a full statutory public inquiry, which can compel witnesses to give evidence. They have lodged judicial review proceedings at the High Court against the government to that effect.

The DHSC said it could not comment on ongoing legal proceedings.

The current inquiry was launched in response to a highly critical report from the Parliamentary Health Service Ombudsman, published in June 2019, into the deaths of two patients at North Essex Partnership University Foundation Trust, which has since merged to form Essex Partnership University FT.

There has also been an investigation by Essex Police into 25 of the deaths. This concluded in 2018, when the force said there had been “clear and basic” care failings, but there was not enough evidence to prosecute the trust for corporate manslaughter.

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Source: HSJ, 11 May 2021

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'Major changes needed' at Northern Ireland emergency departments

Major change is required if Northern Ireland's emergency departments are to avoid another "exceptionally difficult" winter, a senior consultant has warned.

Dr Brendan Lavery, who works for the Western Health Trust, said "standing still is not an option". He described the system as currently operating on a "knife edge".

The Department of Health said it was "a very challenging time" for staff "with COVID-19 restrictions impacting on an already fragile system".

Speaking to BBC News NI, Dr Lavery likened the situation to "Groundhog Day" with decade-long problems like capacity and staffing exacerbated by the lingering effect of the COVID-19 pandemic on other healthcare services.

The department responded: "Well before COVID-19, there was clear evidence that our urgent and emergency care services were under increasing pressure. This is an unsustainable position that requires sustained investment and reform, including, of course, long-term investment in staffing. There is no quick or easy solution to these problems."

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Source: BBC News, 12 May 2021

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How making mental wellbeing a priority can lower healthcare costs

 

There are many reasons why mental wellbeing is important. Not only is it protective against physical illnesses and linked to greater productivity, but the mental wellbeing of a population is essential for a country’s sustainability, long-term growth and development.

But despite the clear benefits, governments tend to focus public spending on treating and preventing disease, and providing care for those who are ill. While this is important and should continue to be prioritised, such strategies alone won’t increase levels of mental wellbeing overall.

Not only would enhancing mental wellbeing across all segments of the population lead to better health on average, it would also be beneficial from an economic perspective.

In a new study, the link between mental wellbeing and government expenditure was explored. It was found that each increase in mental wellbeing in a population was associated with lower social and health care costs the following year. In other words, the greatest savings could be made by maximising everyone’s mental wellbeing.

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Source: The Independent, 11 May 2021

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COVID-19: Doctors feel under pressure to work extra shifts unpaid, survey shows

Thousands of doctors feel under pressure from their employers to work extra shifts, often unpaid, to help tackle the backlog of care caused by the covid pandemic, the BMA has warned.

The warning came after results from the BMA’s latest tracker survey showed that more than half its respondents (58%, 2834 of 4876) had worked extra hours in the previous month as part of the response to the pandemic. Almost a third (29%, 1387) said they were not paid for the additional time they worked.

More than two fifths (44%) of respondents (2086 of 4719) said they felt under pressure from their employer to do extra hours in the last month. And more than a third (36%, 1759) had either skipped taking full breaks altogether or taken them on rare occasions in the past fortnight.

Nearly six in 10 doctors who responded (57%, 2889 of 5059) reported a higher than normal level of fatigue or exhaustion because of working or studying during the pandemic.

Chaand Nagpaul, the BMA’s chair of council, said, “To learn that an already depleted and now exhausted workforce feels forced into doing more and more hours, with many reporting higher levels of fatigue than ever, is extremely worrying. It is putting them and their patients at risk. Working ‘flat out’ without a change to rest and recuperate is simply unsustainable and unsafe."

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Source: BMJ, 10 May 2021

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Millions of pounds to treat young people with eating disorders diverted elsewhere

Just 10% of money allocated to help treat young people with eating disorders reached the NHS frontline, a new analysis has revealed.

The latest data on NHS mental health spending comes amid concern the pandemic has exacerbated eating disorders in young people, sparking a rise in demand.

A report commissioned by MPs compiled by the eating disorder charity Beat, using NHS data, shows local clinical commissioning groups (CCGs), who purchase NHS services on behalf of NHS England, spent just £1.1m of the £11m they were given for community eating disorder services in 2019-20.

The money was set aside by NHS England to try and tackle increasing referrals and to ensure young people could get treatment. 

Wera Hobhouse MP, chair of the All-Party Parliamentary Group on Eating Disorders, and which commissioned the work said: “Eating disorders are serious mental illnesses, and we know that early intervention and access to specialist treatment saves lives."

“NHS England has continued to allocate extra funding to clinical commissioning groups for children and young people’s community eating disorder services, but this report shows that much more needs to be done to ensure this money reaches the frontline services, particularly now as they face unprecedented numbers of referrals.”

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Source: The Independent, 11 May 2021

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Nurse in court accused of murdering eight babies

A nurse accused of murdering eight babies in an alleged year-long killing spree at an NHS hospital has appeared in court.

Lucy Letby, aged 31, appeared at Manchester Crown Court via videolink from HMP Peterborough on Monday morning.

She has been charged the murder of five boys and three girls at the neonatal unit at the Countess of Chester Hospital.

The babies all died between June 2015 and June 2016.

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Source: The Independent, 10 May 2021

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NHS to offer new drug that halves the risk of cancer returning

A world-leading treatment that halves the risk of lung cancer patients suffering a return of the disease after undergoing treatment, is to be rolled out by NHS England.

In a trial of the drug – the first of its kind – around nine out of ten patients treated, remained alive and disease-free after two years – compared to more than four in ten who hadn’t received the new therapy.

Lung cancer is the most common cause of cancer death in the UK, accounting for one in five of all cancer deaths.

Around 100 patients in England with a rare form of cancer will initially have access to the drug, called Osimertinib, with many more expected to benefit this year.

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Source: NHS England, 7 May 2021

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700 anaesthetists may not secure a training job this summer, warns royal college

A perfect storm of pandemic pressures, changes to the medical curriculum and inadequate Health Education England funding threatens to leave 700 anaesthetists without a job this summer, HSJ has learned.

The news comes as the NHS prepares to tackle the huge backlog of elective care work that has built up during the pandemic. Anaesthetists will play a critical role in the recovery effort. 

Each year around 300 higher training, or ST3, places for anaesthetists are offered by the NHS. However, this year there are over 1,000 applicants for these posts. The oversupply has been created by the inability of trainees to seek work overseas because of the pandemic and a change in the curriculum overseen by the Royal College of Anaesthetists.  

Royal College of Anaesthetists’ council member Helgi Johannsson told HSJ  he was concerned trainees could become “so demoralised” after failing to secure a a job that they might switch to another specialty.

“We need those trainees to come through,” he said. “There is a shortage of anaesthetists with around 10 per cent of consultant jobs unfilled and we need to protect our supply line and get on top of our elective backlog.”

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Source: HSJ, 7 May 2021

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Safer standards for nursing care unveiled as public fear effect of shortages

New standards for the safe working of nurses across hospital wards, care homes and in the community have been set out by the Royal College of Nursing, for the first time in its 100 year history.

In a bid to underline the safety-critical nature of expert nurses in healthcare, the RCN hopes the minimum standards will be used to force improvements in safe staffing levels and the treatment of nurses across the country by NHS trusts and other employers.

It comes as a new poll finds a majority of adults believe there are not enough nurses to provide safe care. There are 50,000 nursing vacancies across the NHS and research has repeatedly shown having degree-educated nurses leads to better patient safety.

A major study across 500 hospitals in 12 European countries found for every extra patient a nurse was expected to look after, the chances of the patient dying increased 7%. Other studies have shown replacing degree-educated nurses with less educated staff led to an increase in mortality of 21%.

Despite the research, the UK government and NHS England has consistently opposed tougher ratios of nurses to patients and has invested in new non-degree roles to fill gaps in staffing.

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Source: The Independent, 9 May 2021

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How COVID-19 has disrupted efforts to care for blood cancer patients

Blood cancer patients are one of the most vulnerable groups of people at risk of COVID-19, according to research, being 57% more likely to suffer severe disease compared to other cancer patients. 

Despite the high risk these patients face, charities such as Anthony Nolan, which assist blood cancer patients with finding a stem cell match, were left out of the allocated government budget that was announced in March.

The cancellation of face-to-face fundraising and events, despite the increase in demand for services, have led their gross income to be down by an estimated £5.5m for 2021.

Henny Braund, chief executive of the charity, said people with blood cancer and blood disorders were “heavily impacted by the pandemic and everyone who needs treatment and support must be able to access it without delay”.

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Source: The Independent, 9 May 2021

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Regulator removes struggling hospital’s junior doctors

Ten junior doctors have been removed from a struggling hospital over concerns they were being left without adequate supervision on understaffed wards.

Health Education England (HEE) removed the 10 foundation year one doctors, all on a general medicine rota, from Weston General Hospital last month. The General Medical Council said the trust’s previous efforts to address the issues “have not been sufficient or sustainable”.

University Hospitals Bristol and Weston Foundation Trust did not say which services HEE had removed the juniors from or what mitigations had been put in place. However, the trust told HSJ none of the positions concerned were from the hospital’s emergency department, where the GMC has already imposed conditions on juniors’ training.

HEE very rarely uses its power to withdraw trusts’ trainees. HSJ reported last June the regulator had only removed two posts at trusts under enhanced monitoring since the start of 2019. 

William Oldfield, University Hospitals Bristol and Weston FT medical director, said in a statement to HSJ: “We recognise the seriousness of the step taken by HEE to temporarily suspend the training programme for a small number of junior doctors at Weston General Hospital.

”We are working to provide the assurance HEE require to allow this training to recommence, and in the meantime we have appropriately mitigated the impact on services at Weston.”

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Source: HSJ, 10 May 2021

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More than a million children given access to NHS mental health support at school

More than a million children and young people will have access to mental health support at school, as the NHS rapidly expands services to help deal with the huge disruption caused by coronavirus and lockdown.

From this year, teams of experts are offering support to children experiencing anxiety, depression, and other common mental health issues.

Around 400 mental health support teams will be up and running covering 3,000 schools in England, offering support to almost three million pupils, by 2023.

The roll-out represents a dramatic acceleration of the programme announced in the NHS Long Term Plan, funded from £79 million to boost mental health support for children and young people in England, which is part of £500 million Government pot for investment in mental health services.

Experts hope that by intervening early they can prevent problems escalating into serious mental health issues, with health chiefs warning that the isolation and upheaval of the pandemic can be compounded by factors like pressure experienced on social media platforms.

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Source: NHS England, 8 May 2021

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Alcohol-related deaths jumped to highest level during Covid pandemic

The highest number of alcohol-related deaths in England and Wales since records began was seen in 2020, official data shows. 

A survey by the Office for National Statistics (ONS) showed that alcohol killed more people in 2020 than in any of the previous 20 years. The data also showed a rise of 20 per cent compared to 2019.

Overall, there were 7,423 deaths from alcohol misuse last year, compared to 6,209 in 2019. Deaths increased from March 2020 onwards, when the coronavirus pandemic forced the UK into a series of national lockdowns. 

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Source: The Independent, 6 May 2021

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Police launch investigation into patient death

Police are investigating allegations around the death of a patient who was under the care of Hertfordshire Partnership University Foundation Trust.

The probe by Hertfordshire Constabulary relates to the case of Margaret Molyneux, 69, who according to a review by the trust’s commissioners, was prescribed doses of anti-psychotic medication which were significantly higher than recommended limits.

Police said the investigation is ongoing and no arrests have been made.

Ms Molyneux had been admitted to the trust’s mental health unit in Radlett in 2017, after which her physical health declined and she was admitted to Watford General Hospital with pneumonia and dysphagia, which relates to difficulties swallowing.

She was discharged back to the Radlett unit, but died several weeks later at Watford General Hospital, after choking on her food and developing aspiration pneumonia. 

An inquest in February 2018 ruled she died from natural causes, but an investigation into her case commissioned by East and North Hertfordshire Clinical Commissioning Group, seen by HSJ, subsequently suggested high doses of Olanzapine, an anti-psychotic drug, were “likely to have at least contributed to some of the physical problems she experienced… including low blood pressure, falls and dysphagia”.

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Source: HSJ, 6 May 2021

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Infection rules for NHS staff leave them at risk from airborne Covid, warn experts

Pressure is growing on the government to change its stance on coronavirus infection rules which it is feared may leave NHS staff and patients at risk from airborne transmission.

Experts told The Independent the current guidance from Public Health England (PHE), which effectively says staff working on general wards can rely on just surgical masks for protection, was “outdated and potentially misleading” and put NHS staff at risk.

At the start of the pandemic the emphasis on stopping infection was focused around droplets containing the virus both in the air over short distances and on surfaces. Increasingly scientists have begun to warn the virus can also spread through much smaller aerosols which can remain airborne for a lot longer and over further distances.

On Friday, the World Health Organisation updated its information on how Covid spreads to acknowledge the risk of aerosols and last month papers released by the government’s Scientific Advisory Group for Emergencies (Sage) said health workers may need to use better protection for longer.

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Source: The Independent, 6 May 2021

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Pregnant women struggling to get Covid jab says MP

Pregnant women are struggling to get the coronavirus vaccine because clinics are unable to guarantee they will have the right type of jab available, Labour MP Stella Creasy has said.

The Pfizer-BioNTech or Moderna jabs are preferable for pregnant women because there is more safety data available.

But the online booking system in England does not allow them to specify which vaccine they require.

Pregnant women are advised to speak to their GP instead of booking online. But Ms Creasy, 44, said GPs do not always know when local vaccination centres will have specific types of the jab available.

The MP for Walthamstow, who is currently pregnant with her second child, said she had received five invitations to be vaccinated but she could not take them up because there is no system to specify she needs the Pfizer or Moderna jab.

"I don't think it's been made enough of a priority because there's a presumption it will become more of a priority as they move through the age groups, which is a misreading of the data about pregnancy," she told the BBC.

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Source: BBC News, 7 May 2021

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UK needs £102bn boost to NHS and social care, says major report

Spending on the NHS, social care and public health needs to rise by £102bn over the next decade, funded by big tax rises, to improve Britain’s health in the wake of the coronavirus pandemic, an inquiry has said.

The massive funding boost would cut avoidable deaths from cancer and heart disease, tackle glaring health inequalities and rebuild the NHS after Covid exposed weaknesses such as a lack of beds and staff, a team of experts have urged ministers.

The money would come largely from increases in income tax, national insurance and VAT, which evidence suggests the public is willing to pay, according to a four-year commission of inquiry by the London School of Economics and the Lancet medical journal.

“Without concerted action and increased funding we risk the UK falling further behind other high-income countries in health outcomes and life expectancy, continued deterioration in service provision and worsening inequalities, increased reliance on private funding and an NHS that is poorly equipped to respond to future major threats to health,” said Dr Michael Anderson of the LSE, the commission’s joint research lead.

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Source: 6 May 2021

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Covid: Depression rises in young and women during second peak

Women and younger adults were more likely to feel depressed during the second UK coronavirus peak than men and other age groups, Office for National Statistics (ONS) data suggests.

Four in 10 women aged between 16 and 29 were affected, compared to 26% of men. One in five adults experienced depression in early 2021 - more than double pre-pandemic levels.

But GPs in England diagnosed fewer cases of depression in adults in 2020 compared with the year before. Many people may not be seeking medical help, the ONS says.

Health experts have always warned that the combined effects of ill health, isolation and job losses during the pandemic would have a negative impact on people's mental health and wellbeing.

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Source: BBC News, 5 May 2021

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Wards to get ‘star ratings’ under first new NHS cleaning rules for 14 years

The first new hospital cleaning standards for 14 years have been outlined by regulators, including confirmation of new food hygiene-style star ratings.

Wards and theatres will be given ratings from one to five stars – based on audits which score the cleanliness of areas against safe standards – and these ratings will be made visible to patients.

The plans for the new star ratings, which are expected to be easier for patients to understand than the current cleanliness percentage scores, were first revealed by HSJ in 2019.

The ratings are also designed to encourage a more collaborative approach, by reflecting the cleanliness score for whole areas, as opposed to the performance of individual parties responsible for cleaning certain elements.

Areas rated one to three stars would require improvement plans and be automatically placed under review, with “immediate action” being required in one-star rated areas.

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Source: HSJ, 6 May 2021

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Early cancer diagnoses plummeted in England during Covid pandemic

The number of people being diagnosed with cancer early in England has plummeted during the Covid pandemic, sparking fears that many will only be treated when it is too late to save them.

Official figures show a third fewer cancers were detected at stage one, when the chances of survival are highest, in the early months of the pandemic than during the same months a year before.

Cancer experts fear that the figures, which have been collected by Public Health England’s National Cancer Registration and Analysis Service, mean thousands of people have the disease but have not yet started treatment because of “a shift to later diagnosis”. They urged anyone with possible symptoms of the disease to get them checked out immediately.

“While it’s fantastic that Covid rates are dropping and lockdown is easing, the knock-on impact of the pandemic on cancer care cannot be overstated,” said Steven McIntosh, the executive director of advocacy and communications at Macmillan Cancer Support. “We are likely to be dealing with Covid’s long shadow for many years to come.”

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Source: The Guardian, 5 May 2021

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Pfizer vaccine ‘95% effective against coronavirus,’ new data shows

Two doses of the Pfizer-BioNTech vaccine can provide more than 95% protection against infection, severe illness and death from Covid, according to a groundbreaking study in Israel.

The middle eastern country currently leads the world in its inoculation programme, with more than half (56 per cent) of its population having already received both doses of the Pfizer vaccine.

The research, published today in The Lancet journal, also concluded that a single dose of the jab provides 58 per cent protection against infection, 76% against hospital admission, and 77% against death.

The researchers said their study highlights the importance of fully vaccinating adults against the virus but acknowledged challenges remain to get the pandemic under control – including uncertainty around how long immunity lasts, from both vaccines and natural infection, and the emergence of variants that may be resistant to jabs currently on the market.

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Source: The Independent, 6 May 2021

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Half of all hospitals inspected broke covid safety law

Nearly half the hospitals targeted in covid-related spot checks were found to be breaching health and safety laws.

An unpublished Health and Safety Executive report found just five out of 17 acute hospitals inspected had high levels of compliance with measures to manage the risks around covid. 

Meanwhile, letters were sent to eight hospitals “formally requiring them to take remedial action to remedy contraventions of health and safety law”. The remaining four hospitals were given advice.

The inspections — which involved 13 hospitals in England and two each in Scotland and Wales — focused on seven areas: risk assessment; management arrangements specific to covid; social distancing; cleaning and hygiene; ventilation; dealing with suspected covid cases; and personal protective equipment.

The health and safety watchdog highlighted social distancing in non-clinical areas — which covered areas outside of clinical wards such as offices, rest areas, changing rooms and workshops — as needing improvement in some hospitals. 

The inspectors — who visited between November last year and January this year — also found some hospitals needed more robust covid security measures if they were to comply with government guidance.

HSE also noted that, although all the hospitals had adequate supplies of PPE, not all had adequate arrangements in place for ensuring it was used effectively.

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Source: HSJ, 5 May 2021

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