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Government launches new portal for care home coronavirus testing

With all care home staff and residents now eligible for testing, with a priority given to those in homes looking after residents over 65 years of age, a new online portal has been launched to streamline the process of arranging coronavirus test kit deliveries.

As national testing capacity continues to increase, the government is prioritising testing for care homes and other areas identified as having the greatest need. As such, across England, all symptomatic and asymptomatic care home staff and residents can be tested for coronavirus.

The Department of Health and Social Care (DHSC) is working alongside local authority Directors of Public Health, Directors of Adult Social Services and local NHS providers to deliver this testing programme for care homes.

Tens of thousands of care home workers and residents have already been tested, either by Public Health England or at drive through testing sites, mobile testing units and via satellite testing kits – packages of tests sent to care homes for staff to use on residents.

Secretary of State for Health and Social Care Matt Hancock said: “The additional testing capacity we have achieved delivers many thousands of tests a day for residents and staff in care homes. This new portal allows those who book tests for staff and residents to do so even more easily, and it also offers a route for the prioritisation of care homes with the greatest need."

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Source: National Health Executive, 12 May 2020

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Ministers were warned two years ago of care homes' exposure to pandemics

Ministers faced fresh allegations on Wednesday of failing to prepare care homes for a pandemic, as it emerged that COVID-19 may have killed 22,000 residents in England and Wales – more than twice the official toll.

Council social care directors in England warned the government two years ago, in a series of detailed reports, about care homes’ exposure to a pandemic, the Guardian has learned.

They called for better supply plans for personal protective equipment (PPE) – warning that “demand for PPE could rapidly outstrip supply” – plus improved infection control and a system to enlist volunteers to help services expected to be stretched to breaking point.

The Association of Directors of Adult Social Services (Adass), which represents directors of adult social services in England, told the Guardian it carried out the work to improve government planning for a flu pandemic at the request of the Department of Health and Social Care. But it said: “We are not aware of whether government departments picked up on any of the recommendations set out.”

A Department for Health and Social Care spokesperson said: “As the public would expect, we regularly test our pandemic plans – allowing us to rapidly respond to this unprecedented crisis. Our planning helped prevent the NHS being overwhelmed and means we are past the peak of the virus.”

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Source: Guardian, 13 May 2020

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NHS England seeks advice amid ‘shielded’ patient concerns

NHS England has set up an advisory group to look at how physical and mental health services can be delivered to patients who are most vulnerable to COVID-19 and have been asked to shield themselves from the pandemic.

There are now around 2.5 million patients on the list of people considered to be at the highest clinical risk, including solid organ transplant recipients and patients on chemotherapy, who have been told to cut themselves off from society as far as possible.

They are going to have to stay that way beyond the end of June, with suggestions that their isolation could continue for many more months hence, and there is significant concern about the impact of this on their ongoing physical and mental health.

The NHS has therefore set up an advisory group to examine how care can be provided to these patients.

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Source: HSJ, 13 May 2020

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Coronavirus: Restarting NHS services will be a major challenge, warn experts

Restarting NHS services will be an even greater challenge than coping with the first coronavirus infections, health think tanks and hospital chiefs have warned.

Since March, the NHS has freed up more than 33,000 beds to prepare for an influx of COVID-19 patients needing intensive care, but since the peak of infection health chiefs have worried that delays to care were harming patients.

Around 46,000 so-called excess deaths have been recorded during the pandemic, as compared against a five-year average. Around a quarter of these are believed to be unrelated to COVID-19.

In a joint statement, the Health Foundation, Nuffield Trust and King’s Fund think tanks have said it could take months before the NHS and social care are able to fully restart. All three bodies will be giving evidence to the Commons health committee on Thursday, where they will warn about the impact on the health service’s “exhausted staff” and demand action to help care homes – which are now at the frontline in the fight against coronavirus.

The experts will stress the need for the NHS to begin planning for a second peak of infections, especially if it comes in winter – when the service is usually overwhelmed by seasonal flu.

They will warn about concerns over how the NHS manages the risk of infection, with the need for more protective equipment, social distancing and increased testing. This will “severely limit capacity for many months”, they said.

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Soruce: The Independent, 14 May 2020

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Lockdown easing could see tens of thousands of excess deaths if vulnerable not protected, study suggests

Measures to ease the lockdown in the UK could lead to tens of thousands of extra deaths if vulnerable people are not sufficiently protected and health care systems are put under strain, a study has suggested.

Boris Johnson announced the first step towards normalcy — allowing unlimited exercise, one on one outdoor social meetings and a return to work for those who cannot do so at home — against a background of flattening infection numbers and fatalities caused by the virus.

However in a study published in medical journal The Lancet, research led by University College London (UCL) has warned between 37,000 and 730,000 excess deaths could take place due to the direct and indirect effects of the virus within a year.

Lead author Dr Amitava Banerjee said: “Older people, those with one or more underlying conditions and their carers are asking what easing the lockdown might mean for their health. Using data modelling on a number of different scenarios, our findings show the mortality risk for these vulnerable groups increases significantly, and could lead to thousands of avoidable deaths.”

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Source: The Independent, 13 May 2020

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Testing suggests 3% of NHS hospital staff may be unknowingly infected with coronavirus

Hospital staff may be carrying SARS-CoV-2, the coronavirus that causes COVID-19 disease, without realising they are infected, according to a study by researchers at the University of Cambridge.

Patients admitted to NHS hospitals are now routinely screened for the SARS-CoV-2 virus, and isolated if necessary. But NHS workers, including patient-facing staff on the front line, such as doctors, nurses and physiotherapists, are tested and excluded from work only if they develop symptoms of the illness. Many of them, however, may show no symptoms at all even if infected, as a new study published in the journal eLife demonstrates.

The implications of the new study, say senior authors Dr Mike Weekes and Professor Stephen Baker from the Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), are that hospitals need to be vigilant and introduce screening programmes across their workforces. 

“Test! Test! Test! And then test some more,” Dr Weekes explains. “All staff need to get tested regularly for COVID-19, regardless of whether they have any sort of symptoms – this will be vital to stop infection spreading within the hospital setting.”

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Source: University of Cambridge, 12 May 2020

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Coronavirus: NHS shielding letters miss thousands of cancer patients

Tens of thousands of cancer patients have not yet received letters advising them to “shield” themselves from the coronavirus threat, The Times has learnt.

Peter Johnson, national clinical director for cancer, has written to charities asking for their help in tracing the missing patients and alerting them to the need to take stringent self-protection measures against infection.

His appeal comes as the government increased by one million its estimate of the number of people at greatest risk of severe illness should they contract COVID-19.

Its new strategy document stated that it had identified 2.5 million people who were “clinically extremely vulnerable and advised to shield”. At the onset of the lockdown in March, ministers estimated the number at 1.5 million.

Professor Johnson’s letter, seen by The Times, states: “We are still receiving reports of cancer patients who believe that they should have received a shielding letter but have not yet received one or have not been added to the national list. It is crucial that those who are clinically extremely vulnerable receive a letter advising them to shield.

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Source: The Times, 12 May 2020

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Testing for coronavirus in UK care homes a ‘complete system failure’

Care home operators have accused the UK government of “a complete system failure” over testing for COVID-19 after officials repeatedly deflected responsibility for the task and left vulnerable residents unchecked.

As ministers admitted it will be more than three weeks before all homes are offered tests, care home managers said lives have been put at risk and conditions for dementia sufferers worsened because of the government’s failure so far to test hundreds of thousands of staff and residents.

The programme was announced by the health secretary, Matt Hancock, two weeks ago but only tens of thousands of people have been tested.

Public Health England (PHE), the Care Quality Commission (CQC) and the Department of Health and Social Care (DHSC) have repeatedly passed the buck about who should carry out the tests, according to correspondence with care homes seen by the Guardian.

When Nottingham Community Housing Association (NCHA) tried to get tests for its care home residents and staff, a PHE official said it didn’t know anything about testing residents, before pointing them to the CQC. PHE then changed its mind again saying it would send the tests, but when they failed to arrive, PHE reversed again saying CQC was responsible.

“It is very frustrating because we can’t effectively manage the risk without knowing [who has the virus],” said Holly Dagnall, director of homes and wellbeing at NCHA.

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Source: The Guardian, 12 May 2020

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Covid sparks boom in digital hospital outpatient appointments

Tens of thousands of outpatient video consultations have been carried out by NHS trusts following the national rollout of a digital platform to support the coronavirus response.

Digital healthcare service Attend Anywhere was introduced across the country at the end of March after NHSX chief clinical information officer Simon Eccles called for its rapid expansion.

There has been a major push to boost digital healthcare services across the country in order to support the national response to coronavirus. Much of primary care has already switched to working virtually. Undertaking hospital outpatient appointments digitally has been identified as a way of keeping patients safe by removing their need to travel.

There have now been more than 79,000 consultations with Attend Anywhere. The number of consultations started at around 200 per day, but has rapidly increased to more than 6,000 per day.

Data released by NHS Digital showed that GPs moved swiftly to change their practice model in the face of COVID-19. The proportion of appointments conducted face-to-face nearly halved and the proportion of telephone appointments increased by over 600 per cent from 1 March to 31 March as GPs moved to keep patients out of surgeries except when absolutely necessary.

However, concerns have been raised over the limitation of remote appointments, particularly in mental health services. Royal College of GPs chair Martin Marshall raised concerns that video appointments could make it difficult for doctors to diagnose and manage patients’ conditions during the pandemic.

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Source: HSJ, 11 May 2020

 

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Ministers to set up ‘dedicated team’ to aid NHS recovery

The government said it will set up ‘dedicated team’ to look for innovative ways for the NHS to continue treating people for coronavirus, while also providing care for non-covid health issues.

In its pandemic recovery strategy published today, the government also said step-down and community care will be “bolstered” to support earlier discharge from acute hospitals.

The 60-page document contained little new information about plans for NHS services, but said: “The government will seek innovative operating models for the UK’s health and care settings, to strengthen them for the long term and make them safer for patients and staff in a world where COVID-19 continues to be a risk.

“For example, this might include using more telemedicine and remote monitoring to give patients hospital-level care from the comfort and safety of their own homes. Capacity in community care and step-down services will also be bolstered, to help ensure patients can be discharged from acute hospitals at the right time for them".

To this end, the government will establish a dedicated team to see how the NHS and health infrastructure can be supported for the COVID-19 recovery process and thereafter.

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Source: 12 May 2020

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Report on the coronavirus contact tracing app published

The Joint Committee on Human Rights has published a report on the contact tracing app, concluding that if effective, the app could pave the way out of the current lockdown restrictions and help prevent the spread of coronavirus, but there are significant concerns regarding surveillance and the impact on other human rights which must be addressed first.

Last month the Committee launched their inquiry into the Government’s response to Covid-19: human rights implications. Following this, the Committee has produced a Reportthat outlines the key actions the Government must take to ensure that the app respects human rights including the right to privacy and non-discrimination at the same time as enabling individuals to move around more freely whilst helping to prevent the spread of the virus.

The Chair of the Committee, Harriet Harman MP, said: “Assurances from Ministers about privacy are not enough.  The Government has given assurances about protection of privacy so they should have no objection to those assurances being enshrined in law."

"The contact tracing app involves unprecedented data gathering. There must be robust legal protection for individuals about what that data will be used for, who will have access to it and how it will be safeguarded from hacking. Parliament was able quickly to agree to give the Government sweeping powers. It is perfectly possible for parliament to do the same for legislation to protect privacy.”

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Source: www.parliament.uk, 7 May 2020

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Coronavirus drugs trial to begin at UK homes and GP clinics

Drugs that could relieve the symptoms of coronavirus in vulnerable patients and help them avoid admission to hospital are to begin trials in homes across the UK.

The experiment, led by a team at Oxford University, seeks to test pre-existing treatments for older people in the community who show signs of the disease.

Known as Principle, or “Platform Randomised trial of interventions against Covid-19 in older People”, it is the first to take place in primary care settings such as health clinics.

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Source: The Independent, 12 May 2020

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Coronavirus: Care home deaths 'starting to decline'

The number of deaths linked to coronavirus in care homes in England and Wales has fallen, figures show.

The Office for National Statistics analysis showed there were 2,423 fatalities where the virus was mentioned on the death certificate in the week ending 1 May. That is down from nearly 2,800 the week before.

More than 8,300 deaths in care homes have been linked to virus since the epidemic started. The number of hospital deaths have been falling since early April but the government and care sector had been struggling to contain outbreaks in care homes.

Despite the drop, the virus is still have a major impact on the overall number of deaths in care homes. The total number seen in the week to 1 May is still nearly three times higher than you would normally expect.

That means there a large number of deaths happening where the cause is unclear.

One suggestion has been that the lack of testing in care homes has meant coronavirus has not always been listed on death certificates when it should.

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Source: BBC News, 12 May 2020

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Data on deaths in mental health and learning disability units will now be published, NHS announces

The NHS will this week begin to publish the numbers of people who are dying from coronavirus in mental health and learning disability units, the government has announced.

England's national medical director Stephen Powis told the Downing Street daily press briefing that the figures would be published on an "ongoing basis" after calls to paint a clearer picture of the problem.

It comes as figures from the Care Quality Commission showed a sharp increase in deaths among mental health patients compared to last year.

Asked by The Independent whether the numbers could be made public, he replied: "Yes, I can commit that we will publish that data.

"We've been looking at how we can do that; we publish deaths daily, we're looking at how we can report on those groups and I can commit that from next week we'll be publishing data on learning disabilities, autism, and mental health patients who have died in acute hospitals and we will do that on an ongoing basis."

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Source: The Independent, 9 May 2020

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Public health directors in England are asked to take charge of COVID-19 testing

Ministers have asked local directors of public health to take charge of COVID-19 testing in English care homes in what will be seen as a tacit admission that centralised attempts to run the programme have fallen short.

In a letter to sector leaders, seen by the Guardian, the care minister, Helen Whately, acknowledged that testing of care home residents and staff needs to be “more joined up”. She describes the new arrangements as “a significant change”.

Under the new approach, public health directors employed by local councils will take lead responsibility for arranging the testing of some 400,000 care home residents and 500,000 staff, in discussion with directors of adult social services, local NHS bodies and regional directors of Public Health England (PHE).

Critically, the local public health directors will decide which homes should have priority in the testing programme, which is still working up to a capacity of 30,000 tests a day for the sector.

The switch is a conspicuous, if belated, vote of confidence in local government’s ability to help get a grip on the Covid crisis. There has been frustration and incomprehension that public health teams have until now been left as bit-players in the testing programme and in tracking and tracing carriers of the virus.

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Source: The Guardian, 8 May 2020

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‘Fundamental’ changes to London’s NHS in wake of COVID-19

The NHS in London is planning to “fundamentally shift the way we deliver health and care” in the wake of coronavirus, according to documents obtained by HSJ.

The plans from NHS England and Improvement’s London office say leaders should:

  • Plan for elective waiting times to be measured at integrated care system level, rather than trust level.
  • Accept “a different kind of risk appetite than the one we are used to”.
  • Expect decisions from the centre on the location of cancer, paediatric, renal, cardiac, and neurosurgical services.
  • Plan for a permanent increase in critical care capacity.
  • Transform to a “provider system able to be commissioned and funded on a population health basis”.
  • Work towards “a radical shift away from hospital care”.
  • Expect “governance and regulatory landscape implications” plus “streamlined decision-making”.

The document, titled Journey to a New Health and Care System, says there are three “likely” phases, with the final new system in place “from November 2021”.

The preceding two phases are “action programmes” over the next 12 to 15 months which will be about reconfiguring services to deal with “immediate covid, non-covid and elective need”, and “transition” when the move to new configurations is evaluated and “public consent” sought.

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Source: HSJ, 11 May 2020

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UK health watchdog may investigate coronavirus deaths

The deaths of more than 50 hospital and care home workers have been reported to Britain’s health and safety regulator, which is considering launching criminal investigations, the Guardian has learned.

The Health and Safety Executive (HSE), which investigates the breaking of safety at work laws, has received 54 formal reports of deaths in health and care settings “where the source of infection is recorded as COVID-19”. These are via the official reporting process, called Riddor: Reporting of Injuries, Diseases and Dangerous Occurrences.

Separately, senior lawyers say any failures to provide proper personal protective equipment (PPE) may be so severe they amount to corporate manslaughter, with police forces drawing up plans to handle any criminal complaints.

Despite weeks of pleading, frontline medical staff complain that PPE is still failing to reach them as hospitals battle the highly contagious virus. Senior barristers say criminal investigations should be launched, and that there are grounds to suspect high-level failures.

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Source: The Guardian, 10 May 2020

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More people dying at home during COVID-19 pandemic – UK analysis

About 8,000 more people have died in their own homes since the start of the coronavirus pandemic than in normal times, a Guardian analysis has found, as concerns grow over the number avoiding going to hospital.

Of that total, 80% died of conditions unrelated to COVID-19, according to their death certificates. Doctors’ leaders have warned that fears and deprioritisation of non-coronavirus patients are taking a deadly toll.

Doctors’ leaders have warned that some sick people are too scared to go to hospital and are aware that much of the usual NHS care had been suspended in the pandemic. “These figures underline that the devastation wrought by Covid-19 spreads far beyond the immediate effects of the illness itself,” said Dr Chaand Nagpaul, the council chair of the British Medical Association.

“While all parts of the NHS have rallied round in a bid to meet the immediate rocketing demand caused by the pandemic, more than half of doctors in a recent BMA survey have told us that this is worsening the care of non-Covid patients.”

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Source: The Guardian, 8 May 2020

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New face cover for cancer test patients to stop COVID-19 spread

Surgeons have invented a new device to make it safer to diagnose some cancers during the coronavirus pandemic.

Most nose and throat investigations have been cancelled due to increased risks of medics contracting COVID-19 via patients' coughs and sneezes.

Two consultants have developed a device that clips over patients' masks and protects front-line workers. The West Midlands-based doctors want to raise £50,000 they say is enough to make devices for use across the NHS.

Chris Coulson, a consultant ear, nose and throat surgeon at University Hospitals Birmingham NHS Foundation Trust, said procedures involving an endoscope to examine the nose or throat were known to put clinicians at a significantly increased risk of contracting coronavirus.

"When clinicians carry out a nasendoscopy it can make patients cough, sneeze, and splutter - which risks spreading the virus to doctors, nurses and therapists," he said.

His company endoscope-i Ltd, co-founded with Ajith George, a consultant head and neck surgeon at University Hospitals North Midlands, has now developed the SNAP. It clicks on to a conventional surgical mask, creating a hole through which the clinician can pass an endoscope directly into a patient's nose. A valve means, despite there being a hole, any coughs, sneezes or splutters are caught within the mask.

Mr George said: "If we can raise the money needed to produce the devices, we can keep looking after patients and ensure that diagnosis and treatment is not delayed."

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Source: BBC News, 11 May 2020

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Covid-19: Allow pharmacists to dispense controlled drugs without prescription, urge specialists

Revised legislation allowing pharmacists to supply some controlled drugs without prescription must be enacted “without delay” to protect patients and to support clinicians, experts have said.

Last week (28 April) the UK home secretary, Priti Patel, laid legislation before parliament that allows for a relaxation of the regulations for prescribing controlled drugs, to ensure access is not delayed during the COVID-19 pandemic. The relaxation would allow pharmacists, in a pandemic situation, to supply some drugs that were previously only supplied to a patient by doctors on prescription. It would also allow pharmacists, in cases of shortages, to alter dosages or substitute drugs without having to go back to the prescribing doctor to seek a new prescription.

But the changes can be triggered only with the express permission of the home secretary, who has so far not given this despite the legislation being tabled to be used in situations of crisis.

Ian Hamilton, an academic at the University of York with an interest in addiction and mental health, who coordinated the letter, told The BMJ that although it was positive that the home secretary laid the legislation before parliament, it needed to be activated now.

He said, “Each day there’s a delay our concern is that the potential for suffering just goes on.”

“The problem with this is that if somebody is in a lot of pain and they’re really severely short of breath, that in itself is problematic because it can trigger a cardiac arrest. A worst case scenario is that someone could actually die because of a two or three hour delay in getting morphine. So this is something that I think is essential for healthcare workers to have.”

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Source: The BMJ, 7 March 2020

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ICUs advised how to improve staffing ratios as covid pressure eases

Intensive care units (ICU) will be advised how to improve their staffing-to-patient ratios shortly as the number of patients admitted to hospital with COVID-19 falls across the country.

In expectation that the pandemic would put intense pressures on ICUs, staff ratios were relaxed. NHS England told trusts to base their staffing models on one critical care nurse for every six ICU patients, supported by two non-specialist nurses, and one senior ICU clinician for every 30 patients, supported by two middle-grade doctors.

Before the pandemic, guidance from the Faculty of Intensive Care Medicine recommended a ratio of one non-specialist nurse per patient. For senior clinicians the ratio was 1:10

New guidance, expected as early as next week, will encourage trusts to reduce the number of patients per ICU specialist nurses and senior clinicians on a localised basis as part of “transitional arrangements” aimed at moving staffing models back towards normal standards of care, HSJ has been told.

The new guidance, drawn up by NHS England, the Faculty of Intensive Care Medicine and the British Association of Critical Care Nurses, will give trusts recommended staffing ratios based on the occupancy rates of their ICUs. It will tell trusts the existing ratios should be applied if their ICUs are running at four times their normal capacity. For ICUs running at double capacity, this ratio would be reduced to 1:2 for ICU nurses, and 1:15 for senior clinicians.

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Source: HSJ, 8 May 2020

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Deaths in mental health hospitals double as COVID-19 spreads

Deaths in mental health hospitals have doubled compared to last year after 54 deaths linked to coronavirus in just three months, it has emerged.

The care watchdog, the Care Quality Commission (CQC), has issued a warning to mental health hospitals that they must take action to protect vulnerable patients.

New data published by the regulator showed there was a total of 106 deaths of people in mental health hospitals between 1 March and 1 May compared to 51 in the same period in 2019. In total 54 of these deaths are from confirmed or suspected coronavirus infections.

The CQC has now written to all mental health hospital providers highlighting its fears over the spread of the virus within secure hospitals and units.

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Source: The Independent, 8 May 2020

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Government acts after claims covid deaths of disabled people are being 'ignored'

Deaths of those with learning disabilities and autism fromCOVID-19 are to be analysed by Public Health England (PHE), HSJ can reveal.

Several senior sources have confirmed PHE has put together a group, which includes independent experts, to analyse mortality data. They had previously not been included in the government’s inquiry into the over-representation of some groups among covid fatalities.

The news comes amid mounting concerns from major charities over the of lack transparency in data collected centrally on the deaths of people from these these groups during the pandemic. 

In a letter yesterday , seen by HSJ, Labour’s shadow secretary for social care Liz Kendall, urged Department of Health and Social Care minister Helen Whately to publish data on deaths reported to the Learning Disabilities Mortality Review Programme (LeDer).

Earlier this week NHS England and NHS Improvement told HSJ the weekly data it is receiving from the national learning disability morality review programme (LeDer) on suspected and confirmed deaths of those with learning disabilities and autism from COVID-19 would not be published until next year.

In her letter Ms Liz Kendall said the Government should “immediately” release the deaths notifications being provided by LeDer along with a “retrospective” analysis from the beginning of the pandemic.

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Source: HSJ, 7 May 2020

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Black people four times more likely to die from coronavirus than white people, ONS figures show

The Office for National Statistics (ONS) has published its first figures analysis Covid-19 related deaths by ethnic group in England and Wales between March 2 and April 10.

The results showed that the risk of death involving the coronavirus among Black, Asian, and minority ethnic (BAME) groups is “significantly higher” than that of those of white ethnicity.

Researchers found that when taking age into account, in comparison to white men and women, black men are 4.2 times more likely to die from a Covid-19-related death and black women are 4.3 times more likely.

People with Bangladeshi, Pakistani, Indian and mixed ethnicities have a raised risk of death, too.

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Source: The Telegraph, 7 May 2020

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Shipment of 400,000 delayed protective gowns from Turkey deemed unusable

The shipment of 400,000 gowns from Turkey which was part of a delayed consignment of personal protective equipment (PPE) has been impounded in a warehouse after falling short of UK standards.

The personal protective equipment (PPE) was flown into the UK by the RAF last month, arriving three days late, but has been held in a government warehouse near Heathrow since, the Daily Telegraph said.

During mid-April, when coronavirus deaths in the UK were at their highest, the NHS required 150,000 gowns each day.

Cabinet minister Brandon Lewis said the gowns were “not be of the quality that we feel is good enough for our frontline staff”.

Speaking on Sky News, Mr Lewis said: “Well when we’re securing PPE from around the world you do it based on a set of standards that you’re looking to acquire to, but obviously once it’s here we check that it is good enough for what we want to use and in this instance some of this PPE turned out not to be good enough.”

“I think it is right that if we have got particular standards for what we want our frontline staff to be able to have access to we make sure we stick to that. If something isn’t right, if we’re not even sure about it then I think it is better to be safe and not use that product and stick with products we are confident are the right products and the right standards.”

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Source: ITV News, 7 May 2020

 

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