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A lack of coronavirus tests for NHS staff is leading to staff absences and services being put at risk, hospital bosses have warned. NHS Providers, which represents hospital trusts in England, said staff are having to self-isolate rather than work because they cannot get tests for themselves or family members. It comes after widespread reports of people struggling to get tested. The home secretary defended the system, saying capacity was increasing. The government's testing system - part of its test, track and trace operation which Prime Minister Boris Johnson promised would be "world-beating" - has faced criticism in recent weeks. An increase in demand for coronavirus tests has led to local shortages - with some people being directed to test sites hundreds of miles from their homes. One doctor working in a coronavirus hotspot said she applied for a test for herself and her partner after they developed coughs and fevers. After refreshing the website for five hours, she managed to get an appointment but on arrival was told no booking had been made. She had taken screenshots of a confirmation code but was not sent a QR code to scan. "I showed the screenshots but I was told that the appointments weren't happening," she said. "I have to say I burst into tears. I was meant to be seeing patients and I feel guilty." Dr Rachel Ward, a GP in Newbury, told BBC Breakfast she was seeing a lot of patients who were struggling to get tests, saying a lot of families were "at the end of their tether" as it was "very stressful when you are faced with two weeks off work". She said if the staff at her practice were unable to get tests and had to self-isolate it would have a "huge impact" on patients as some of their healthcare workers are booked in to administer 100 flu jabs in a day. Read full story Source: BBC News, 14 September 2020

A trust which accounted for one in eight of covid deaths in hospital during part of the summer has been criticised by the Care Quality Commission for its infection control. Staff did not follow social distancing rules in a staff room at East Kent Hospitals University Foundation Trust, did not always practise hand hygiene, and the trust had used incorrect PPE, the CQC said. In addition, two hourly cleans were not always carried out, soap and hand sanitiser were missing, and the emergency department at the William Harvey Hospital in Ashford did not have enough sinks for staff and visitors to wash their hands in. There was also a lack of hand hygiene guidance on display. Inspectors added that not all staff understood what needed to be done when a walk-in patient presented with covid symptoms, and the emergency department did not have an escalation plan if areas were crowded and patients could not socially distance. The CQC inspected the William Harvey Hospital on 11 August and took enforcement action after the visit. It has yet to publish the report but the initial feedback was summarised in the trust’s latest board papers, together with the trust’s response. Read full story (paywalled) Source: HSJ, 14 September 2020

A third of those who died with diagnosed or suspected COVID-19 in English hospitals did so at Tameside and Glossop Integrated Care Foundation Trust in the seven days to 10 September. The Greater Manchester Trust has seen a significant rise in COVID-19 deaths, from a weekly total of five on 4 September to 18 six days later. The total number of COVID-19 hospital deaths in the seven days to 10 September across England was 54. COVID-19 deaths at Tameside and Glossop had fallen to a weekly total of zero on 23 July, before beginning to climb steadily from 20 August. The last time the trust recorded 18 deaths in a seven-day period was in late April when the pandemic was still close to its first peak. The highest seven day figure recorded by the trust was 28, meaning the 10 September figure is equivalent to 64% of its peak covid-19 mortality. Nationally, hospital deaths with the virus are running at less than 1 per cent of the early-April peak. No other trust recorded more than three covid-19 deaths during the seven days to 10 September. Read full story (paywalled) Source: HSJ, 13 September 2020

The government has now officially recognised the long-term health implications some people can suffer after contracting coronavirus. Lung inflammation, gastrointestinal disturbance, and fatigue are just some of the listed long-term health effects published by Public Health England. But it’s no new revelation - as campaigners made up of politicians, expert clinicians and sufferers have fought hard over the past few months to bring what has become known as ‘long covid’ into the public domain. One of them is Jo Platt, former Labour MP for Leigh, who says the virus hit her ‘like a train’ in the week before lockdown in March - when it wasn’t possible to get a test. She's been left with symptoms months on - although recently tested negative twice for COVID-19. “It was like a train hitting me, like a switch, I felt so unwell for two days. I had general dizziness, fatigue but nothing you could pinpoint. I didn’t have a cough or a temperature, although I felt hot; had gastric trouble; shortness of breath; then it eased and I was okay and thought ‘thank goodness. It must have just been mild’,” Jo said. Two days later the symptoms came back, but that spell of illness lasted for two weeks. Jo said she couldn’t get out of bed, suffered intense headaches and a burning sensation in her lungs, was unable to concentrate and couldn’t read. “I’m not normally an anxious person, but then came anxiety", she said. "I felt a real sense of dread, a heightened pending sense of doom. It continued on and off for months, and particularly worsened at the weekend. The 48-year-old got in touch with her GP who said anxiety was bringing the symptoms on. It wasn’t until a week later when Jo read an article by Professor Paul Garner, of Liverpool School of Tropical Medicine, who talked about his fight with symptoms, that she realised she wasn't alone. “Everything he was saying was the same as what I was going through. I cried and cried. It was all validated. Then the journey began of finding other people - which does make it feel better,” said the mum-of-three. Prof Garner has described coronavirus as a 'very bizarre disease' that left him feeling 'repeatedly battered the first two months' and then experiencing lesser episodes in the subsequent four months with continual fatigue. “Navigating help is really difficult,” he said in a BMJ webinar. With the help of Jo's connections in parliament, Prof Garner, and meetings with the shadow cabinet health team, a support group for long covid sufferers has been formed, which has 20,000 members. They’re calling for recognition, which they finally got from the government on 7 September 7, research and rehab. Matt Hancock said at the Health and Social Care Committee the following day: “The long-term impacts of covid are not very strongly correlated with severity of the initial illness. While we have a significant amount of work going into supporting those who come out of hospital, this is not just about people hospitalised. “In fact, this is especially relevant for now with the latest rise largely among young people, it doesn't matter how serious your infection was the first time, the impact of long covid can be really debilitating for a long period of time, no matter if your initial illness wasn't all that severe.” The Health Secretary, when questioned on calls by the Royal College of GPs for covid clinics, said the NHS has set up clinics, but he is ‘concerned’ that not all GPs know how to ensure people know how to get into those services. “That’s something I am sure we can resolve,” he added. Read full story Source: Manchester Evening News, 13 September 2020

Almost 86% of doctors in England say they expect a second peak of coronavirus in the next six months, according to a new survey, as concern continues to grow over a recent rise in cases. On Friday, new results from a population-based study suggested the R number for England is now at 1.7, with infections doubling every 7.7 days. While the prevalence of the disease remains lower than it was in the spring, an R value above 1 means cases could grow exponentially. Sunday marked the third day in a row that new coronaviruses cases reported for the UK topped 3,000 – the highest figures since May – with 2,837 new cases reported in England alone. While testing has increased over the past months, experts have said this does not fully explain the recent surge. In a poll, the British Medical Association (BMA) asked more than 8,000 doctors and medical students in England what their top concerns were out of five possibilities, from a second peak of coronavirus to sickness and burnout among staff and winter pressures, including a possible flu outbreak. Almost 30% of respondents selected a second peak as their number-one worry. Overall, 86% of respondents said they believed a second peak of coronavirus during the next six months is either “quite likely” or “very likely”. When asked which of a range of factors might risk causing a second peak, almost 90% of respondents agreed or strongly agreed that failures of the test-and-trace system posed a risk, while a similar proportion cited a lack of infection-control measures in places like bars and restaurants, and 86% agreed or strongly agreed confusing messaging on public health measures was a risk. Read full story Source: The Guardian, 14 September 2020

The government has written to care home providers in England to warn them of a rise in new coronavirus infections within the sector. A letter from the Department of Health urged care bosses to take "necessary action to prevent and limit outbreaks". Cases were mainly among staff but risked spreading to residents, it said. It comes as a further 3,330 positive cases were recorded in the UK - the third consecutive day in which cases have been over 3,000. It brings the total number of confirmed cases to 368,504. Friday's letter from the Department of Health and Social Care said testing data had revealed an increase in the number of positive results in care homes and called on the care sector to work with the government. "You will know already that we are experiencing a rise in confirmed Covid-19 cases across the UK population," wrote Stuart Miller, director of adult social care delivery. "I need to alert you to the first signs this rise is being reflected in care homes too." "I am writing at the earliest opportunity, so we can work in partnership to prevent further spread of the disease. The rapid flow of data and information, to and from care providers, is vital to this effort." Mr Miller said the infections had been detected chiefly among staff but had been transmitted to residents in some cases. He went on to stress "the importance of regular testing and consistent use of PPE". Read full story Source: BBC News, 14 September 2020

Millions of people who are at risk of serious illness from COVID-19 could be asked to start shielding again if infection rates continue to rise, according to reports. Officials are planning to send out letters telling the most vulnerable either to stay at home or to follow advice specifically tailored to their health conditions. The Daily Telegraph reports that the new programme will initially target those living in areas with dangerous levels of coronavirus but went on to quote an anonymous official as saying it could be applied to the whole of England if necessary. If so, it could affect up to 4.5 million people – more than double the number who were asked to shield at the start of the lockdown in March. The new shielding scheme is reportedly based on a "stratified risk model" which would target individuals based on factors such as their underlying health conditions, age, sex and weight. Read full story Source: 13 September 2020

People across England have told BBC News they are struggling to access coronavirus tests. Health Secretary Matt Hancock said last week that no-one should have to travel more than 75 miles for a test, after the BBC revealed some were being sent hundreds of miles away. But dozens have now reported being unable to book a swab at all. The Department of Health and Social Care (DHSC) said testing capacity was targeted at the hardest-hit areas. A significant rise in demand for testing led the government to reduce the number of appointments available in areas of lower prevalence, to prioritise areas with outbreaks. This in turn led to people applying for tests being directed to centres sometimes hundreds of miles away. But last Thursday Mr Hancock pledged to put in "immediate" solutions to make sure people did not have to travel more than 75 miles, effective from last Friday. Since then, postcodes entered into the government's booking system return a message suggesting there are no testing centres or home kits available - even if you are an essential worker with symptoms. Frances, in Suffolk, tried to apply for a test when her daughter developed a high temperature. She didn't think it was coronavirus but "the rules are the rules". She had understood that anyone with a temperature should apply for a test, and was not able to send either of her children to school until she did. "Their teachers need to be kept safe, their classmates need to be kept safe, we need to do the right thing," she said. But Frances was also not able to get a home kit, and when she tried to get an appointment at a drive-through centre was told no test sites were found. Read full story Source: BBC News, 12 September 2020

Cases of coronavirus in England are doubling every seven to eight days, research has revealed in the latest figures to show a resurgence of COVID-19. The study, known as React-1, is a population surveillance study that began in May and uses swabs from about 120,000 to 160,000 randomly selected people in England across 315 local authority areas each month to track the spread of coronavirus using PCR analysis – the “have you got it now” test. “The prevalence of the virus in the population is increasing. We found evidence that it has been accelerating at the end of August and beginning of September,” said Steven Riley, professor of infectious disease dynamics at Imperial College London and a co-author of the work. The findings came as, elsewhere, the latest R figure for the UK was reported to be between 1.0 and 1.2, with the number of new infections somewhere between shrinking by 1% and growing by 3% every day. Previous rounds of the study revealed a falling prevalence of COVID-19, even as lockdown restrictions were eased: according to data for the period 19 June to 8 July, the prevalence of Covid in the general population was low, and halving every eight to nine days. However, the results from the fourth round of the survey suggest that is no longer the case. While the latest findings from the React study have yet to be peer-reviewed, researchers say out of more than 150,000 swabs collected between 22 August and 7 September, 136 tested positive for coronavirus, suggesting 13 people out of every 10,000 in the general population had COVID-19. Read full story Source: The Guardian, 11 September 2020

PRESS RELEASE (London, UK, 11 September) – The charity Patient Safety Learning are calling on the NHS to publish details of post-COVID support clinics and clarify how these can be accessed by thousands of ‘Long COVID’ patients. Patient Safety Learning has written to Sir Simon Stevens, Chief Executive of the NHS, calling on him to take steps to publicise the locations and details of these services. This follows Matt Hancock MP, Secretary of State for Health and Social Care, expressing concerns in the Health and Social Care Select Committee on Tuesday that not all GPs know how to access these services. Helen Hughes, Chief Executive of Patient Safety Learning, said: “We have heard from many Long COVID patients that they are not clear on the location of these clinics, what services they offer and who is eligible for support. Some patients have been advised by their GP that there are no post-COVID clinics available within their area. Though the NHS launched the ‘Your COVID Recovery’ online portal for patients recovering from COVID, there is no clear indication of how the clinics fit into this and how patients can access the support they need.” Long COVID patients are those with confirmed or suspected COVID-19 who continue to struggle with prolonged, debilitating and sometimes severe symptoms months later. In their letter, the charity has identified a series of steps needed to provide greater clarity for these patients, including: Publishing a list of all existing post-COVID clinics and contact details. Confirming whether these clinics are accessed by referral from your GP or self-referral. If by GP referral, publish the guidance issued to GPs on this process. Confirming who is eligible for these services, whether they are restricted to those hospitalised by COVID-19 or open to those who are managing their symptoms at home. Confirm what services are available from these clinics. Specifically, whether they can help patients access clinical investigations, as well as treatment and rehabilitation. Clarify whether these services are available to all patients or only those who have had a confirmed positive test for COVID-19. Notes to editors: Patient Safety Learning is a charity, which helps transform safety in health and social care, creating a world where patients are free from harm. We identify the critical factors that affect patient safety and analyse the systemic reasons they fail. We use what we learn to envision safer care. We recommend how to get there. Then we act to help make it happen. For more information: www.patientsafetylearning.org In the Health and Social Care Select Committee on Tuesday 8 September 2020, Matt Hancock commented that “The NHS set up Long COVID clinics and announced them in July. I am concerned by reports this morning from the Royal College of GPs that not all GPs know how to ensure that people can get into those services. That is something I will take up with the NHS and that I am sure we will be able to resolve.” The full transcript can be found here. Patient Safety Learning’s full letter to Sir Simon Stevens can be found here. Patient Safety Learning have previously set out patient safety concerns for Long COVID patients, outlining these issues in more detail. Read more here.

COVID-19 may have contributed to the deaths of 18 people who contracted the infection while being treated at Weston general hospital in Somerset, an investigation has found. The layout of the hospital and the proximity of staff and other patients who had Covid but were asymptomatic may have been among the reasons for the 18 people acquiring the virus. The hospital temporarily stopped accepting new patients, including into its A&E department, on Monday 25 May following a Covid outbreak among patients. It fully reopened on 18 June. As part of its investigation, University Hospitals Bristol and Weston NHS foundation trust identified 31 patients who died after contracting Covid while they were in-patients from 5-24 May. A detailed review of each of the cases was undertaken and it concluded that in 18 patients, the infection may have contributed to their death. Dr William Oldfield, the trust’s medical director, said: “We are deeply sorry for this. We are already in contact with the families of these patients and have informed them of the outcome of the review. We have apologised unreservedly and have offered them support." “For each family concerned, we will undertake an investigation into the specific circumstances that led to the death of their loved one. We will invite them to help inform the investigation to ensure that any questions they have are addressed. We recognise that other patients and families may have concerns and we would like to provide reassurance to everyone that the safety of our patients and staff continues to be our main priority.” Read full story Source: The Guardian, 10 September 2020

The UK government is seeking views on proposed changes to the Human Medicine Regulations 2012 to help with the safe and efficient distribution of a COVID-19 vaccine and expanded flu vaccine programme in the UK, along with treatments for COVID-19 and any other diseases that become pandemic. Ministers say there will be no shortcut on safety or effectiveness, and that any vaccine will be approved for the UK only if it meets the highest standards. The deputy chief medical officer for England, Prof Jonathan Van-Tam, said: “If we develop effective vaccines, it’s important we make them available to patients as quickly as possible but only once strict safety standards have been met. The proposals consulted on today suggest ways to improve access and ensure as many people are protected from Covid-19 and flu as possible without sacrificing the absolute need to ensure that any vaccine used is both safe and effective.” What do you think? Are there patient safety concerns here? We'd love to hear your views. Comment below.

The Royal College of GPs (RCGP) has stressed the importance of GPs having rapid access to testing results for patients, as newly-released research highlights the role general practice is playing during the coronavirus pandemic. Released by Queen Mary University of London, and published in the British Journal of General Practice, the research showed GPs and their teams were continuing to deliver frontline care to NHS patients with both Covid and non-Covid conditions. The active role of GPs in the COVID-19 response is nothing new or surprising, though notably the Queen Mary research focused in heavily on ‘suspected’ cases of Covid, due to limited community testing throughout the pandemic, giving a clearer picture of the primary patient group using general practice services. Responding to the research, Professor Martin Marshall, Chair of the RCGP, said: “This data shows the significant role GPs and our teams have played in tackling Covid-19 and delivering care to patients during the pandemic – and how the virus has impacted on all parts of the health and care services. “General practice has been open throughout the pandemic with GPs and our teams continuing to deliver the vast majority of NHS patient care to patients with both Covid and non-Covid conditions." Read full story Source: National Health Executive, 8 September 2020