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Content ArticleEuropean governments hope that contact tracing apps can allow them to ease lockdowns. But much work must be done at both national and EU level before restrictions can be eased. There are growing calls for lifting lockdowns across European countries. Austria and Denmark have already announced plans to open schools. But ending lockdowns without mass testing and contact tracing firmly in place will be very dangerous, as COVID-19 is far more infectious than its predecessors, like SARS. Even with rigorous testing and contact tracing, some curbs on social contact will be needed, and lockdown measures will need to be eased step by step. Once it has been shown that restrictions can be eased while containing the spread of the disease, there will still need to be co-ordination at the EU level to allow travel between member-states. Without trust in each other’s exit strategies, countries will be wary of opening up. In this article, John Springford, Deputy Director of the Centre for European Reform, stresses that mass testing and contact tracing apps must be in place before lockdowns can be eased in Europe - and that the EU has an important role to play.
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News ArticleA&E admissions in the UK have fallen to the lowest on record, with a 57% year-on-year drop in attendances in England, new NHS data shows. The latest figures show a dramatic fall in demand for emergency treatment, falling below one million attendances per month for the first time since records began in 2010. The coronavirus crisis has placed additional strain on NHS resources, but is thought to have had the opposite effect on A&E, with the public staying at home and avoiding hospitals where possible. Read full story (paywalled) Source: The Telegraph, 14 May 2020
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News Article
Government launches new portal for care home coronavirus testing
Patient Safety Learning posted a news article in News
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." Read full story Source: National Health Executive, 12 May 2020 -
News Article
Ministers were warned two years ago of care homes' exposure to pandemics
Patient Safety Learning posted a news article in News
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.” Read full story Source: Guardian, 13 May 2020 -
News Article
NHS England seeks advice amid ‘shielded’ patient concerns
Patient Safety Learning posted a news article in News
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. Read full story Source: HSJ, 13 May 2020 -
News Article
Coronavirus: Restarting NHS services will be a major challenge, warn experts
Patient Safety Learning posted a news article in News
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. Read full story Soruce: The Independent, 14 May 2020 -
Content Article
When and how should we transition safely into ‘normal work’ in healthcare?
Claire Cox posted an article in Blogs
In her latest blog, Claire reflects on the last few months working as a critical care outreach nurse during the pandemic and looks to the future and how we can transition into the new 'normal'. She urges us all to work together to redesign our health and social care services, building a service that meets all our needs.- Posted
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Content ArticleBetween 25-30 April 2020, three nurses working at Waitakere Hospital, New Zealand tested positive for coronavirus (COVID-19). In the week prior to testing positive, the nurses had been working on a ward caring for a group of elderly patients with COVID-19. The patients were from an aged residential care (ARC) facility in West Auckland.
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News ArticleMeasures 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.” Read full story Source: The Independent, 13 May 2020
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News ArticleHospital 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.” Read full story Source: University of Cambridge, 12 May 2020
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Content Article
COVID-19 Narrative Seventeen: Routes out of lockdown
Patient Safety Learning posted an article in Exit strategies
In this article, Dr David Nabarro and John Atkinson discuss the routes out of the coronavirus lockdown. Quality information is at a premium. Decisions will be based on data about the spread of the virus disaggregated by locality. Numbers of people becoming infected will need to be factored into decisions. The goal is to understand the extent of transmission and whether the rate of increase in people infected is starting to reduce. The sequence for easing a lockdown will vary from place to place. Decision-makers will be considering multiple factors when deciding how best to do this. Here they explore the questions decision-makers will be asking and indicate some of the factors they might consider. -
News Article
Coronavirus: NHS shielding letters miss thousands of cancer patients
Patient Safety Learning posted a news article in News
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. Read full story Source: The Times, 12 May 2020 -
Content ArticleThe impact of COVID-19 on communities of colour in the US is dramatically and disproportionately affecting African-Americans most of all. The reasons are complex, with underlying health conditions (e.g., hypertension, diabetes) acting as one contributing factor. Yet, these health problems, public health experts say, largely reflect the history and ongoing realities of racism in the US that have created barriers to accessing quality health care and the conditions that can lead to better health.
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News Article
Testing for coronavirus in UK care homes a ‘complete system failure’
Patient Safety Learning posted a news article in News
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. Read full story Source: The Guardian, 12 May 2020 -
Content ArticleThe impact of the virus that causes COVID-19 could hardly be more disparate. While billions are stuck at home and restricted by social-distancing guidelines, millions of people must still put themselves and their families at risk by continuing to go to work. Millions are coping with the requirement of effectively working from home, but millions more have lost their jobs and don’t know how they will pay for housing or food. And for those who contract the virus, its effects span from nothing at all to death. Derek Feeley discusses these inequities in an article for the Institute of Healthcare Improvement.
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Content ArticleCarmel is a staff nurse on a trauma and orthopaedic ward in Liverpool. She’s also an RCN steward and chair of her RCN branch. Since the COVID-19 pandemic took hold she’s been recording an audio diary of how it’s had an impact on her personal and professional life. Here you can listen to the full audio diary in three chapters or read the highlights.
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Content ArticleNadia Whittome, an MP, went back to work in social care when the pandemic struck but was dismissed when she spoke out about the lack of personal protective equipment (PPE) faced by workers on the frontline. She recounts her experience in a blog to the Guardian.
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Content ArticleThe government's plan to rebuild the UK for a world with COVID-19. Inevitably, parts of this plan will adapt as we learn more about the virus. The government 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. It outlines a phased recovery approach and the roadmap to lift restrictions step by step.
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News Article
Covid sparks boom in digital hospital outpatient appointments
Patient Safety Learning posted a news article in News
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. Read full story Source: HSJ, 11 May 2020 -
News Article
Ministers to set up ‘dedicated team’ to aid NHS recovery
Patient Safety Learning posted a news article in News
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. Read full story Source: 12 May 2020 -
News Article
Report on the coronavirus contact tracing app published
Patient Safety Learning posted a news article in News
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.” Read full story Source: www.parliament.uk, 7 May 2020 -
News Article
Coronavirus drugs trial to begin at UK homes and GP clinics
Patient Safety Learning posted a news article in News
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. Read full story (paywalled) Source: The Independent, 12 May 2020 -
News Article
Coronavirus: Care home deaths 'starting to decline'
Patient Safety Learning posted a news article in News
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. Read full story Source: BBC News, 12 May 2020 -
News ArticleThe 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." Read full story Source: The Independent, 9 May 2020
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Content ArticleThe steps that need to be taken to end the coronavirus crisis are not unknown; they are clear and informed by evidence and the experience of other countries. The public deserves a plan of action to ease and ultimately lift restrictions in a careful manner that does not risk a resurgence of the epidemic, resulting in an endless cycle of infection waves and economic depression. In this article, Emanuel et al. outline the steps the federal government and states need to take and systems to implement, at a minimum, to prevent a second wave and allow a return to some degree of normal life.
