Casebook April 2023

Casebook April 2023

Posted: April 17th 2023


In Casebook this time: mental health support (or the lack of it!) in rural areas, the threat and ongoing challenge of the pandemic, from a number of vistas along with a scary story about ticks and some interesting reflections on our recent activities in “Other Stuff.” We also include some further reading from Casebook members.

‘Buckling’ NHS fails to treat 250,000 children with mental health problems

I suspect a location analysis would show a significant number of the children profiled in this article will be based in rural settings it tells us:

A quarter of a million children in the UK with mental health problems have been denied help by the NHS as it struggles to manage surging case loads against a backdrop of a crisis in child mental health.

Some NHS trusts are failing to offer treatment to 60% of those referred by GPs, the research based on freedom of information request responses has found.

The research carried out by the House magazine and shared with the Guardian also revealed a postcode lottery, with spending per child four times higher in some parts of the country than others, while average waits for a first appointment vary by trust from 10 days to three years.

Lloyd’s of London offers to insure NHS for unexpected costs such as pandemic

The first of three pandemic related articles this week and in many senses the most novel….

The head of Lloyd’s of London has offered to strike a world-first deal with the UK government to help the NHS meet unexpected increases in costs triggered by major events such as another pandemic.

John Neal, who runs the world’s largest insurance market, where 76 firms operate, floated the possibility of providing bespoke insurance contracts to the struggling health service, as well as government cover for floods or droughts caused by the climate crisis, when he met the chancellor, Jeremy Hunt, for the first time last month.

“One of the challenges the government has is around peak demand in the NHS relative to NHS budgets,” said the Lloyd’s of London’s chair, Bruce Carnegie-Brown.

“If we can provide an insurance solution that effectively funded the NHS if it breaches its capacity, or budget issues, then it would show the insurance industry responding in a positive way to something that was caused by an exogenous event,” he said. “Obviously things like a pandemic might cause very dramatic increases in demand on the NHS and its resources.”

Top Scientists warn “The next pandemic is coming and we’re not ready.”

It sounds as if amidst all the other trials and challenges facing our healthcare system we are letting our guard down! This article tells us:

The UK is not ready for the next global pandemic because public services are being dismantled and key research is being defunded, experts have claimed.

More than three years after the global outbreak of coronavirus, top scientists have warned that the UK is no better prepared for a pandemic than it was in 2020.

They say another epidemic on the scale of Covid-19 is inevitable, but that disinvestment in infection-monitoring services, dismantling of key infrastructure, and the state of the NHS mean the country is “losing ground”.

Mapped worst areas in the UK covid amidst fears over new Arcturus variant

There is a significant cohort of rural dwellers in the North East and this article gives considerable cause for concern for Casebook readers. It tells us:

England’s North East currently has the highest Covid infection rate of any UK region, according to new figures from the Zoe Health Study app.

Nearly 1.25 million people are currently thought to have symptomatic coronavirus in the UK, according to the Zoe Covid study, whose estimates are based on users self-reporting symptoms and test results.

This is down from a recent peak of nearly 1.5 million suspected symptomatic infections a fortnight ago, which itself was below previous highs of more than 1.6 million over New Year and in mid-October.

The ongoing study, run by King’s College London, found that rates of daily new symptomatic infections are highest in England’s North East, where there are potentially as many as 2,188 new daily cases per million people, based on data from Wednesday.

There are estimated to be up to 1,716 new cases per million in the West Midlands, which is followed closely by Scotland and the North West.

These infection rates contrast with an upper estimate of 1,301 new daily cases per million people in the South East. Overall, there were estimated to be more than 81,000 new symptomatic cases of Covid in the UK on Wednesday, according to Zoe app data.

The study is among the most reliable trackers of infection levels in the UK, not least since the end of the Office for National Statistics’ figures stopped last month, leaving Britain “completely in the dark”.

Warning as deadly tick borne virus detected in several areas of the UK

Ticks make my flesh creep and this article shows the importance of taking care when out and about in rural settings it tells us:

A deadly tick-borne disease that can cause meningitis is “likely” to be present in the UK, health officials have warned after cases were spotted across the UK.

A confirmed case of tick-borne encephalitis (TBEV) was found in Yorkshire last year, and a probable case was also detected in the Loch Earn area of Scotland in 2022.

A joint UK Health Security Agency (UKHSA) and Defra committee said the virus has also been seen in the Hampshire/Dorset and Norfolk area, but may also be present in other parts of England as the tick species which carries the virus is widespread in the UK.

Encephalitis is an uncommon but potentially deadly condition in which the brain becomes swollen.

It can cause a range of illnesses from completely asymptomatic infection, to mild flu-like illness, to severe infection in the central nervous system such as meningitis or encephalitis.

Other Stuff

Just a brief summary of our activities over the last few months:

In addition to its ongoing core services and the achievements set out in our most recent impact card the Centre has recently:

  • Submitted evidence to the Hewitt Review on the Governance of ICBs
  • Submitted evidence to the House of Lords Select Committee on Primary and Community Care (
  • Supported the operational planning for the new £8.6 million coastal clinical trials facility in Mablethorpe, Lincolnshire
  • Begun detailed plans for the implementation of the Rural Health and Care toolkit with the health systems in Devon and Northamptonshire along with a shared approach to the application of a rural version of the toolkit with Rural Community Network in Northern Ireland
  • Held more detailed research and collaboration discussions with the Nuffield Trust in relation to the evolution of policy in relation to rural health and care

The Centre has a major planning and development session organised for June 2023 and we would be pleased to receive any thought from members on key priorities prior to that event. These can be sent in the first instance to

Campus for Future Living

Casebook readers will be interested to learn that the £8.6 million clinical trials and medi-tech Campus for Future Living in Mablethorpe is seeking an operator. Due to market failure in the area, this is a once in a lifetime opportunity for a commercial operator with an interest in clinical trials and medical research to acquire a lease on highly favourable terms. We have already begun exploring potential sub-tenants and the facility which will be completed by March 2024 will come with tenants and projects already committed and significant international scope for business development and growth. The local PCN, Medical Technology Facility at Nottingham Trent and University of Lincoln have all signed an MoU committing to support the development of the facility. In addition to two fully equipped labs capable of supporting trials the Campus has facility has 7 dedicated bedrooms to enable remote working in the field. We have a prospectus which is available to potential operators and please email if you would like to receive more details.