Casebook March 2020

Casebook March 2020

Posted: March 11th 2020


Casebook, March 2020

Everything is currently dominated by coronavirus. I have tried to show in Casebook that there are other things as well we need to keep in view. I’ve also set out some of the really interesting progress the National Centre is making on other areas of work.

Budget: Sunak to pledge billions to soften Covid-19 impact as virus reaches Downing Street

These are exceptional times as this article tells us:

The chancellor is to pledge billions of pounds to ease the strain on the NHS as it tackles the Covid-19 outbreak and to reassure an increasingly nervous Britain after the nation’s first MP contracted the virus.

With the UK facing the biggest financial threat in more than a decade amid fears the epidemic could cause a recession, the chancellor, Rishi Sunak, is expected to announce a raft of measures in Wednesday’s budget to safeguard jobs, extend the scope of sick pay, and prevent businesses going under by deferring tax payments.

There was growing speculation in the City that the Bank of England would respond to crashing share prices on global financial markets with an unscheduled cut in interest rates, designed to dovetail with Treasury action.

Coronavirus: Care home residents could be 'cocooned'

With our higher than national average of over 65s in rural England I suspect a number of management approaches to coronavirus will impact disproportionately on us. Here is one example of something which is likely to fall into that category.

The government is considering a policy of "cocooning" groups of people who are most vulnerable to coronavirus. 

People in care homes and others who are less likely to survive the disease may be kept apart from the wider population until herd immunity has been established. 

A government adviser said an army of volunteers could be recruited to support those in group isolation.

Dr David Halpern said they could take pressure off care home staff.

If the virus spreads as modelling suggests it will, government advisers believe some hard choices will need to be made about how to protect groups that are more vulnerable to the disease - particularly the 500,000 older people in care homes and those with respiratory conditions.

Dr Halpern is chief executive of the government-owned Behavioural Insights Team, known as the "nudge unit", and a member of Whitehall's Scientific Advisory Group for Emergencies (Sage).

Government fails to detail how retired doctors plan will work for coronavirus

We know intimately about the challenges of delivering GP services in rural settings, this interesting article suggests tempting people who have left such places to return in the short term is likely to be a complicated and challenging process. It tells us:

The government is under pressure to spell out how it will use retired doctors to help tackle the coronavirus after ministers failed to provide any detail about how the scheme would work.

Questions are being asked about the widely reported NHS initiative, which was included in the government’s coronavirus action plan that Boris Johnson launched last week.

But the Department of Health and Social Care (DHSC) did not flesh out any of the detail about how it would resolve the complexities of launching the scheme when quizzed by an ex-health minister.

The Conservative MP Dr Dan Poulter last week tabled a parliamentary question to Matt Hancock, the health secretary, asking “what steps the government is taking to ensure that retired medical staff will be (a) re-registered and (b) re-certified to practise in the event that they are required to work as a result of Covid-19”.

But in a reply published on Monday, the DHSC said only that it “has indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.”

Poulter, who also works part-time as an NHS psychiatrist, said the lack of detail was concerning, especially as the idea could help the health service cope with a huge rise in the number of very sick patients.

UK in Danger of Failing a Generation Says Child Health Study

I think its harder to be a child, in terms of health and opportunity now than at any time in my life. This story is a shocking indictment of where we currently are socially. It tells us:

Rising violence, drug use and mental health problems among young people in England mean society is in danger of “failing a generation”, children’s doctors have said.

English teenagers are increasingly likely to be injured in youth violence and the UK is lagging behind other European countries on measures including infant mortality, according to UK-wide research into the state of child health by the Royal College of Paediatrics and Child Health.

The numbers of children in poverty, under child protection plans and being “looked after” have increased since its 2017 report, and progress on mental health among five- to 15-year-olds has stalled or reversed.

“It’s not a pretty sight,” said the president of the college, Prof Russell Viner. “On many vital measures we risk lagging behind other European countries. We’re in danger of failing a generation if we don’t turn this situation around. The government has made welcome commitments on childhood obesity and young people’s mental health but we need to see delivery in these and other areas.”


Matt Hancock asks MPs and Peers for Views on Adult Social Care Reform

In all this coronavirus crisis some of these long term challenges will end up falling out of sight. Well done to Matt Hancock for keeping this issue in focus. This report tells us:

Matt Hancock has written to MPs and peers, urging them to help secure a cross-party consensus on reform of the adult social care system, as the government commits to finding an answer to the ongoing problem.

In his letter, the health secretary says he is determined to find a sustainable solution to the problem of people being hit by large costs that are hard to plan for when their loved ones require social care.

“We know this will not be easy,” Hancock said in his letter. “The number of reports that have been published in recent years with different suggested approaches shows how difficult it is to reach agreement on the best way to reform the social care system.”

The government has committed to the principle that nobody should be forced to sell their home to pay for care, saying that everybody accessing care must have safety and security.

The letter sets out a two-step timeline for social care reform talks. The first phase began on Friday, calling for the views of MPs. The next steps will be structured talks in May on reform options. The letter says Hancock welcomed “all views, proposed solutions, and concerns about reforming the way people pay for adult social care”.

He added: “Any solution also needs to consider the financial impact on taxpayers as a whole, and the competing demands on taxpayers’ money from other public services.”

Other stuff
Parliamentary Inquiry 

We’re now in full swing with the new Parliamentary Inquiry again and we had a fascinating session on 28 February about systems. A number of excellent speakers were involved including the new CEO of the Kings Fund and representatives from the BMA and Care England. We’re just finalising the notes from the session so look out for them on the website where they will be featured in the next fortnight.


Defra and Farmer Networks

We have been working with Rose Regeneration and Bishop Grossteste University who run our day to day activities, on proposals to work with a number of farmer networks across England on a system for measuring their impact on mental health and well-being. They are hoping to begin this activity in a couple of weeks and will report progress directly to the National Centre.


National Rural Health Association (USA)

Through our Board Member Dr John Wynn-Jones we have been able to begin a dialogue about a partnership concordat with the National Rural Health Association in the USA. They have 22,000 members so that is something to aspire to!! We are confident that this will be the first of a number of international relationships as the work of the National Centre proceeds.


Rural Proofing Toolkit

Progress with the toolkit continues apace and if there are any examples of good practice you would like to share with us that we could include, showing how thinking about rural issues has led to an improvement in health and care services, please contact me at


Workforce Research Phase II

Our colleagues at the University of Birmingham are making good progress. We have refined the focus of the work to concentrate on a small number of pithy case studies and these are currently in train on the following areas of good practice:

Application of Buurtzorg [Dutch model of neighbourhood care] to a UK rural context

Volunteering [Helpforce and Lancashire Volunteering Collaborative]

Cambridgeshire and Peterborough Social Care Progression Academy

Airedale Digital Hub case study (already completed)

If you’d like a bit of a peek before publication let me know at


Rethinking Remote – Aviemore April 2020

Our Deputy Chair Jan Sobieraj is to speak at this event. Creating a great opportunity to network with Scottish and Welsh colleagues.


Rural Health and Care Alliance

We now have an excellent new membership lead in place, Nadine Trout, who has already begun to make a real impact in terms of our membership offer and approach. If you have any ideas of refinements to the membership offer or any issues you would like to raise in terms of membership please do feel free to let us know.


Rural Mental Health Seminar – 9 April 2020

We still have places for this seminar on 9 April. In view of the corona virus we may decide to run it using zoom. If you’d like more information contact: