Casebook December 2020

Casebook December 2020

Posted: December 14th 2020


In Casebook this month – some great exposure for our campaigning on rural health inequalities. Vaccine, Brexit, AI, test and trace…. Then some great news about the launch of our Rural Proofing Toolkit and the evolution of our Covid Impact Dashboard. 

Covid response hits rural NHS services hard – report

I am thrilled that in partnership with the Nuffield Trust we have managed to achieve this exposure in the national press. This story tells us:

NHS patients in rural areas of England face extra long waits for treatment, according to a study.

The Nuffield Trust think-tank says urban areas benefited most from measures put in place to help the NHS cope with the coronavirus pandemic.

Researchers found rural hospitals now faced an uphill challenge when it came to restoring services to normal.

NHS England says that funding reflects the higher costs of delivering care in rural communities.

The Nuffield Trust report says while the number of Covid cases in rural areas was lower than in big urban centres, the pandemic's impact on services has been much greater.

It says the coronavirus crisis highlighted pre-existing problems facing rural trusts.

For example, it can be hard to recruit and retain doctors and nurses who are willing to work in smaller hospitals, which means trusts rely more heavily on expensive agency staff to fill gaps in rotas.

This, in turn, has a detrimental effect on the finances of hospital trusts which struggle to balance the books.

In addition, rural trusts often have only a limited capacity to treat any extra patients as they are often already very busy.

Prof Richard Parish, chair of the National Centre for Rural Health and Care, said: "We continue to be concerned that Covid has made a number of rural inequalities worse.

"There doesn't appear to be much short-term prospect of respite. When there is, we still have to make progress towards a level playing field.

"This would involve, for a start, reducing the reliance on agency staff in rural health settings, speeding up rates of hospital discharge and reducing waiting times for elective surgery."

Covid-19: Vaccine rollout 'ready' for any Brexit outcome

I hope this story proves to be true…..

The Covid vaccine will reach everyone in the UK who needs it - whatever the outcome of post-Brexit trade talks, the medicines regulator head has vowed.

Dr June Raine said officials had a clear "goal" and were "fully prepared for any possible outcome".

Asked about a no-deal situation, she told the BBC's Andrew Marr Show: "We have practised. We are ready."

The first jabs are being given this week and Dr Raine said people could have "real confidence" in their safety.

The EU and UK are trying to reach a trade deal before a 31 December deadline.

Dr Raine, chief executive of Medicines and Healthcare products Regulatory Agency (MHRA), said: "We are ready and we know that whatever the deal we will be able to ensure that people have access."

She said the "goal" of the MHRA was to "make sure that whatever the outcome, whatever the deal, that medicines and medical devices and vaccines reach anyone in all parts of the country in the same way without any interruption at all".

Responding to a question on the same issue, Environment Minister George Eustice told Sophy Ridge on Sky News: "We have got many contingency plans in place and there won't be any effect on the deployment of this vaccine from a no-deal Brexit."

U.K. Invests $330 Million To Lead The World In Healthcare AI

A fascinating glimpse of the planning for the future…..

The year 2020 has undoubtedly provided those in healthcare and technology communities with multiple problems to solve. From enabling telemedicine at scale to creating and distributing an entirely new vaccine, the problems caused by the pandemic have required collaboration, investment and adoption at speed previously unseen in healthcare.

As well as solving the acute problems caused by the vaccine, healthcare organisations are now faced with the challenge of addressing a significant backlog. New NHS England figures show the number of patients waiting to start treatment at the end of October 2020 was 4.44 million and of those, 162,888 were waiting more than a full year. While we were dealing with the immediate issue, a lot of healthcare stopped, but the requirement for it certainly did not. A great deal now needs to be done.

In September 2020, NHSX, the organisation driving the digital transformation of health and social care, announced that 42 tech companies will receive a share of over £50M in phase one of its £140M AI in Health and Care Award.

Covid's 'devastating impact' on NHS services exposed by latest figures

This is a really sad story and has not been fully weighed in the balance in terms of our covid impact assessment.

Soaring numbers of patients are having to wait more than a year for surgery because Covid has disrupted hospital care so badly, new NHS performance statistics show.

The big rise in people facing delays of at least 52 weeks for an operation comes amid warnings that access to treatment will take years to get back to normal.

In October, 162,888 people in England had waited more than a year for a non-urgent planned procedure, even though the supposed maximum waiting time is 18 weeks. That was the largest number of patients forced to wait that long since October 2008.

The total was 123 times more than the 1,321 such cases there were in October 2019 and was 23,343 (16.7%) up on the 139,545 in that situation just a month earlier. Jonathan Ashworth, the shadow health secretary, said the surge in year-long waits was “staggering”.

Dr David Wrigley, the British Medical Association’s deputy council chair, said: “It is quite frankly alarming that the number of patients waiting more than a year for care is now 123 times higher than last October. These are patients in pain, distress and needing treatment.”

Prof Neil Mortensen, president of the Royal College of Surgeons of England, said the people waiting for surgery would often be in pain and unable to get on with their normal life. “These waiting time figures drive home the devastating impact Covid has had on wider NHS services. Waiting lists for planned treatment were already heaving when the virus first struck. It has made the situation many times worse.”

England's test and trace repeatedly failed to hit goals despite £22bn cost

£22bn down the line we seem to have replaced any interest in test and trace with the vaccine. I suspect in part because one suggests inconvenience and the other freedom! It will be interesting to see how this all pans out in the next month or so…

The government’s test-and-trace programme to combat Covid-19 in England has repeatedly failed to meet targets for delivering test results and contacting infected people despite costs escalating to £22bn, a damning official report has revealed.

The National Audit Office (NAO) has found that the centralised programme is contacting two out of every three people who have been close to someone who has tested positive, with about 40% of test results delivered within 24 hours, well below the government’s targets.

The report said a target to provide results within 24 hours of in-person testing deteriorated to a low of 14% in mid-October before rising to 38% in early November.

Call handler contracts for those working on test and trace were worth up to £720m but many staff had very little to do, auditors said.

By 17 June, the utilisation rate – the proportion of time that someone actively worked during their paid hours – was 4% for health professionals and 1% for call handler staff, the report shows.

Other Stuff

Rural Proofing - A great month for the National Centre. We launched our Rural Proofing toolkit developed through a commission with Rural England. You can access it here. More information from the seminar at which we launched it with insights from other key speakers is available here.

Covid Dashboard - We also got some fabulous exposure for our work with Nuffield on the impact of the pandemic on rural settings. This is featured in the first story in Casebook this month. 

International Perspectives - We also had a great international series of insights from the Parliamentary Inquiry with speakers from USA, Japan, New Zealand, South Africa, Canada, India Spain and Brazil. We are following up with a detailed partnering discussion linked to the National Rural Health Association in the USA. Watch this space for more information. They have a fabulous library of international best practice resources.

Parliamentary Inquiry - We have a further session on emergency services planned for the Parliamentary Inquiry on 15 December which will be followed by plans to begin drafting the overall report. Look out for Easter.

Member Benefits – We are currently revising and looking to strengthen still further our package of member benefits in the new year – we’ll be in touch in early 2021.

Mobilising Around Community Responses to Rural Health and Care – We are currently developing a new bid to supplement our work on community engagement in rural health care. 

Successful Funding Applications – Two bids we have been cited in: an Innovate UK proposal to provide driverless delivery vehicles with a range of foci including rural health and care with the University of Lincoln and a proposal led by Dr Tom Kingstone at Keele entitled: FIRESIDE study (Optimising Fire and Rescue Service “Safe & Well” visits to support detection and sign-posting for mental health problems in older adults) have both been approved.

Wider Mental Health Work – Finally for this edition to make you aware of the work we have begun with Support in Mind Scotland, Mental Health Foundation Wales and Rural Support Northern Ireland to explore the case for a rural mental health forum in each UK country. I can provide more information on request. This has involved a submission to the Comprehensive Spending Review and is gathering pace as we move forward into 2021.

And Finally – Merry Christmas!!!!!