Our NHS in Crisis Issue: 110

What Impact Will the Second National Covid-19 Lockdown Have On Reducing Covid-19 Deaths?

This of course must be one of the key questions. Seemingly no-one wants to predict a future lockdown-induced death rate figure. It’s probable that the Covid-19 death rate will not fall in November 2020 as those about to die will already be infected, unwell and in hospital. Some have estimated that the lockdown might cut down the Covid-19 infection rate by up to 75%. But with hospitals filling up with Covid-19, patients needing care for cancer, strokes and heart attacks might have their treatment delayed or cancelled resulting in an increase in non-Covid-19 deaths.

The exact nature of the lockdown is being disputed by some. Schools do seem to be a breeding ground for spreading infection. In Ealing of the 98 state-funded schools 70 of them have Covid-19 cases. Is keeping the schools open such a clever thing to do? Most pubs and restaurants have invested money, time and continuing efforts in making their facilities compliant with Covid-19 restriction. There is scant evidence that they are prime areas for Covid-19 spreading. Closing them all down for at least a month could finally finish off those businesses that don’t own their properties, and will damage the ‘social’ health of their customers.

There are, of course, increasingly alternative voices who are saying that the lockdown will not save lives but just delay Covid-19 deaths. This lockdown could go on for months, and might be followed by a series of lockdowns – until a successful vaccine is universally available. This would destroy the economy and create huge financial, employment, social, housing, mental health and physical health problems. NHS services would be decimated.

The lockdown might be buying us time – but at what cost?

MENTAL HEALTH

£400 Million Announced to Revamp Mental Health Facilities

This initiative is aimed at replacing ‘dormitories’ with en-suite rooms. 21 NHS mental health Trusts have apparently been identified to receive the first tranche of grant funding. Sadly the two NHS North West London mental health Trusts are not on this list.

Also, of the 40 ‘new’ NHS hospitals recently announced by Prime Minister Johnson only two of them will be mental health facilities.

£250 Million committed to Introducing Mental Health Support in Schools by 2023

The targets are to cover 25% of England (1.5 million children) by 2023 and for CAMHS to see 345,000 young people by 2023/24. (CAMHS stands for Child and Adolescent Mental Health Services).

2016 to Date the English NHS Mental Health Workforce has Increased by 13,860

So said Claire Murdoch at the 20 October 2020 Health and Social Care Select Committee meeting. She ought to know as she is the NHS England (NSHE) Mental Health Director. If you find that figure hard to believe, what is more believable is the number of the extra mental health staff she thinks are needed by 2023. It’s 20,000. This would cast £2.3 billion – if the staff could actually be found.

NHSE Announces £15 Million Mental Health Support for Covid-19 Nurses and Support Staff

Claire Murdoch again rather coyly adds that in order to supply the service ‘we will be working with another provider’. Presumably what she means is a private company.

Mental Health ‘999’ Police Call Outs Up by 41% in Five Years in England

After years of the Police saying how inappropriate it is for them to deal with the mentally ill, answers to a Freedom of Information request have revealed 301,1444 reported incidents in 2019. In 2015 the figure was 213,513. The biggest increases were in Wiltshire and Lancashire.

The Royal College of Psychiatrists disclosed in October 2020 that 40% of those waiting for mental health support ended up seeking help from emergency and crisis services.

NHS Test and Trace

If it wasn’t so tragic it might be amusing. Just how much longer can Baroness Harding hang on as NHS Test and Trace boss? On 27 October 2020 ‘The Independent’ reported that the Sitel software is clearly not that robust. On Sunday 25 October there was a system fault which resulted in Covid-19 cases not being scheduled for clinical assessment and contact tracing. The fault was still in play on the following day.

In order for a test and trace operation to be successful 80% of identified close contacts need to be contacted and told to self-isolate. Performance figures released on 22 October 2020 show NHS Test and Trace is attaining 59.6%. The Government claims 300,000 Covid-19 tests are taking place daily and that daily figure will soon reach 500,000. Even if we all believe these figures, what’s the point if 80%+ timely contact tracing and self-isolation isn’t happening?

Only 15.1% of those tested received test results within 24 hours. In June 2020 Prime Minister Johnson said he wanted 100% test results within 24 hours. 7.1 % of those tested were found to be Covid-19 positive – the highest figure yet.

Seemingly one of the Government’s approaches to problem solving is to throw much more money at the problem. Briefly an advertisement lingered in the public domain searching for a new boss to ’deliver Trace operations’. The recruitment agency Quast’s advertisement stated its client (DHSC)  was offering £2,000/day (£520,000/year?)

‘The Guardian’ on 28 October 2020 revealed that 18 year olds with no clinical experience or knowledge are now working as ‘skilled contact tracers’ for Serco. They were recently ‘upskilled’ to perform this role. They are all being paid minimum wage of £6.45/hour. Whistle blowers have reported unskilled teenagers in tears and having panic attacks as they struggle to perform tasks such as like public health risk assessments.

Professor Allyson Pollock has yet again exposed one of the key failings of the NHS Test and Trace undertaking. This was the Government’s decision to take testing out of public health services and Local Authorities. This overlooked the importance of clinical input, clinical oversight, clinical integration and statutory disease notification.

NHS North West London (NWL) Finally Persuades West London CCG to Join the Single Regional CCG 

‘Health Service Journal’ has reported that although GPs in Kensington, Chelsea and Westminster voted against the merger of local CCGS in September 2020, in October 2020 they changed their minds. The NWL CCG will be the largest in England with 2.5 million patients and a 2020/21 budget of £4.2 billion. By April 2021 there will be just 5 CCGs in London. In 2019 there were 32 CCGs.

Discover What the Covid-19 Infection Rate is in Your Neighbourhood

Just type in your post code at:

https://coronavirus-staging.data.go.uk

To give you an idea of the range of rates throughout England, Blackburn with Darwen is one of the highest at 752.5/100,000 people and the lowest includes Somerset Wilton at 44.9/100,000.

Eric Leach