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    There has been too much reliance on the private sector when it comes to laboratory testing for coronavirus and not enough investment in long-established NHS facilities, Unite, Britain and Ireland’s largest union, said today (Wednesday 16 September).
    Unite’s stance is underpinned by its Biomedical Scientist Covid-19 survey, launched today, which highlights the under-use of NHS science facilities and resources as the crisis over the nationwide gaps in the Covid-19 testing regime escalates.
    The survey reveals Unite members’ unhappiness at the government’s reliance and priority given to the seven Lighthouse Laboratories, with private sector involvement, while long-established NHS facilities are being apparently sidelined when it comes to investment.
    The report is being sent to health and social care secretary Matt Hancock, and the chair of the Commons health and social care select committee Jeremy Hunt, as well as MPs.
    The survey said: Concerns about under-utilisation of NHS resources were matched by concerns around the introduction of the new Lighthouse Laboratories and the impact this was having on NHS services.
    “Broadly these concerns focused on the quality of services provided, the diversion of resources from the public sector and the decision making, and transparency process used to commission these new laboratories.
    Healthcare science staff and their trade unions have been left in the dark regarding these processes.”
    More than 85 per cent of the survey’s respondents agreed that there was concern about the service quality from the Lighthouse Laboratories and over 90 per cent concurred that there were worries about the transparency and contracting arrangements for these laboratories.
    In contrast, only 38 per cent said their NHS laboratories were working at full capacity, but there was near unanimous support for further investment in NHS labs, so they are well-placed to undertake the mass testing of millions envisaged by Operation Moonshot.
    Unite said that Operation Moonshot should not become ‘an ill-deserved pay day bonanza’ for private healthcare companies which had fallen short during the pandemic to the extent that they have asked the NHS to help out.
    Unite lead officer for healthcare science Gary Owen said: “The government’s obsession with involving the private sector in the Covid-19 ‘trace and test’ regime has been shown to be flawed and misguided, as more and more people report difficulties in trying to get a test near to their home.
    “If ministers have learnt any lessons from Covid-19 it should be that the NHS, with the right level of investment, is best placed to provide laboratory testing for such a global pandemic as we are currently going through.”
    Chair of the Unite healthcare science committee Ian Evans said: “Long-established NHS laboratories with a wealth of professional experience built up over decades appear to have been marginalised in the battle against coronavirus – this has been a huge mistake.”

    The report can be accessed via:

    https://unitetheunion.org/media/3331/9199_biomed-scientists_survey_summer2020_final-digital.pdf

    The survey was distributed on two dates in June by email to all Unite members within healthcare science. This snapshot survey generated 388 responses from across the UK.

    Unite senior communications officer Shaun Noble

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    This is SHA Scotland Secretary Dave Watson’s contribution to a Jimmy Reid Foundation paper; ‘Reconstructing Scotland after COVID-19: learning further lessons from the pandemic.’

    A Scottish Care Service

    Even before the pandemic, it was clear that the social care system in Scotland was in urgent need of reform. The current system is underfunded, lacks capacity, and has major workforce recruitment and retention problems with fragmented delivery through a discredited commissioning process. When former Conservative ministers are openly talking about the nationalisation of care homes, there is widespread recognition that there is a problem (even if not agreement on what should be done to solve the issue). The system is not just failing those who need social care but is also damaging the NHS with over half a million hospital bed days lost every year because of delayed discharges at the cost of £120m. These problems have been magnified during the pandemic. The lack of Personal Protective Equipment (PPE), inadequate testing, minimal sick pay, and use of agency staff, have all contributed to the tragic deaths in care homes and amongst social care staff. Care at home has also been impacted with care packages reduced or abandoned. Informal carers have all too often been left to pick up the pieces.

    The concept of a (national) Scottish Care Service (SCS) as part of the solution is not a new one. It has been Scottish Labour policy for a number of years, most recently as a 2019 General Election manifesto commitment (see p35 here). My own organisation, the Social Health Association, outlined the idea in its recent social care consultation paper. And, UNISON Scotland has recently published what it describes as a ‘road map’ towards the creation of a national care service. But while there is growing support for the principle of a Scottish Care Service, many in the sector have reasonably asked what it means in practice.

    There seems to be a consensus in favour of a national framework rather than a service delivery organisation or making it part of NHS Scotland, not least to recognise the different models of care. But that leaves open what the SCS would undertake directly and what would be the governance arrangements. A national framework approach must end the current marketisation of social care. It could set consistent standards, contracts and charges for services not covered by free personal care. Most importantly, it would include a statutory workforce forum to set minimum terms and conditions, organise effective workforce planning and put a new focus on training and professionalism.

    On governance, the usual approach would be to create a new Non-Departmental Public Body (NDPB). This would leave the SCS with a similar democratic deficit to NHS Scotland and would undoubtedly be populated with the ‘usual suspects’ by the ministers who make the appointments. As the service will be delivered locally, another approach would be to create a joint board from councils across Scotland. This was a solution UNISON Scotland proposed for police and fire, which had the added advantage of keeping the VAT exemptions. The joint board could have places for relevant stakeholders, including users and worker providers.

    A national service would also need to address regulation. The Care Inspectorate’s ‘light touch’ response to rising complaints has highlighted the need for reform. In fairness, it has been constrained by the Scottish Government’s own ‘Better Regulation’ code, together with inadequate powers and resources. There would also need to be a review of workforce regulation currently administered by the Scottish Social Services Council and UK professional regulatory bodies.

    If the service is going to be delivered locally, this leaves open the question of local governance and ownership. As the Accounts Commission noted in its annual overview, the current system of Integrated Joint Boards (IJBs) has struggled to deliver integration or a shift in spending from hospitals to community care. There have been many attempts to improve integration in Scotland since the joint finance arrangements of the 1970s and all have struggled. It may be that this iteration will eventually deliver, but many will argue that it requires stronger democratic accountability to make difficult decisions, and that means a bigger role for councils. This happens in other parts of Europe, but even here, they have not always shifted resources from hospitals to community services.

    Greater integration does not require staffing integration. Professional barriers have been broken down in recent years, and joint teams have shown that they can work effectively together, particularly when physically working together in community hubs. A huge staffing reorganisation would create stasis, just at the time when we need to free up staff to innovate. When IJBs were created, I – as a UNISON Scotland official – wrote a workforce framework, which would have addressed many of the current problems. Sadly, workforce issues were largely ignored at the time.

    The fragmentation in service delivery is a significant problem that does need to be addressed with more than one thousand care at home providers, and the scandal of care home firms registered in tax havens. In the short-term, the pandemic has highlighted the need for greater coordination on issues like procurement. Abolishing the market, standard contracts and common workforce standards will help shift resources to the front-line. In the medium-term, there should be greater common ownership, particularly in residential care.

    Common ownership does not preclude innovative voluntary sector operators who can meet the new standards as the best in the sector already do. The private sector likes to make a false link between personalised care and marketisation. All care should be personalised, and that requires a range of services, not a range of ownership models. Local delivery should also be about greater innovation in service delivery, trying new models of care that integrate people with care needs into communities.

    Finally, there is the tricky issue of funding. In England, the issue has at least been considered in the Dilnott Report, although it was overly focused on protecting assets. In Scotland, we cannot simply hope for the Barnett consequentials of reform in England to plug the current funding gap, let alone future demographic pressures. It requires a mature conversation with citizens about taxation. If we want to go further and fund care on the same basis as the NHS, then the conversation shifts to proposals like the former health minister Andy Burnham’s care levy, which involved a form of inheritance tax. Calling it and similar plans a ‘death tax’ is not a mature conversation.

    The creation of a Scottish Care Service is an idea which has come of age. Turning it from a concept into a practical solution requires more work and some difficult conversations. If we are to ‘Build Back Better’, as the Tories implore, an integrated health and care service, with national standards and local delivery should be the highest priority.

    Dave Watson, Secretary of the Socialist Health Association Scotland
    www.shascotland.org

    sha_social_care_reform

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    Today HIV i-Base (where I work part-time) and the UK-CAB (of which I’m a member) joined with more than 70 other organisations sending a joint statement to the Prime Minister, the Secretary of State for Health, and the interim leadership of Public Health England regarding our concerns of the restructuring of public health in England.

    Over 70 health organisations unite to raise serious concerns with Government about plans to reorganise the public health system

    Today over 70 health organisations and alliances have sent a joint statement to the Prime Minister, the Secretary of State for Health, and the interim leadership of Public Health England, raising serious concerns about the reorganisation of public health now underway. This follows recent announcements that PHE will cease to exist by April next year and be replaced by the National Institute of Health Protection.

    The statement is endorsed by a wide range of leading health organisations, including the Association of Directors of Public Health, the Faculty of Public Health, the Royal Society for Public Health, the Academy of Medical Royal Colleges, the BMA, the SPECTRUM public health research collaboration, the Smokefree Action Coalition and the Richmond Group of health and care charities. The statement warns that:

    “Reorganisation risks fragmentation across different risk factors and between health protection and health improvement. Organisational change is difficult and can be damaging at the best of times and these are not the best of times. A seamless transition from the current to the new system is essential.”

    While recognising that there are opportunities:

    “There are opportunities from this re-organisation to improve on current delivery, but only if there is greater investment combined with an emphasis on deepening expertise, improving co-ordination and strengthening accountability.”

    The statement, launched today in a letter to the BMJ from key signatories sets out the principles which all agree must underpin the new health improvement system. This includes the need for renewed investment into public health to address the years of cuts the sector has seen, an interconnected approach with the right infrastructure and expertise to support national, regional and local delivery; and the need to sustain local government system leadership at local level, while strengthening co-ordination with the NHS.

    Dr Nick Hopkinson, a respiratory specialist at Imperial College London, chair of Action on Smoking and Health, speaking on behalf of the Smokefree Action Coalition as a signatory to the letter said:

    “We are in a state of public health emergency because of COVID-19, and system reorganisation at this time brings with it great risks, as well as opportunities. That is why the public health community has come together to set out for Government the principles that we all agree must underpin any reorganisation of the health improvement and wider functions of Public Health England (PHE). If we are to recover from the global pandemic and recession, health improvement is not a ‘nice to have’ but an essential component of a successful response to the challenges we face.”

    Professor Maggie Rae, President of the Faculty of Public Health, signatory to the BMJ letter, said:

    “Reorganisation of Public Health England (PHE) brings with it a real risk that some of the critical functions of PHE will be ignored. The pandemic has shone the light on the health inequalities that exist in the country and it is clear that those with the poorest health have been hit hardest. Scaling up, not down, the health improvement functions of PHE is a prerequisite if the Government is to deliver on its commitments to ‘level up’ society; increase disability-free life years significantly, while reducing inequalities; to improve mental health; increase physical activity; reduce obesity and alcohol harm; and to end smoking. Ensuring there is adequate funding, a robust infrastructure and sufficient public health expertise to deliver at national, regional and local level, is fundamental.”

    Professor Linda Bauld, Chair of Public Health at the University of Edinburgh and Director of public health research consortium SPECTRUM, signatory to the BMJ letter said:

    “While COVID-19 is a pressing emergency, the truth is that chronic non-infectious diseases are still overwhelmingly responsible for preventable death and disease in this country. What’s more those with the poorest existing health have the worst outcomes from COVID-19. A future public health system must be robust enough to protect us from the threats posed by both infectious and non-infectious diseases.”

    Joint statement to the Government on Public Health Reorganisation. Link to statement and list of signatories https://smokefreeaction.org.uk/phehealthimprov/

    Link to BMJ letter: Rapid Response: Joint statement to the Government on Public Health Reorganisation: https://www.bmj.com/content/370/bmj.m3263/rr-1

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    The Local Government Association, on behalf the broad leadership of the social care sector including the Association of Directors of Social Services, has published a set of 7 principles to guide the future of adult social care post Covid. But they show the sector’s leadership continuing to be high on rhetoric, but empty on substance. They are bankrupt of ideas to make the rhetoric a reality.

    The 7 principles talk, for the umpteenth time, of social care needing to be based on ‘what works for people, not what works for systems or structures’. They seek to emulate the person centredness that makes the NHS so valued by the public. People trust that when they present symptoms to an NHS clinician the diagnosis and treatment will be based solely on the clinician’s knowledge of what is wrong and what is possible. It would not even occur to the person that the determination of their diagnosis and decisions about the treatment options will be referred upward to a manager, least of all to a manager whose primary task is to manage the budget.

    But, for reasons set out in my recent blog, this is exactly what happens in social care. At the individual level, while need precedes resources in health care, resource precedes need in social care. It’s an arrangement that serves very well the political expedients of keeping spend precisely to budget while denying the existence of any funding gap. The sector’s leadership, sadly and only too willingly, obliges.

    So sector leaders are left yet again repeating mantras with a long record of failure. The history is lamentable.

    Following the failure of the Community Care strategy of the 1990’s to make social care ‘needs led’, the personalisation strategy was launched in 2008 with personal budgets the centre piece. ‘Up-front’ allocations of money would empower service users to purchase their own support package, the ultimate in person centredness. Bu it quickly became apparent that up-front allocations would not happen. Completely impracticable and ignored by the Care Act ‘up-front’ allocations became ‘indicative’ only and thus tokenistic. In 2012, Think Local Act Personal, the organisation charged by Government with leading implementation of the strategy, issued a series on exhortations to practitioners and councils under the banner Making It Real.

    The irony in the implicit message that personal budgets had completely failed to ‘make it real’ was lost on the sector’s leaders. Inevitably, Making It Real had no impact. TLAP duly issued a second iteration of Making It Real in 2018. It too has had no impact. And so to the present and the 7 principles amount to yet a third exhortation to ‘make it real’.

    Exhortations to practitioners and councils to deliver ‘what works for people’ are hopeless in the face of underlying, powerful systemic forces that ensure the system’s priority is to work to sustain itself.

    What of the future for social care – integration with the NHS?

    It’s hard to imagine anyone taking the analysis and remedies of sector leaders seriously. This is not just because of the self harm in exposing the bankruptcy in their own ideas. Covid’s exposure of the impoverishment of social care invites questions of the leadership Councils have provided over the decades. Is it really just about government under-funding? How soon, if not already, before Councils are seen as a busted flush?

    Signs are pointing to integration with the NHS as the political solution. But with social care in its present state, that would be a disaster for both services and the older and disabled people who rely on them. The NHS is at its best delivering clinical care to deliver best possible health. When it moves beyond that into care, its record is even more lamentable than that of local authorities. The bureaucratic opaqueness and gross inequity of Continuing Health Care bears witness to that. A weak and unreformed social care service risks being reduced to little more than a servant to health objectives. This would sound the death knell of the ambition of social care to be the driver of our older and disabled citizens being supported to lead the fulfilling and dignified lives they are capable of.

     

    Colin Slasberg – former Assistant Director of Social Care and Independent Consultant in Social Care.

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    This week the Government is expected to announce that it will scrap the pandemic response function of Public Health England, and merge this with NHS Test and Trace to form an agency “similar to the German Robert Koch Institute”. It is also particularly distressing that the news was leaked to the press before PHE staff could be told.

    The SHA warns the reckless decision to restructure and defund public health services in the midst of a pandemic will result in further avoidable deaths. The public health service, nationally and locally has already been severely starved of funds as a result of austerity.

    The NHS Test and Trace Service (led by Baroness Dido Harding, and run by Deloitte, Serco, Sitel and other private sector outsourcing companies) has received strong criticism for its poor response to the COVID 19 pandemic.

    Dr Brian Fisher, SHA Chair, says “This is yet another example of the Government putting lives at risk by pursuing ideologically driven privatisation in a time of crisis.”

    Socialist Health Association members have told us that “this is another example of this government’s scapegoating, most especially since the man telling us the PHE response has been unacceptable was the man in charge, deliberately ignoring their expert recommendations and favouring sweet manufacturers and other non-expert businesses to deliver a service to the public. Public health has been underfunded, to the point it has required almost superhuman efforts from its staff to maintain a quality of service from the time of the so called Lansley Reforms. For that, our public health experts, like our nurses, are rewarded with a kick in the teeth.”

    SHA calls on the Government to reinvest funds from failing NHS Test and Trace private providers into the public sector pandemic response across the NHS, Public Health England and Local Authorities.

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    Public Health England (PHE) and its dedicated staff are being lined up as ‘the fall guy’ for ministers’ bungling over the handling of the coronavirus pandemic, Unite, Britain and Ireland’s largest union, said today (Monday 17 August).
    Unite, which is the lead union for employees at PHE, said that instead of merging PHE into a new body charged with preventing future pandemics, the PHE should continue in its present role – and the money cut from its budget by the government should be restored.
    Unite also said that there should be proper consultations with the unions about the future of PHE, an executive agency of the Department of Health and Social Care. Unite strongly disputes media reports that the unions were consulted.
    Unite national officer for health Jackie Williams said: “It is clear that Public Health England and its dedicated staff are being lined up to be the fall guy for continual bungling by Boris Johnson and his ministers since coronavirus emerged at the beginning of the year.
    “The catalogue of errors ranges from the lateness to lockdown in March to the failure to have a so-called ‘world beating’ test-and-trace system in place by June.
    “In their desperation to find anyone or any organisation to blame for their own failings, Boris Johnson and health and social care secretary Matt Hancock are lining up the PHE and its staff to be the fall guy.
    “We think that the underlying agenda here is the future privatisation of PHE’s national infection service – the Tory government is obsessed with NHS privatisation which has been shown to be highly flawed and not a good use of taxpayers’ money.
    “We are calling for PHE to continue in its present role and allowed to do its vital work, rather than spend huge amounts of time, effort and money reorganising England’s public health structures in the middle of a global pandemic.
    “We are also calling for the swingeing cuts to its budget over recent years restored. The lack of consultation is both appalling and insulting.
    “PHE needs to have the resources to do the job it is designed to do, which is protecting the public health of the people in England, without inappropriate buck-passing political interference.”
    Shaun Noble
    Unite senior communications officer
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    The Camden New Journal (CNJ) have published the sixth article about the NHS written by Susanna Mitchell and Roy Trevelion. You can see it on the CNJ website under ‘Forum’ published on 16 July 2020 here. Or you can read it below:

    Neglect and inadequate excuses lie at the heart of the government’s failures, argue Susanna Mitchell & Roy Trevelion

    It is understood that there will be a public inquiry into the UK’s handling of the coronavirus pandemic.

    This should begin now, and not when the current crisis is over. Criticisms will be focused on the government’s disastrous response:

    Its initial adoption of a “herd immunity” strategy.

    Its failure to provide health care workers and others in front-line positions with adequate personal protective equipment (PPE).

    The shambolic state of its belated testing and tracking operations, including the collapse of its much-heralded app.

    Its reliance on private contractors with no relevant experience to supply services and equipment that they were subsequently unable to deliver.

    Critically, it will be claimed that all the measures taken were put in place far too late. With the result that the UK now has the highest death toll in Europe. The proportion of care-home deaths is 13 times greater than that of Germany.

    All these accusations are currently being met with the excuse that the Covid-19 pandemic was unprecedented. The government claims it has worked to its utmost capacity to control and manage the outbreak.

    But this narrow focus on what was done once the virus had established itself in the country is completely inadequate.

    Rather, any inquiry must examine the long-standing reasons why the country was unable to deal with the situation in a more efficient way. Unless this is done, the necessary steps to improve our handling of future pandemics cannot begin.

    For a start, the argument that government was taken by surprise by a global viral attack is false.

    To the contrary, a research project called Exercise Cygnus was set up in 2016 to examine the question of preparedness for exactly this eventuality.

    Its report was delivered in July 2017 to all major government departments, NHS England, and the devolved administrations of Scotland, Wales and Northern Ireland.

    The report concluded that “…the UK’s preparedness and response, in terms of its plans, policies and capability” were insufficient to cope with such a situation.

    It recommended NHS England should conduct further work to prepare “surge capacity” in the health service and that money should be ring-fenced to provide extra capacity and support in the NHS.

    It also stated that the social care system needed to be able to expand if it were to cope with a “worst-case scenario pandemic”.

    These warnings, however, were effectively ignored.

    One government source is reported as saying that the results of the research were “too terrifying” to be revealed.

    And a senior academic directly involved in Cygnus and the current pandemic remarked: “These exercises are supposed to prepare government for something like this – but it appears they were aware of the problem but didn’t do much about it… basically [there is] a lack of attention to what would be needed to prevent a disease like this from overwhelming the system.

    “All the flexibility has been pared away so it’s difficult to react quickly. Nothing is ready to go.”

    But the reason that the system was too inflexible and unprepared lies squarely with the government’s actions during the last decade.

    The Health and Social Care Act of 2012 ruinously fragmented the system.

    The austerity and privatisation of these polices have lethally weakened both the NHS and the social care services.

    As a result, the NHS is under-staffed, under-equipped and critically short of beds, while the social care service is crippled by underfunding almost to the point of collapse. It is therefore vital that we do not allow any inquiry to be limited to an examination of recent mistakes.

    The government’s bungled handling of the present crisis was virtually inevitable within a public health system depleted and rendered inadequate by their long-term policies.

    No post mortem can achieve a productive conclusion unless it is understood that these policies were the root cause of the shambles.

    If we are to avoid another catastrophe, these policies must be radically changed with the minimum of delay, and public health put back into public hands.

    • Susanna Mitchell and Roy Trevelion are members of the Socialist Health Association.

    Other articles written by Susanna Mitchell and Roy Trevelion are:

    Don’t allow the price of drugs to soar: Drug pricing is still a critical issue for the NHS http://camdennewjournal.com/article/dont-allow-the-price-of-drugs-to-soar?sp=1&sq=Susanna%2520Mitchell

    Beware false prophets: Don’t be fooled by the Johnson government’s promise of new money. It masks a move to further privatise the NHS
    http://camdennewjournal.com/article/nhs-beware-false-prophets?sp=1&sq=Susanna%2520Mitchell

    Brexit and the spectre of NHS US sell-off: Americanised healthcare in the UK – after our exit from the EU – would only benefit global corporations
    http://camdennewjournal.com/article/brexit-and-spectre-of-nhs-us-sell-off?sp=1&sq=Susanna%2520Mitchell

    Deep cuts operation threatens the NHS: The sneaking privatisation of the NHS will lead to the closure of hospitals and the loss of jobs
    http://camdennewjournal.com/article/deep-cuts-operation-threatens-nhs-2?sp=1&sq=Susanna%2520Mitchell

    Phone app that could destroy our GP system: A private company being promoted by government to recruit patients to its doctor service spells ruin for the whole-person integrated care we need from our NHS
    http://camdennewjournal.com/article/phone-app-gp?sp=1&sq=Susanna%2520Mitchell

     

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    A deserved boost in pay for NHS staff, who have battled through the pandemic, is ‘the elephant in the room’ in the latest plan for the health service in England, Unite, Britain and Ireland’s largest union, said today (Thursday 30 July).
    Health and social care secretary Matt Hancock today welcomed the launch of the NHS People Plan as a new bureaucracy busting drive, so staff can spend less time on paperwork and more time with their patients.
     
    Unite, which has 100,000 members in the health service, said that the aims of this latest plan for the NHS would be hampered by the fragmentation caused by the 2012 Health and Social Care Act with its remit for increased competition for NHS services.
    Unite national officer for health Colenzo Jarrett-Thorpe said: “There have been a plethora of plans for the future of the NHS over the years and this latest manifestation neatly avoids ‘the elephant in the room’ – that of NHS pay.
    “NHS staff have worked ceaselessly throughout the pandemic at great risk to themselves and a generous pay rise would recognise that dedication as well as staunch the ‘recruitment and retention’ crisis that is currently afflicting the NHS – for example, there are about 40,000 nursing vacancies in England alone.
    “It is all very well for the plan to trumpet bureaucracy busting measures, but it was the flawed 2012 Act of the then health secretary Andrew Lansley that created the extra bureaucracy by fragmenting the NHS in the first place.
    “One of the key chapters of the People Plan is ‘belonging to the NHS’. This terms rings hollow to thousands of health visitors and school nurses cast outside the NHS; or the catering, cleaning, portering and maintenance staff that have been outsourced to private contractors or dispensed to wholly owned subsidiaries.
    “The English ideological obsession with marketisation and privatisation in the NHS must be terminated without delay and this report does nothing to address this.
    “We, of course, welcome such measures in the plan as boosting the mental health and cancer workforce; full risk assessments for vulnerable staff, including BAEM workers; and all jobs to be advertised with flexible working options from January.
    “But without addressing the issue of pay, highly skilled NHS staff will consider looking for more lucrative work elsewhere, possibly abroad.”
    Last week, chancellor Rishi Sunak awarded up to a 3.1 per cent pay rise for 900,000 public sector workers, including doctors, teachers and police officers. Unite accused the chancellor of having ‘a selective memory’ when it comes to public sector pay, rewarding some, but ignoring hundreds of thousands of others.

    Unite senior communications officer Shaun Noble

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    On Friday 24 July 2020 HIV i-Base published the sixth COVID-19 supplement to HIV Treatment Bulletin (HTB). Please see this link.

    All i-Base reports are free to copy and i-Base encourages wide distribution. Please credit i-Base when distributing these reports.

    This is a slightly expanded issue of HTB that covers both AIDS 2020 and related virtual meetings plus a fair number of COVID-19 developments that seemed too important to leave out. It is a mixed compilation, but hopefully useful.

    This edition of HTB includes reports from the virtual AIDS 2020 conference and linked satellite meetings on COVID-19.

    The main heading news from AIDS 2020 included continued reductions in the signal concerning dolutegravir and neural tube defects, further results on weight gain from the ADVANCE study, cabotegravir as PrEP in HPTN 083, and an early report of HIV remission.

    As the introduction to these reports shows, interacting with the virtual conference was not always easy. Although we include links to the site in our reports, the site will only be open access (without registration) after 27 July 2020. 

    The difficult website was reflected in overall attendance. Even when watching live events (and many were missed due to technical problems with the site), more than 2000 delegates were rarely online (when more than 20,000 people usually attend).

    Many of the satellite workshops are easier to find and watch, and we include reports from the COVID-19 workshop on HCV drugs to treat COVID-19 and an update on remdesivir. As with the AIDS 2020 website, many of the webcasts and posters are now offline.

    The rest of this extended issue includes both HIV reports and a continued focus on COVID-19.

    For all the hope that coverage of COVID-19 might be less needed, this issue contains another 12 pages about coronavirus. Many important developments come from UK research – including new treatments, immune response, race and ethnicity and vaccines.

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    The damning report by MPs into hospital patients in England being discharged into care homes without a Covid-19 test reinforces the need for a public inquiry, sooner rather than later, into the government’s handling of the pandemic, Unite, Britain and Ireland’s largest union, said today (Wednesday 29 July).
    The influential cross-party Public Accounts Committee (PAC) accused ministers of being slow to support social care during the crisis. The initial decision to allow untested patients into care homes was an ‘appalling error’.
    Unite assistant general secretary Gail Cartmail said: “The committee’s findings are a welcome first step, but MPs need to dig deeper into the long-standing crisis in social care.
    “Covid-19 has heightened attention on the underlying shortcomings in the social care system that have been building up for decades.
    “The pain and distress of families whose elderly relatives died in care homes because of the government’s flawed policy will be forever etched in the nation’s memory.
    “We need swift government action on the broken business model, so prevalent in the world of privatised care, with measures to tackle the underpayment of the workforce and, what Unite members tell us, measures to address the inadequate training they receive in such areas as infection control.
    “The social care sector is predicated on an environment of insecure work leading to multiple work placements.
    “The workforce needs job security, decent pay that recognises their skills and assurances on the basics, such as adequate PPE and sanitation provisions.
    “There also needs to be a safeguarding structure for workers disproportionately at risk, such as those from the BAEM communities.
    “Today, Unite repeats its call for a public inquiry into the government’s handling of the pandemic.
    “This inquiry should happen, sooner rather than later, as we suspect that Boris Johnson wants to play for time before such an inquiry is set-up as it will expose the lamentable failings of his government during this national emergency which has seen more than 45,000 lives lost to Covid-19.”
    The PAC said about 25,000 patients were discharged into care homes in England between mid-March and mid-April to free up hospital beds. After initially saying a negative result was not required before discharging patients, the government then said in mid-April all patients would be tested.

    Unite senior communications officer Shaun Noble

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    Unite NHS members will be at the forefront of a march to Downing Street tomorrow (Wednesday 29 July) to show their anger at being overlooked in the latest round of public sector pay rises – despite more than 500 NHS and social care staff dying from Covid-19.
    The Unite branch at Guy’s and St Thomas Hospital will be marching to Downing Street at 18.00 tomorrow from St Thomas Hospital, Westminster Bridge Road, SE1 7EH to protest at the government’s decision to put off a pay rise for NHS staff until April next year – when the three year pay deal comes to an end. The march will be attended and supported by NHS staff across London.
    Last week, chancellor Rishi Sunak awarded up to a 3.1 per cent pay rise for 900,000 public sector workers, including doctors, teachers and police officers. Unite accused the chancellor of having ‘a selective memory’ when it comes to public sector pay, rewarding some, but ignoring hundreds of thousands of others.
    Unite national officer for health Colenzo Jarrett-Thorpe said: “Nursing staff and other allied health professionals have reacted with anger to being overlooked when pay rises were given to many in the public sector last week and the government not hearing the health trade unions’ call to bring their pay rise forward from April 2021.
    “This sense of anger was heightened, especially in light of their work and sacrifices during the global pandemic which has taken the lives of more than 500 NHS and social care staff across the UK.
    “We are facing a perfect storm for recruitment and retention in the NHS – in a decade of Tory austerity, NHS staff have seen their pay cut by 20 per cent in real terms and many are considering leaving the health service; at the same time, there are about 40,000 nursing vacancies in England alone.
    “This crisis is also being exacerbated by the scrapping of the student bursary, which is putting off many who may have considered becoming one of the next generation of nurses.
    “What we have seen in the last few months is generous praise, warm words, and lots of Thursday evening clapping by ministers; yet we got a flavour of the government’s true feelings with Rishi Sunak’s lack of a pay announcement for NHS staff last week, with no statement dealing with our call to move the pay of NHS workers forward.
    “The public expects – and ministers should deliver – a substantial pay increase for NHS staff that reflects their real worth to the NHS and society more generally. NHS workers shouldn’t have to wait till April 2021.”
    Unite branch secretary at Guy’s and St Thomas Hospital Mark Boothroyd said: “We have called this demonstration to express the anger that so many of our members feel at the government’s derisory treatment of NHS staff.
    “After all our sacrifice during the pandemic, to exclude us from the pay deal and make us wait till April 2021 is a slap in the face, and our members are going to Downing Street to tell Boris Johnson this directly.”

     

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    The threat to cut health visitor and community nurse jobs in County Durham, while Covid-19 is still widespread, has been branded as ‘incomprehensible’ by Unite, Britain and Ireland’s largest union, today (Friday 24 July).

    Harrogate and District NHS Foundation Trust (HDFT), which is taking over the County Durham 0-25 family health service contract from 1 September, wants to axe about 37 whole time equivalents (WTEs), while the coronavirus is still widespread across the country.

    Although the HDFT also says it wants to employ 21 WTE new posts, there will be a net loss of 16 WTEs out of a workforce of about 230 WTEs.

    Unite lead officer for health in the north east Chris Daly said: “It is almost incomprehensible that when ‘public health’ is foremost in people’s minds because of coronavirus, Harrogate and District NHS Foundation Trust is swinging the jobs axe.

    “The vast majority of those being earmarked to lose their jobs are health visitors and school nurses – the very professionals at the public health frontline helping families with babies and young children, and children returning to school.

    “Disgracefully, the trust is consulting when staff, have been working flat-out throughout the Covid-19 crisis supporting very stressed families and young people. This flawed exercise is happening before the first wave of the pandemic is over and with the expectation that a second wave will hit this autumn and winter.

    “It is also very wrong that schools and GPs have not been told about the proposed cuts in school nurses. School staff returning in September will be phoning school nurses to come and help with children that they have not seen since March and who may be exhibiting worrying behaviours and dealing with distressing emotions.

    “We believe that already stretched GPs will be expected to pick up the shortfall in keeping babies, children and young people safe. However, there is a real risk that those most at risk may fall through the current safety net that HDFT seems intent on weakening.

    “This is not the time to reduce the health and school nurse provision for children and young people. However, it will be some time before the adverse impact of these cuts are brought into sharp relief.

    “The Durham country council should work with the trust to increase the funding for these essential frontline services. The long-term health of families is never enhanced by reducing the number of healthcare professionals.”

    Unite, which embraces the Community Practitioners’ and Health Visitors’ Association (CPHVA), will be making strong representations on behalf of its members before the consultation process ends on 31 July.

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