Care Homes were ‘thrown to the wolves’

The UK Government’s “slow, inconsistent, and at times negligent approach” to social care in the Covid-19 pandemic has exposed the “tragic impact of  years of inattention, funding cuts and delayed reforms”, leaving the sector as a “poor relation” that has suffered badly in the pandemic.

The Public Accounts Commons Select Committee is demanding from Government a “3-point plan” by September, ahead of the second wave, covering health, the economy & procurement of medical supplies and equipment.

This was illustrated early on by the “appalling error” committed when 25,000 patients were discharged from hospitals into care homes without ensuring all were first tested for COVID-19 – even after there was clear evidence of asymptomatic transmission of the virus. 

Thanks to the commitment of thousands of staff and volunteers and by postponing a large amount of planned work, the NHS was – just – able to weather the “severe and immense” challenges to health and social care services in England and meet overall demand for COVID-19 treatment during the pandemic’s April peak – “unfortunately, it has been a very different story for adult social care”.

The Committee is particularly concerned about staff in health and social care “who have endured the strain and trauma of responding to COVID-19 for many months” and who are now expected to “cope with future peaks and also deal with the enormous backlogs that have built up”.

Failure to protect staff by providing adequate PPE has hit staff morale and confidence, while a lack of timely testing led to increased stress and absence. These same staff will be called upon in the event of a second peak and the NHS will need extra staff to deal with the backlog of treatment.

As well as its calls for a “second wave ready” plan, for health and the economy, the Committee expects an account to be provided in September of the spending under “policies designed to create additional capacity quickly” which – while necessary, especially in the haste the Government was acting in – have resulted in “a lack of transparency about costs and value for money”.

Meg Hillier MP, Chair of the Committee, said: “The failure to provide adequate PPE or testing to the millions of staff and volunteers who risked their lives to help us through the first peak of the crisis is a sad, low moment in our national response.

“Our care homes were effectively thrown to the wolves, and the virus has ravaged some of them.

“Vulnerable people surviving the first wave have been isolated for months, in the absence of a functional tracing and containment system. Yet there were bold and ambitious claims made by ministers about the roll out of test, track and trace that don’t match the reality.

“The deaths of people in care homes devastated many, many families. They and we don’t have time for promises and slogans, or exercises in blame. We weren’t prepared for the first wave. Putting all else aside, Government must use the narrow window we have now to plan for a second wave. Lives depend upon getting our response right.”

Cancer clinical trials back on track

Throughout the COVID-19 pandemic, patients across Lothian and the south-east of Scotland have continued to receive cancer treatment through a range of clinical trials.

Recently, with pandemic restrictions easing, more patients have resumed participation in cancer trials. And today (29 July) teams in the South East Scottish Cancer Research Network (SESCRN) are pleased to announce that any remaining trials that have been on hold in the region are all now able to reopen and would like to reassure patients that all trial options will be available to them.

The SESCRN teams – based in the Edinburgh Cancer Centre at the Western General Hospital – are also recruiting patients to take part in a series of new clinical trials.

Stefan Symeonides, a Consultant Oncologist and Clinical Lead for SESCRN, said: “COVID-19 presented us with significant challenges – and still does – but our teams have worked hard to minimise disruption caused by the pandemic.

“We’ve had to adapt how trials are delivered to patients, implementing a range of infection prevention and control measures required as a result of COVID-19, including social distancing. This enabled all patients already started on clinical trials for cancer treatment to remain on those trials.”

However, COVID-19 has restricted access to clinical trials for other patients who would have started treatment during the peak of the COVID-19 challenges.

“We share the concern and frustration experienced by these patients, which is why we are pleased that the recent easing of pandemic restrictions has allowed us to open trials back up again and widen patient access to other trials,” said Stefan Symeonides. “We are now able to reopen all remaining studies and we are excited to have started recruiting patients to new clinical trials.”

Dot Boyle, Network Manager with SESCRN, said: “Colleagues across the Network have made monumental efforts to continue clinical trials.

“For example, we were able to keep some trials running, where there were no safety concerns for patients and, since June, a range of other trials have resumed. We are currently engaged in over 100 clinical trials, half of which are open, with the other half now due to open imminently.

“In addition, every day, our teams work in collaboration with a range of partners to help facilitate more and more new trials, the first of which have opened, covering a range of different areas, including cancer of the bladder, breast and kidney.”

Professor Charlie Gourley, Professor and Honorary Consultant in Medical Oncology, Western General Hospital, said: “Clinical trials offer cancer patients new opportunities, either in addition to standard treatments, or after standard therapies have failed.

“They provide patients with hope and are a vital part of our armoury. The South East Scotland Cancer Research Network is rapidly reinstating these studies in order to offer our patients the best possible treatment options.”

Right Care, Right Place

NHS Pharmacy First Scotland offers expert help in the community.

People will be able to get healthcare advice and support to treat minor illnesses and common conditions in their local community following the launch of a new service.

NHS Pharmacy First Scotland will allow community pharmacies to give people expert help for treating conditions such as sore throats, earache and cold sores, along with common clinical conditions such as Urinary Tract Infections. Pharmacy teams will offer advice, treatment or referral to other healthcare teams if required.

This new service will help people access the right care in the right place, without having to go to their GP practice or local Accident and Emergency Department for non-urgent treatment.

Everyone who is registered with a GP practice in Scotland, or who lives in Scotland, is encouraged to use their local pharmacy when they have a minor illness or common condition. Accident and Emergency Departments remain open for emergency care, with public health measures in place to protect staff and patients.

Health Secretary Jeane Freeman said: “During the first phase of the COVID-19 pandemic people followed public heath guidance closely and used their local pharmacy for medical advice and help.

“The launch of NHS Pharmacy First Scotland will make sure that people across Scotland can continue to do this. It gives access to the right care in the right place, getting medical support that is closer to home and often with no waiting time or appointments needed.

“While the NHS is there for all of us, we don’t all need to go to accident and emergency. For many of us, it is not the right place for the care we need. NHS Pharmacy First Scotland provides a local service, giving local access to healthcare help for many illnesses.

“In an emergency you should always call 999 or go to your nearest accident and emergency department. By continuing to do what we have been doing throughout this pandemic and accessing the right care in the right place, we continue to help our emergency teams and ensure accident and emergency provides the fastest and often lifesaving care for people when they really need it.”

Chair of Community Pharmacy Scotland Martin Green said: “NHS Pharmacy First Scotland is an exciting service development for everyone.

“It recognises the role that the community pharmacy network can play in helping patients and the wider NHS team by ensuring people get the right care in the right place. Pharmacists, supported by their pharmacy teams, will be able to offer consultations for anyone with minor illnesses and provide the appropriate advice and support.

“We look forward to community pharmacy demonstrating its value with the Scottish public through this service and developing it further in years to come in line with the needs of the public and the NHS.”

Postgraduate Pharmacy Dean at NHS Education for Scotland (NES) Anne Watson said: “NES are delighted to be underpinning this important service development by providing educational support for the community pharmacy teams – using online resources, national webinars and facilitating peer discussion forums with experts within the Boards.

“In addition, we have provided a quick reference guide sent to all community pharmacies and education and training to support common clinical conditions will continue to be a focus as the service expands.”

More information on NHS Pharmacy First Scotland will be available online and on NHS Inform later today – 29 July 2020.

Building Back for the Better

a perspective from Carnegie UK Trust

The COVID-19 pandemic has touched every part of our society: our economy; our environment; our social connections; and the relationships we have with our governments.

As we embark on the process of recovery, the Carnegie UK Trust believes that there is a collective responsibility to use what we have learned, not just to repair the damage, but to reconsider the fundamentals of economic, social and democratic structures that are no longer delivering positive outcomes for citizens and communities.

Others have referred to this process of collaborative sense-making as “building back better”. “Building Back for the Better: a perspective from Carnegie UK Trust” is our own contribution to that debate.

We have used what we know from our long history of research and practice development to set out a series of propositions, backed up by recommendations of practical things that could be done to improve wellbeing. The propositions are:

  • National wellbeing can be the goal
  • The relationship between the state and the citizen can be reset
  • The future can be local (as well as global)
  • Our relationship with work can be remodelled
  • We can build a new level of financial resilience
  • Technology can be for all

These will not be the only things that require to be considered for the medium-term recovery, but we hope that by taking a wide perspective we can connect the recovery effort with the transformative change to prevailing systems that so many have identified a need for, both before and during this pandemic.

Over the coming months, we will continue to work with organisations across all our networks to understand the impact of the pandemic on the people they work for. This will include central and local government; third sector and community organisations; credit providers; good work stakeholders, and many others. Where gaps remain in the space for collective sense-making, we will explore new opportunities to stimulate the necessary discussions.

If you would like to contribute to these conversations, please email me (Sarah@CarnegieUK.org) or join the debate online by tagging @CarnegieUKTrust – we would be pleased to hear from you.

Best wishes,

Sarah

Sarah Davidson

Chief Executive, Carnegie UK Trust

MSPs to investigate impact of Covid-19 on local government finance

The impact of the coronavirus pandemic on Scottish council finances and whether it will lead to a “new normal” in the way some services are delivered is to be investigated by a Holyrood Committee.

The Scottish Parliament’s Local Government and Communities Committee has launched a call for views on the impact of Covid-19 on the financial sustainability of local government in Scotland.

MSPs will seek to identify which council services have been most impacted by the public health emergency, as well as exploring which parts of local government have been least affected or most resilient.

A key focus for the Committee will be what steps local government takes, in the short and long term, to manage the financial impact of the crisis. It will also ask what further help councils will need to overcome the ongoing funding pressures.

Looking beyond the crisis, the Committee is also keen to hear views on how soon the sector will return to normal, or whether it is time for a “new normal” in the way councils deliver services and what that future might look like.

Committee Convener, James Dornan MSP, said: “Councils are responsible for delivering a vast range of important services that are a crucial part of our everyday lives; from social care and street cleaning to public libraries and planning. 

“When Covid-19 struck earlier this year, it had a massive impact on local authorities. They suddenly had to change basic working practices and finds ways of delivering emergency services to many vulnerable people. This has had a knock-on effect on their ability to maintain some core services.

“Council staff have risen to the challenge and there are many positive stories to share – for instance on how councils worked with others to help homeless people and rough sleepers during the lockdown.

“However, the impact of Covid-19 will likely be felt for years and the full extent of the financial implications, and the ability of councils to provide these vital public services, remains unclear. We therefore want to hear views on what can be done to help councils weather the financial storm, in the short and long-term.

“We also want to know if the crisis has also provided an opportunity for fresh thinking about how councils deliver local services and local democracy and whether there are already good practises councils can share.

The Committee scrutinises Scottish Government housing policy, as well as local government housing responsibilities, and views on the impact of Covid-19 on housing policy are also welcome.

To help with its scrutiny work, the Committee wants to hear views on these issues:

1. How has Covid-19 impacted the local government sector and, in particular, council finances? Which council responsibilities are most impacted?

2. Which parts of local government have been least affected or most resilient?

3. What help will councils need in future from the Scottish Government or others to overcome the ongoing financial strain?

4. What can local government sector do, in the short and long term, to manage the financial impact of the crisis? What positive examples can councils and others share about the good work done at local government and community level to lessen the crisis?

5. How soon do you think the sector will be back to normal? Or is this time for a “new normal” in the way we deliver some council services or practice local democracy? If so, what will it look like?

The call for views is open until Friday 4 September 2020.

Please send your views to:

LocalGovernmentandCommunities@parliament.scot or https://yourviews.parliament.scot/lgc/local-gov-sustainability-covid

Walk the Walk’s SunWalk Festival: Real fun in the virtual world!

Grant-making breast cancer charity Walk the Walk has announced a week long Virtual SunWalk Festival to be held from 8th – 15th August.

This really is a virtual event with a difference, there is a walking challenge to suit everybody of any ability or age, tips and advice on how to achieve the goal and a DIY Festival Kit to download … not to mention lots of inspiration and motivation!

The charity will provide those signing up with lots of downloadable fun ideas, recipes for healthy snacks, including delicious lollies and smoothies, bunting and games to play.

Everybody can start planning and getting creative, maybe taking part in one of the shorter distances and finishing with a romantic picnic for two, a BBQ with family or friends or involving young children in the activities, following government guidelines, of course.

Women, men and children are being encouraged to sign up and make the SunWalk Festival Experience a special date in their summer diaries. What a wonderful way to get fitter and get rid of lockdown fatigue plus have fun and at the same time raise money to help cancer charities working on the front line – every mile walked and every penny raised will make a difference.

Walk the Walk has committed to making £20,000 Emergency Grants every month until the end of the year to charities who are struggling to keep going.

Walkers can choose between a 5k,10k, Half Marathon (13.1 miles, 21k) and a Full Marathon (26.2 miles, 42k) or for those that want an extra bite … a 100k challenge to walk in one go or over the 7 days. As a reward for completing the challenge, walkers will receive a downloadable certificate and a fantastic medal.

With experts predicting the return of COVID-19 in the autumn, there is no better time to get fit and healthy. By taking part in the Virtual SunWalk Festival, not only will people be improving their physical health but their mental health too.

Nina Barough CBE, Founder and Chief Executive of Walk the Walk said: “Walk the Walk is famous for not just organising events, but experiences, so we wanted our Virtual Challenges to have that same unique flavour.

“Raising money at this time is vital for us, but after months of self-isolating and social distancing, this is an opportunity for families and friends to come together and have fun, whilst doing so much good for those with cancer.

“By having an event that has 5 different challenges, there really is something for every age and ability. I hope that we can inspire many people to get back into shape by walking. The SunWalk Festival really is where virtual meets reality, people can let their imaginations run wild, come together and share a new positive experience whilst getting fitter!”

Due to the coronavirus, Walk the Walk have sadly postponed some of their events including The MoonWalk London, The MoonWalk Scotland and The MoonWalk Iceland.

Visit www.walkthewalk.org for updates and to find out more about the charity.

New outdoor café with space for 100 now open in city centre

A CITY café is opening a new outdoor seating area this week to give diners a place to relax in the centre of Edinburgh.

Café 1505 on Nicolson Street is extending its outdoor seating into the courtyard of The Royal College of Surgeons of Edinburgh, which will be able to accommodate up to 100 guests for food and drinks.

Café 1505 “Al Fresco” will open to the public between 12pm and 8pm, from Friday 24 July until Monday 31st August.

The venture is bringing life back to the courtyard which is normally used as a venue for the Edinburgh Fringe Festival – The Space @ Surgeons Hall.

Chris Wallace, Café Manager at Café 1505, said: “Given everything that’s happened in the city recently, we are so excited to be bringing a new outdoor café to Edinburgh.

“From Friday, visitors can enjoy food and drinks from our café and fully stocked bar, in a safe outdoor space. There’s a large marquee which hopefully will keep any turbulent Scottish weather from dampening spirits!

“We’ll be serving everything from pizza and nachos to tapas boxes. The team is really looking forward to recreating some of the magic we experience every year as a Fringe venue – albeit on a smaller scale.

“After 8pm, visitors are free to visit the bar and restaurant at our other venue, Ten Hill Place Hotel.”

Visitors will not be required to book ahead but will be asked to leave their contact details as part of the Scottish Government’s Test and Protect programme. In line with current guidance, groups will be limited to a maximum of eight people.

All staff have received full health and safety training and social distancing will be fully observed throughout the venue.

Café 1505 is owned and managed by Surgeons Quarter, the commercial arm of The Royal College of Surgeons of Edinburgh.

Profits from the café go towards the College’s charitable objectives of improving access to surgery and saving lives worldwide.

The café uses seasonal produce and serves what it claims to be one of the most ethical cups of coffee in Edinburgh – Coffee Grown by Women, a fair-trade product which empowers female farmers in Mexico and Peru.

Ten Hill Place Hotel gave 2,137 free room nights to NHS staff working in Edinburgh’s hospitals between March-May this year.

Parents under pressure as virus limits childcare options

  • More than one in four parents feel unable to ask for childcare help from loved ones as a result of pandemic
  • 15% of parents require additional childcare help from friends and family this year as they continue to juggle parenting and work responsibilities
  • Grandparents now providing £3,770 worth of childcare a year

While more than two-fifths (44%) of parents rely on grandparents for childcare support, more than a quarter (27%) feel they can no longer be as dependent on family and friends, due to ongoing health and safety concerns around the pandemic.

New How Scotland Lives research from Bank of Scotland revealed that whilst some parents are considering keeping their children away from their grandparents through the summer months in order to keep them safe from the virus, grandparents themselves seem less concerned, with just one in 10 (10%) expecting to do less childcare, and almost half (46%) expecting their usual school holiday childcare duties to stay the same.

In fact, 12% of grandparents who do not usually take on childcare, have offered to do so in order to support their own children.

Staying indoors

Despite ongoing concerns, the circumstances of 15% of parents mean they are having to be more reliant than they would usually be on friends and family this summer, as they continue to balance work and home life commitments.

Parents who are allowing grandparents to take on childcare responsibilities this summer have shown real concern around how time together should be spent, which has led to the ruling out of several of the typical summer activities, in light of ongoing social distancing restrictions.

There has been a significant reduction in the number of parents allowing trips to the cinema (-26%), holidays (-21%), theme parks (-7%), and swimming (-4%) due to the Covid-19 outbreak. Instead, they are more encouraging of activities that keep everyone in open spaces, such as picnics (+6%).

Tara Foley, Managing Director, Bank of Scotland, said: “For many parents, the challenge of conflicting work and childcare commitments continues this summer, with some facing difficult decisions around who is best to take care of their children.

“Whilst some parents remain worried about relying on loved ones for support during the ongoing pandemic, not all families can rely on holiday clubs and professional childcare. These will likely be a stretch too far for some budgets where paying for additional childcare wasn’t part of the plan.”

Regional variations

There are significant regional differences when it comes to the number of parents who rely on their own parents for childcare support (see table 1).

More than half (52%) of mums and dads in the West of Scotland receive regular help with childcare, which is more than in any other region, and 8% more than the Scottish average. Likewise, parents in Mid-Scotland, which includes Stirlingshire, Fife, Perth and Kinross, (48%), and Central Scotland (45%), are also more reliant on their parents for help with the kids.  At the other end of the spectrum is the Highlands and Islands, where just over a third (35%) of parents, receive support from grandparents.  

On average, grandparents report spending nine hours a week caring for their grandchildren, up from eight hours in 2019. Given the UK average pay for professional childcare is just over £8 per hour, this means grandparents are providing the equivalent of over £3,770 worth of childcare throughout the year, or at least £432 for the six weeks of the summer holidays.

Excess weight can increase risk of serious illness and death from COVID-19

Supporting people to move towards and maintain a healthier weight may reduce the serious effects of COVID-19 on the population, a new Public Health England report finds.

Being obese or excessively overweight increases the risk of severe illness and death from COVID-19, a new Public Health England (PHE) report confirms.

The report summarises findings from evidence published during the pandemic on the effects of excess weight and obesity on COVID-19. UK and international evidence suggests that being severely overweight puts people at greater risk of hospitalisation, Intensive Care Unit (ICU) admission and death from COVID-19, with risk growing substantially as body mass index (BMI) increases.

The current evidence does not suggest that having excess weight increases people’s chances of contracting COVID-19. However, the data does show that obese people are significantly more likely to become seriously ill and be admitted to intensive care with COVID-19 compared to those with a healthy BMI.

One study found that for people with a BMI of 35 to 40, risk of death from COVID-19 increases by 40% and with a BMI over 40 by 90%, compared to those not living with obesity. Other data found that in intensive care units, 7.9% of critically ill patients with COVID-19 had a BMI over 40 compared with 2.9% of the general population.

Almost two-thirds (63%) of adults in England are overweight or obese, with people aged 55 to 74, those living in deprived areas and certain black, Asian and minority ethnic groups more severely affected.

Excess fat can affect the respiratory system and is likely to affect inflammatory and immune function. This can impact people’s response to infection and increase vulnerability to severe symptoms of COVID-19. Obese people may be less likely to access healthcare and support, and it is also thought that COVID-19 affects other diseases associated with obesity.

The report highlights that supporting people to achieve and maintain a healthy weight may reduce the severe effects of COVID-19 on the population, especially among vulnerable groups that are most affected by obesity.

Dr Alison Tedstone, Chief Nutritionist at Public Health England, said: “The current evidence is clear that being overweight or obese puts you at greater risk of serious illness or death from COVID-19, as well as from many other life-threatening diseases.

“It can be hard to lose weight and even harder to sustain it, which is why people cannot easily do it on their own. Losing weight can bring huge benefits for health – and may also help protect against the health risks of COVID-19. The case for action on obesity has never been stronger.”

The report notes some limitations on evidence to date and highlights the need for more evidence, including research to establish the effect that weight management might have for groups at greater risk of the severe effects of COVID-19.

The report also summarises evidence regarding the nation’s eating and exercise habits during the COVID-19 pandemic. While some data suggests that more people have exercised during lockdown, evidence indicates that the nation’s exercise levels have not increased overall since before the pandemic. Meanwhile, snack food and alcohol sales in high street shops have increased.

The UK Government is expected to announce details of a new campaign to tackle obesity tomorrow.

Travellers from Spain face quarantine

If you arrive in England, Wales, Scotland or Northern Ireland from Spain you will now need to self-isolate.

Spain will be removed from the list of countries exempt from quarantine requirements due to an increased number of cases of coronavirus (COVID-19) in the last few days.

The decision, also made by the devolved administrations in Northern Ireland and Wales as well as the UK Government, has been made to reduce the risk of the transmission of the virus by those travelling from Spain and arriving in Scotland.

The public health measures came into effect from midnight and will mean those arriving in Scotland from Spain will now be required to quarantine for 14 days.

Justice Secretary Humza Yousaf said: “The decision to exempt Spain earlier this week, was taken when the data showed there was an improvement in the spread of the virus. But clearly the latest data has given us cause for concern to overturn that decision.

“We appreciate that this will be disappointing. However, we have always been clear we are closely monitoring the pandemic situation in all countries and that we may require to remove a country from the list of places exempt from quarantine requirements should the virus show a resurgence.

“It is still active and it is still deadly. Supressing the virus, preventing it from being transmitted and protecting public health is our priority.”

The FCO is advising against all but essential travel to mainland Spain – this does not cover the Canary Islands or the Balearic Islands because travel advice is based on the risk to the individual traveller and COVID-19 infection rates are lower there than mainland Spain.

A UK government spokesperson said: “The Joint Biosecurity Centre together with Public Health England have updated their coronavirus assessments of Spain based on the latest data. As a result, Spain has been removed from the lists of countries from which passengers arriving in England, Scotland, Wales and Northern Ireland are exempted from the need to self-isolate.

“Protecting public health is our absolute priority and we have taken this decision to limit any potential spread to the UK.

“We’ve always been clear that we would act immediately to remove a country where necessary. Both our list of quarantine exemptions and the FCO travel advice are being updated to reflect these latest risk assessments.”