A new app for health and care home staff carrying out coronavirus (COVID-19) vaccinations will provide rapid access to relevant patient information and collect data on how many people have received the vaccination.
The ‘Vaccination Management Tool’ was developed in response to the pandemic and, because it functions on PCs, tablets and iphones, can be used in any setting where the vaccine is being administered.
The tool means vaccinators can immediately see whether it is an individual’s first or second dose and which vaccine has been administered – which will be crucial as more become available.
It also means data can be sent to GP systems and, in time the information collected on the app will help demonstrate how effective each vaccine is by linking with testing data.
Health Secretary Jeane Freeman said: “The development of this tool has been a significant collaborative effort involving both clinicians and technical staff and I would like to thank all those involved.
“Clearly we welcome anything which simplifies the process for vaccinators and having this app which can be used wherever they are working will be invaluable, allowing them to quickly access all relevant information on site.”
NHS Education for Scotland Chief Executive Stewart Irvine said: “Delivering a national vaccine programme is a huge undertaking.
“We are trying to make things as easy to use as possible for the staff who have to manage these large numbers of people. That’s in terms of planning their workflows, being able to work flexibly in all kinds of locations, and in providing a steady stream of data to help national planners.
“With tools like these, we are building integrated systems which remove additional burdens from hard-pressed health and care staff – allowing them to do what they do best.”
NHS Greater Glasgow and Clyde trialled the app for the winter flu programme. Immunisation Programme Manager Scott Hanley said: “We’re pleased to have helped test and feed-back on the app. Having all the individual’s information in one place and not having to use paper saved so much time for our staff.
“The fact that it is web-based also gives much more flexibility in who can use it – which gives us greater flexibility. And using a mobile tablet will help ensure patients are processed quicker on arrival at sites and will reduce the possibility of queues building up.”
The Vaccine Management Tool was developed by NHS Education for Scotland in partnership with NHS Greater Glasgow and Clyde, NHS Lothian and NHS Fife, NHS National Services Scotland and Public Health Scotland.
It was piloted in NHS Greater Glasgow and Clyde and NHS Lothian to assist with the winter flu vaccination programme and is now being used across Scotland to assist with the COVID-19 vaccination programme.
If you’re feeling a little low this winter, catching up with a pal outdoors can help to lift your spirits.
NHS 24 has welcomed the appointment of new Chief Executive Jim Miller, who will join Scotland’s digital health and care service in the spring of 2021.
Mr Miller, is currently Director of Procurement, Commissioning and Facilities at NHS National Services Scotland. He will take up his appointment with NHS 24 on 5th April 2021 and over the coming months will work closely with current CEO Angiolina Foster to ensure an effective transition.
NHS 24 Chairman, Dr Martin Cheyne said: “We are delighted to be welcoming Jim Miller as our new Chief Executive to NHS 24. His appointment follows a detailed interview process which was carried out with a selection of highly experienced candidates for this senior position.
“Jim has worked in management and leadership for over 20 years and prior to joining the NHS, he led technology, data and resilience programmes in the construction and aviation sectors. He leads national organisations delivering a range of services across acute, primary and community based health and social care.
“He has also recently led strategic responses to the COVID 19 pandemic, including the building and equipping of the Louisa Jordan and establishing PPE routes across the system. I am delighted that he will be bringing this experience and talent to NHS 24.”
Health Secretary Jeane Freeman said: ”I want to congratulate Jim Miller on his appointment as the new Chief Executive of NHS 24. As the current Director of Procurement, Commissioning and Facilities at NHS National Services Scotland, Mr Miller is respected for his collaborative leadership and professionalism.
“I look forward to welcoming him into post and am confident NHS 24 will continue to deliver a high quality service under his leadership, working in partnership across the health and care system to ensure NHS 24 is fully prepared for future challenges.
“I am pleased Mr Miller will be working closely with current CEO Angiolina Foster in the coming months as he familiarises himself in his new role. I would like to thank Angiolina for the leadership she has provided and the many achievements and improvements delivered during her tenure as Chief Executive over the past four years. I wish her the very best for her retirement.”
Jim Miller said: “Joining NHS 24 is an exciting move and one which I am greatly looking forward to. NHS 24 has delivered exceptional services to the public and to the wider health and care system with its range of telephone and digital services during 2020.
“It has provided critical support to the public and the health system during the COVID pandemic and is helping to transform services through the delivery of 24/7 urgent care.
“I am delighted to have been given the opportunity to work with colleagues across NHS 24, and am looking forward to continuing to build on this success and to further develop the role of NHS 24 with colleagues and partners across Scotland.”
A review of research in organizational and workplace psychology conducted by an international team of academics has revealed the implications of working-from-home for women has been more disruptive.
The review of research indicates the impact of the pandemic differs by demographic characteristics, such as gender. The paper reveals two key implications on the workplace; the first that work-from- home models will increase and continue post-pandemic and the second that although men are more likely to face direct health threats from COVID-19, women are more likely to be affected by the adverse social and economic costs.
Working from home is here to stay
The authors of the paper believe that face-to-face working will reemerge post-pandemic but will most likely return in a hybrid form which mixes face-to-face work with virtual work. Prior research has suggested that hybrid forms of working such as this are effective in increasing employees’ productivity, satisfaction, and psychological wellbeing.[1] And even with the option to work on an entirely remote basis, employees may choose to come to office regularly given humans’ strong social motives to connect with others.
Although working-from-home has turned out to increase productivity for some workers, it does also come with downsides. For example, research shows some workers are being burned out as they have to juggle caring for their children or other family members while working from home, whilst some employees feel distress and loneliness as they struggle with blurring work/non-work boundaries and miss out on social opportunities.
Given that working-from-home is likely to increase in the years which follow the COVID-19 pandemic, the negative consequences of such models will continue unless addressed. The review paper found gender and sex to be an influential moderating factor.
WFH more disruptive for women than men
Prior research has shown that in households where two partners are employed, women typically engage in household tasks more than men. And during national lockdowns and the closure of schools, the burden of household tasks tends to increase for couples with children as they become compelled to assist with children’s virtual learning.
Therefore, although working-from-home may increase overall productivity among employees, work may be substantially more disrupted for women, particularly those who have children. Indeed, a recent research (Feng & Savani, 2020) study showed that during the pandemic, among couples who are both employed, women’s productivity was more disrupted and women felt more dissatisfied with their job.
Additionally, the research showed due to their empathy and communal orientation, women, compared to men, may feel more isolated and stressed by working from home. A recent survey on 996 U.K. healthcare workers found that more females are experiencing emotional distress amid the pandemic (IPPR, 2020).
Sunny Lee, one of the paper’s authors and an Associate Professor of Organizational Behaviour at the UCL School of Management, said: “The research has shown that the work-from-home model has been a success for many companies forced to close their offices during the pandemic.
“However, we can see on a day to day basis the pressure this is putting on women to find a balance in their productivity and home life and this something organisations need to be sensitive to if this model is here to stay.
“Interestingly, one of the emerging trends we observed was the success of female leaders in handling this crisis, with leaders such as Jacinda Arden, Angela Merkel and Tsa Ing-Wen able to flourish in these uncertain environments.
“Going into 2021 organisations need to be aware of creating the right environment, one which is sensitive to the needs of both men and women, so that everyone’s skills are able to flourish during times of uncertainty.”
Telling family is the top way Scots make organ decision known
Ahead of Scotland’s move to an opt out system of organ and tissue donation, new research has revealed telling family is the top way people have made their donation decision known.
Almost three quarters (72 per cent) of people who have made their decision have told family what they’d like to happen, followed by over half (54 per cent) recording it on the NHS Organ Donor Register, and 27 per cent sharing it with friends.
The research also reveals one in ten (11 per cent) haven’t yet made their decision known to others – and today (17 December 2020) Public Health Minister Joe FitzPatrick outlined the importance of people recording their decision on the NHS Organ Donor Register and making family aware of their latest views on donation.
The law changes to an opt out system from 26 March 2021, which means that if people aged 16 and over have not recorded a decision about donation, they will be considered as a possible donor when they die.
Under the new law, people can choose to be a donor, or opt out of donation, however sharing that decision with family remains vital, as family members will still be consulted to check what a loved ones latest views on donation were. This is to ensure donation doesn’t proceed where it is against a person’s wishes.
Of those surveyed who hadn’t shared their decision with family – over a third (38 per cent) said it was because they hadn’t got round to it yet, and almost a quarter (22 per cent) said they didn’t feel the need to raise it as it was a personal matter.
The Scottish Government is set to launch a national advertising campaign early next year to highlight what the change of law means, and the options people have, ahead of the March law change date.
Public Health Minister Joe FitzPatrick said: “With the introduction of Scotland’s opt out legislation on the horizon, we’re encouraging people to make time to record their donation decision on the NHS Organ Donor Register, and share it with family.
“Under the new law, family will always be asked about a loved one’s latest views on donation. We know organ donation isn’t something that comes up in everyday conversation but making a point of speaking about what you’d want to happen, means your family will be able to honour it.
“Everyone has a choice and regardless of whether you decide to be a donor, or opt out of donation, making that decision known is vital.”
Heart Research UK Healthy Heart Tip, written by Dr Helen Flaherty, Head of Health Promotion and Education at Heart Research UK
TIPS FOR A HEALTHIER CHRISTMAS
Christmas is a time when we can be tempted to overindulge, but it is possible to enjoy the festive period without it impacting on our health and waistline. Wherever you are spending Christmas this year, we can help you make it a healthy and happy one.
Don’t let food become the main focus this Christmas. Instead of spending days in the kitchen baking cakes, biscuits and puddings, why not invest your time in preparing fun games to play on Christmas day, decorating the house, getting in touch with people who are spending Christmas alone or planning a Christmas Day walk.
Instead of buying gifts that are high in calories, such as chocolates, jams, sweets, biscuits and alcohol, choose non-edible gifts instead. How about buying the kids things that will get them active, such as a football, skipping rope, skateboard, bike, hula hoop or trampoline.
It can be difficult to avoid the consumerism that has taken over Christmas and you can easily buy too much food and drink for the festive season. Having too much can encourage overindulgence and lead to unnecessary waste. Try to be realistic about how much people will eat and drink and avoid overdoing it when you are shopping and cooking. This will also help you to save on your shopping bill!
Watch your alcohol consumption at Christmas. It is fine to enjoy a drink, but try not to have too much. Alcoholic drinks can be high in calories, which can lead to weight-gain. During the Christmas period, it can be tempting to start drinking earlier in the day, which can result in you drinking more. Try to plan in advance how much you will drink and try to stay off the alcohol until later in the day. You can get support with your drinking by visiting the Drinkaware website: https://www.drinkaware.co.uk/tools/self-assessment
Try not to spend too long sitting in front of the TV this Christmas. Wrap up warm and head out for a brisk walk to burn off some calories and get your heart rate up. Why not get out in the fresh air with any new outdoor gifts, such as a football, frisbee or bike.
Look after your mental health this Christmas. Christmas can be a time of stress, anxiety and loneliness for many people. This year, people may struggle more with mental health problems due to the pandemic. Mind provides information and support for people experiencing mental health issues https://www.mind.org.uk/
With a wide range of coaching and courses for babies to pre-schoolers and beyond, physical activity can help a child build fitness, confidence, and resilience, develop coordination skills and teaches them how to socialise.
Release their inner ‘Sugar Plum Fairy’ with Edinburgh Leisure’s dance classes or help them develop motor skills, balance and agility with ‘Gym Nippers’.
From 18 months to 3 years, you can even join in all the fun too. To comply with the current Covid-19 restrictions, Edinburgh Leisure has measures in place to ensure the safety of everyone, including the need for a parent/guardian to accompany pre-school aged children for Gym Nippers, who can physically support them in class, with instruction from the coach.
Children can join in their football classes from 3 years, where they will l develop confidence, spatial awareness and teamwork. For children who like to be airborne, their trampolining classes deliver balance, co-ordination, cardio fitness and self-confidence, whilst their swimming lessons will improve your child’s water confidence in and out of water, with an emphasis on fun and progression.
Swimming coaching can start from as young as 3 months or even younger, giving parent and baby a great opportunity to bond. And for budding Andy Murrays or Johanna Kontas, Edinburgh Leisure’s Tots Tennis offers a fun introduction to the sport allowing parents or helpers to be on court with them.
Things may be a little different now but Edinburgh Leisure’s coaching sessions still remain as popular as ever, with the emphasis on fun, safety, with dedicated, experienced staff ensuring everyone receives a warm welcome and gets the most from their classes.
The EIS has published a new briefing paper which highlights the views of Headteachers (HTs) and Deputes (DHTs) on the pressures of working in schools during the pandemic.
The EIS recently surveyed members across Scotland on a wide range of COVID-related issues and is publishing a series of themed briefings. Today’s report is based on comments received from HTs and DHTs in response to the national survey.
Key issues identified include:
Senior leaders highlighted that they are doing their best to implement the guidance to keep their schools safe, but there are just too many pupils in classrooms and in communal areas.
Some members suggested that the transmission within their school is not being reported.
There was widespread concern over the wellbeing of school staff who feel under pressure with their workload and are anxious about teaching with so many pupils in class full time.
EIS General Secretary Larry Flanagan said, “Headteachers and Deputes have been under immense pressure throughout the pandemic.
“Many Headteachers and Deputes worked through the summer holidays to prepare schools for return after the lockdown, and have continued to work extremely long hours ever since.
“Added to this, HTs and DHTs have been compelled to take on responsibility for contact tracing in their schools, with little or no additional support. With some school buildings set to remain open right up to Christmas, many HTs and DHTs will be expected to handle track and trace calls throughout the festive period.”
A sample of comments from HTs and DHTs who responded to the survey is included below:
“The amount of additional pressure and workload on head teachers is disgraceful. Now working 7 days a week as on call constantly with no time back or recognition. Schools are not safe.”
“Quite concerned about the way in which the public health team is dealing with confirmed cases in school. Parent can report that child has tested positive before 9am yet it takes until 3pm for any decision to be made about the class/staff isolating.”
“All staff are working in a very stressful environment due to working within guidance and are exhausted. Many feel vulnerable and would have appreciated being offered the flu vaccine as some protection against illness this winter. Many are also feeling undervalued as it’s fine for them to work with 30 different families but not for them to visit their own.”
“My desire would be that schools remain open and that our pupils get the service they long for. If the public health situation is severe enough for a level 4 lockdown and all non-essential shops are closed, then serious consideration must be given to risk of staff and pupils in schools. I believe that blended learning is a half-way house and pupils would get a better deal by staff being fully committed to remote learning. The remote learning offer is now far better than what it was in April to June.”
“We are finding staffing incredibly challenging. I currently have 50% of my teachers off and while we are able to cover, the lack of supply teachers available is very concerning. I am concerned about the impact on the staff who are in and the impact long term staff absence is having on our children.”
Staff are exhausted and anxious. There may be a limit to how long they can continue under such pressure.”
Today’s briefing (below) on Headteachers and Deputes is the latest publication to support the EIS campaign #NotAtAllCosts, which argues against the government plan to keep schools physically open ‘at all costs’ even in areas with high rates of COVID infection.
The EIS is continuing to share members’ comments online and urges individual teachers to do the same using the hashtag #NotAtAllCosts and tagging the First Minister and Deputy First Minister in their posts.
Black and minority ethnic (BME) workers have had to self-isolate at a much higher rate than white workers, according to new TUC research published this week.
The poll, carried out by Britain Thinks, shows that more than a third (35%) of BME workers have self-isolated during the pandemic compared to a quarter (24%) of white workers.
Feeling unsafe at work
The TUC believes the research shows that BME workers are being put at greater risk of coronavirus exposure than white colleagues.
While half of white workers (49%) reported that their employer had done a Covid-Secure risk assessment for their workplace, this falls to 36% for BME workers. This is despite the risk assessment being a legal requirement.
Higher stress levels
Working during the pandemic continues to have a negative impact on the levels of stress and anxiety of two-fifths of BME workers (38%).
BME workers (88%) are more likely to have concerns about returning to work than white workers (78%).
Previous TUC analysis has shown that BME people are far more likely to be in precarious work and in jobs with higher coronavirus mortality rates than white workers, such as security guards, carers, nurses and drivers.
Unfair treatment
Almost a third (32%) of BME workers report having experienced 3 or more forms of unfair treatment compared to a quarter of white workers.
In addition, almost a quarter (23%) of BME workers report experiencing abuse from other members of their workplace, compared to 16% of white workers.
TUC antiracism task force
The findings are published today (Thursday) as the TUC’s new antiracism task force meets for the first time. It is chaired by NASUWT General Secretary Dr Patrick Roach.
The task force will lead the trade union movement’s renewed campaign against racism at work. It will engage with Black workers across the UK to hear about their experiences. And it will produce recommendations on tackling structural racism in the UK, in workplaces and in unions themselves.
TUC General Secretary Frances O’Grady said: “This government has been careless of the impact of coronavirus on BME lives.
“BME workers are more likely to be exposed to the virus, less likely to work in Covid-Secure workplaces, and therefore more likely to be plunged into hardship if they have to self-isolate.
“BME workers – and all workers – should be entitled to decent sick pay when they have to self-isolate, and to safe workplaces.
“The government should act to rid the UK of the low wage insecure jobs that keep many BME workers in poverty and put them at higher risk from the virus. And it should set out a real commitment to ending systemic racism and discrimination.”
Chair of the TUC’s anti-racism task force and NASUWT General Secretary Dr Patrick Roach said: “There is a hostile environment for Black workers today which means they are more likely to face discrimination in the workplace, to be in insecure jobs, and more likely to be dismissed from work.
“And, during the pandemic we have also seen how racial discrimination has resulted in Black workers being much more likely to die at work as a result of Coronavirus.
“As the Task Force begins its work, we will be hearing evidence from Black workers about their experiences of everyday racism in the workplace.
“The Anti-Racism Task Force will not hesitate to call out racial injustice wherever we find it. It will bring together a strong coalition to deliver a programme of measures to root out racism and tackle racial discrimination and injustice at work.”
To protect the NHS, the UK government must abandon ‘rash’ plans for household mixing
Two leading medical journals – the British Medical Journal and the Health Service Journal – have joined forces to warn that the UK’s plan to ease Covid rules over Christmas is a “rash decision” that will “cost many lives”:
Since the UK’s first lockdown in March, the government has had one (perhaps only one) consistent message—protect the NHS.
Now, with the number of hospital patients with covid-19 again on the rise, and a third wave almost inevitable, the New Year is likely to see NHS trusts facing a stark choice: be overwhelmed or stop most elective and non-urgent work. Rather than lifting restrictions over Christmas as currently planned, the UK should follow the more cautious examples of Germany, Italy, and the Netherlands.
By and large the NHS has coped well with the additional caseload from covid-19 patients during the autumn. The second wave began to hit hospitals at the start of September. Government figures report 451 inpatients with covid-19 in England on 2 September.1 Over the ensuing 10 weeks, the numbers rose steadily and then rapidly, peaking at a reported 14 712 inpatients in England on 23 November.
If the third wave turns out to be of the same order of magnitude as the second wave, the health service should manage. But this will be the case only if the third wave starts with a broadly similar extra caseload of covid-19 inpatients as at the beginning of the second wave: around 450.
With current restrictions failing to control the virus, extrapolation suggests that the actual figure is likely to be more than 40 times higher, as we explain below. The planned relaxation of restrictions over Christmas will boost the numbers further as the NHS also struggles with the additional demands of winter.
England went into lockdown on 5 November, and the number of inpatients with covid-19 began to fall, down to 12 968 on 5 December.1 If this rate of decline had continued, the English NHS would have been on course for just under 11 000 covid-19 inpatients on 31 December.
However, in the past two weeks, despite most of the country being in tiers 2 or 3 of restrictive measures, numbers of inpatients have started to rise again. By 14 December (the latest data available) the covid bed occupancy had climbed back to 15 053.
Unless something happens to change this trajectory, hospitals in England will have just short of 19 000 patients with covid on New Year’s Eve. This figure, derived by extrapolating a straight line from 5 December to 14 December through to 31 December, would be almost exactly the same as the 18 974 peak of the first wave on 12 April.
The NHS currently has around 95 000 general acute beds. It is operating with around 10% fewer beds than a year ago as a result of infection prevention and control measures introduced to try to stop the spread of covid in hospitals.
The main effect of a further surge in covid-19 inpatients is likely to be felt most by those with other conditions. The NHS has learnt from the first and second waves and has robust plans to rapidly increase intensive care capacity, including through the Nightingale hospitals. But how are these to be staffed? A large influx of patients with covid-19, similar or greater than that seen in the autumn, can only be managed if staff and other resources are diverted from treating non-covid patients.
Having recovered much of their capacity for elective and non-urgent care during the autumn, NHS trusts in the most pressured regional health systems are already having to cancel almost all such activity because of the resurgent virus.
A substantial third wave could wipe out almost all the reductions in waiting times for elective procedures achieved in the past 20 years. Average waiting times will reach 12 months by March next year.
This will take years to recover from, at the cost of much suffering and loss of life.
The coming months are also likely to see the NHS under intense winter pressures from seasonal outbreaks of norovirus, increased admissions of frail older people, and the peak of staff absence. The NHS will also be in the middle of delivering the largest vaccination programme in its 72 year history, through already overstretched general practices and hospitals.
Even if NHS England succeeds in vaccinating all those “at risk” by Easter, this won’t be in time to prevent hospital admission and death for many during the next few months. NHS Track and Trace, which in fact has almost nothing to do with the NHS, continues to squander money on failure.
So too does the mass testing of asymptomatic people using lateral flow tests that are not fit for purpose.
London and many neighbouring counties will enter tier 3 on 16 December. However, other areas such as Kent, which has been in tier 3 since 2 December, are still seeing strong increases in hospital admissions. These measures are clearly inadequate.
Ministers are meeting on 16 December to review current restrictions for England. When they devised the current plans to allow household mixing over Christmas they had assumed the covid-19 demand on the NHS would be decreasing. But it is not; it is rising, and the emergence of a new strain of the virus has introduced further potential jeopardy.
Of particular concern is the effect on staff, many of whom have already worked through the hardest nine months of their professional lives. Levels of burnout and sickness absence are likely to exceed those already experienced.
What should be done
Members of the public can and should mitigate the effect of the third wave by being as careful as possible over the next few months. But many will see the lifting of restrictions over Christmas as permission to drop their guard. The government was too slow to introduce restrictions in the spring and again in the autumn.
It should now reverse its rash decision to allow household mixing and instead extend the tiers over the five day Christmas period. In order to bring numbers down in advance of a likely third wave, it should also review and strengthen the tier structure, which has failed to suppress rates of infection and hospital admission.
This joint editorial is only the second in the more than 100 year histories of The BMJ and the Health Service Journal. We are publishing it because we believe the government is about to blunder into another major error that will cost many lives.
If our political leaders fail to take swift and decisive action, they can no longer claim to be protecting the NHS.
