NHS Covid-19 funding increased

An additional £380 million is being allocated to Health Boards to help with costs arising from the pandemic.

This comes on top of the £1.7 billion already provided to Health Boards and Health and Social Care Partnerships last year. Further financial support will be made available as necessary over the course of this year.

This additional funding includes ongoing support for the vaccination programme, the Test and Protect system, and personal protective equipment (PPE) for health and care workers.

Health Secretary Humza Yousaf said: “Although we are hopefully emerging from this pandemic, coronavirus continues to add significant pressures to our health and care services.

“We will continue to assess the impact of COVID-19 and provide Health and Care services with the support they require. The remobilisation of the NHS is among our top priorities. We will publish a national recovery plan within the first 100 days of this government.

“The £380 million includes £90.3 million for Test and Protect, a further £76.8 million for the COVID and extended flu vaccination programmes, and £85.5 million allocated to National Services Scotland for PPE costs. The rest of the funding will cover costs including additional staffing to support hospital scale-up, equipment, maintenance and IT.”

The 2021-22 Scottish Budget takes total health portfolio funding in excess of £16 billion – an increase of over £800 million (5.3%) – with a further £1.08 billion of funding to address pressures related to COVID-19. 

Royal College of Emergency Medicine: Winter crisis looming?

16,000 additional beds may be needed for the NHS to cope this winter

The NHS urgently needs a rapid increase in bed numbers if it is to meet potential demand this winter according to new analysis from the Royal College of Emergency Medicine.

The College’s new briefing document ‘RCEM Explains: Hospital Beds’ looks at how bed numbers have declined in the past decade, the impact of covid, and the potential number of beds needed this winter, based on previous levels of demand.

The briefing uses the ratio of emergency admissions to beds to model the numbers of beds that will likely be needed, based on the levels of demand seen each winter prior to the pandemic.

In the last five years in England this figure has fluctuated between 11.07 admissions per bed (winter 2015/16) and 12.50 (winter 2018/19). Excluding the most recent winters (both of which saw demand and capacity fall due to the pandemic), there was an average of 11.77 admissions per bed.

If the NHS is to achieve a similar ratio this winter, and there are a similar number of admissions as in the winter of 2017/18, the NHS will need just over 7,500 additional beds. If demand is similar to 2018/19, then this figure rises to 15,788 extra beds.

President of the Royal College of Emergency Medicine, Dr Katherine Henderson said: “We are currently seeing record levels of attendances at Emergency Departments and if this continues into winter – an extremely likely situation – the NHS will have too few beds to be able to cope.

“The consequences of having too few beds could be dire. If we do not have the capacity to admit patients into hospitals, then A&E waiting times will go up, patients will end up being treated in corridors – a very real threat to their safety before the pandemic, but now with the added risk of hospital acquired infection – and the elective backlog will grow further as beds earmarked for surgeries will be used for emergency patients.”

The briefing also makes clear the relationship between high bed occupancy and an increased rate of cancelled elective operations.

Dr Henderson said: “Too few beds means higher rates of occupancy, which in itself puts patient safety at risk, but it is clear that this has a huge knock-on effect on elective care. Lack of beds is one of the top reasons for cancellation of surgeries and if we do not address the shortage now, before winter, the elective recovery will fail.

“We know that access to services is an issue throughout the NHS at the moment with resources short all-round, but Emergency Departments act as the safety net for the NHS – if they cannot function properly the entire system stalls – so it is vital that the new Secretary of State does all he can to enable the NHS to expand hospital capacity. 

“The safe restoration of bed capacity to pre-pandemic levels is no easy fix though – as we’ve seen with the Nightingale initiative, capacity cannot be expanded if we do not have enough doctors, nurses, and clinicians.

“The capacity and staffing issues we face now have been over a decade in the making. Social care is still unfixed. Waiting lists are growing. Structural reconfiguration is in progress. Covid is less of an immediate threat but is unlikely to disappear. The Secretary of State has much to do, but he must start by making the beds.”

RCEM launches public appeal to support A&E staff facing stress and burnout

The Royal College of Emergency Medicine is launching a public appeal  to support the mental health and wellbeing of A&E staff after data show that many have struggled with burnout, distress, and other psychological conditions resulting from the stress of the pandemic, further to the continued pressures of their day-to-day work in Emergency Departments.

The NHS entered the pandemic underfunded, under-resourced and understaffed. This meant the severe demands of the ensuing pandemic were faced by the existing but understaffed workforce.

The shortage of health care workers has meant these existing staff have been continually pushed to their limits and beyond. And throughout the pandemic these health care workers have been physically, mentally, and emotionally challenged. Staff have been working with little or no respite in challenging conditions while facing ever increasing pressures.

The Health and Social Care Committee report “Workforce burnout and resilience in the NHS and social care” cites data from NHS Providers that show 92% of trusts raised “concerns about staff wellbeing, stress and burnout following the pandemic”.

A study published in January 2021 found that nearly half of frontline doctors, including those working in Emergency Medicine, suffered psychological distress during the first wave of the pandemic with others suffering from trauma, PTSD and other psychological conditions.

A study from 2019 found that working as an emergency physician is one of the most fatiguing and stress-inducing professions, a result of regularly working shifts longer than 12-hours, struggling to find work-life balance, and burnout. This was recorded prior to the pandemic, during which the pressures on Emergency Medicine staff significantly increased.

Dr John Heyworth, Consultant in Emergency Medicine in Southampton and Chair of RCEM Fundraising, said: “We know that many Emergency Medicine staff are exhausted and facing burnout.

“After 15 months of this pandemic, with waves of Covid causing intense pressures on our overstretched emergency departments, and now a return to high pre-pandemic levels of hospital activity, added to the stress of the threat of a further wave of covid – this is not surprising. But it is deeply worrying.

“We must do all we can to protect and support our frontline Emergency Department staff. Their hard work and dedication throughout this extremely challenging time has been incredible. As ever, they have been on the frontline throughout the pandemic risking their personal health and dedicating themselves to the care of others.

“The public have shown their remarkable support and respect for the health service. And now, we want to appeal to them to support our A&E staff who work 24/7 in Emergency Departments, ready to treat anyone who seeks care.

“When we know that our Emergency Medicine workforce is struggling with exhaustion, burnout, stress and other psychological conditions then we must take action, and they deserve our support.

“RCEM’s Public Mental Health and Wellbeing Appeal aims to raise money to develop and expand the support services offered to A&E staff who may be struggling with mental health conditions including PTSD, stress, burnout and exhaustion.

“The support offered will be guided and dictated by what A&E staff need most so that we can help them in the best way possible.

“RCEM’s goal is to ensure the services and support provided have a positive and lasting impact on the mental health and wellbeing of our frontline A&E workers.”

RCEM Appeal:

 https://www.rcem.ac.uk/RCEM/Get_Involved/Wellbeing_Appeal.aspx

Donate here:

http://www.rcem.ac.uk/RCEM/Get_Involved/Sign_in_for_donations.aspx?f=SPRW

“No-brainer”: £5 million to remobilise NHS dentists

£5 million to help meet safety standards and see more patients

Additional funding of up to £5 million is available to NHS dentists to help remobilise services as Scotland recovers from the coronavirus pandemic.

This new funding will help NHS dental practices to purchase, renew or upgrade ventilation equipment as improved ventilation in surgeries can substantially reduce the time between seeing patients, and offer dental teams the opportunity to see more patients safely.

Health Secretary Humza Yousaf said: “The remobilisation of the NHS is one of our number one priorities and the Scottish Government remains committed to ensuring that NHS dental services emerge from this pandemic well-placed to care for the oral health of the population.

“This new funding is an important step in ensuring the continued remobilisation of NHS dental services and to ensure more patients can be seen safely. We will also continue to fund free PPE for the dental sector and, from July, we will increase it by up to 50 per cent.

“We are continuing to work with the sector to provide much-needed support to fully remobilise dental services.”

Funding will be available throughout this financial year, and will be distributed by NHS boards to those practices meeting the scheme’s conditions. Claims can be made for the period 1 April 2020 to 31 March 2022. Further details of the scheme and how to apply will be provided to the dental sector by separate circular issued by the office of the Chief Dental Officer.

The British Dental Association Scotland has welcomed confirmation the Scottish Government will allocate £5 million to help practices invest in ventilation equipment to increase patient volumes while meeting COVID restrictions.   

The BDA first made the bid for financial support to improve ventilation to the Scottish Government in November. England is now the only UK nation not to have committed any capital funding for ventilation to help restore services.   

Chief Dental Officer Tom Ferris has confirmed funds can be used to purchase, renew or upgrade ventilation systems, and practices can claim retrospectively for the period 1 April 2020 – 31 March 2022.

 The BDA is awaiting details of the conditions applied to the scheme, but has expressed concern that it may not cover those practices who have already installed portable units or air cleaners (such as HEPA filters) when they were unable to improve ventilation by other means in the short term, following guidance from the Scottish Dental Clinical Effectiveness Programme (SDCEP).

Many in this position are based in sites unsuitable for major works, such as premises owned by health boards, in densely packed city centres with adjoining residential and commercial units, or in listed properties.

To meet strict guidelines on COVID transmission, dentists have had to leave surgeries fallow between most common procedures. Investment in ventilation ensures practices can reduce these gaps and increase patient throughput.    

Restrictions have left practices operating at a fraction of their former capacity. Data from Public Health Scotland has shown a dramatic reduction in NHS dentistry delivered, which has hit those in most deprived communities the hardest. Between April and November 2020, the number of courses of treatment delivered was 83% lower than during the same period in 2019.  

This week Scotland’s CDO joined colleagues from the other three UK nations to commit to reviewing current restrictions. [1] While the review may reduce the need for a fallow time longer-term, the BDA has stressed this investment is required to ‘future proof’ services in the advent of any future pandemic, to secure an immediate boost in access, and will prove cost-neutral through increased patient charge revenues.   

David McColl, chair of the British Dental Association’s Scottish Dental Practice Committee said: “This is a no-brainer from the Scottish Government. Investment in ventilation can future proof Scotland’s dental services, boost patient numbers, and pay for itself.

“We must avoid half measures. Many dentists have had no option but to buy portable systems to get patients back through their doors. Ministers must ensure they do not lose out.  

“For our patients’ sake, this needs to mark a turning point when it comes to providing ongoing support to practices. Access to services has fallen off a cliff. A signature policy on free dentistry for all will be a promise that can’t be kept unless we see real commitment from ministers.”  

Letters: The Coming Attack

Dear Editor

At the end of the war in 1945 the population, including the armed forces, were exhausted, many having also lived through the 1930s of unemployment and poor living conditions. The population were determined to change things after six years of war.

The main thing to tackle was the formation if a National Health Service. In 1948 this would tackle the poor state of the nation and provide an example of how the nation could be organised for the people.

Now, more than seventy years on, the foresight of setting up the NHS has been experienced and it is paying off, particularly in the circumstances of the Covid 19 epidemic.

Millions of people have expressed their gratitude for the NHS, for it’s originators and for all the people who work within it.

But now, a danger looms over our NHS. The Conservatives, who voted AGAINST the formation of the NHS, feel they are able to start ‘reorganising’ the service to allow the private sector a controlling role in it.

This infiltration is the first step by the Tories in a plan to kill off the NHS as a service for all.

TONY DELAHOY

Generosity has increased since lockdown began, research reveals

I think we can all agree the last 12 months have been challenging in so many ways, for people and businesses alike. But one of the most heart-warming parts since the first lockdown was announced has been seeing how many people have pulled together to help those in need.

New research by thortful.com has shown that people are now looking to give back. thortful analysed Google Trends data since the start of the first lockdown and found that there has been a huge increase in terms like ‘care packages for friends’ and ‘care package ideas’ seeing a 3350% and 250% increase in the last 12 months.

Businesses are also looking to show their appreciation to loyal customers who have continued to support them during these uncertain times, with the search term ‘thank you business cards’ seeing a 400% increase in the last 12 months.

Interestingly, search terms like ‘thank you for your order cards’ and ‘thank you for your purchase cards’ are two breakout queries, indicating this is a growing trend and that businesses want to give back to their customer base.

People’s willingness to give back was also seen during the Mother’s Day period when people donated to thortful’s NHS Charities Together campaign, which raised £130,126.50 for NHS Charities. Thanks to their customers, they were able to smash their target of raising £110,000. .

thortful became the official card company sponsor of the NHS Charities Together during the Mother’s Day period (15th February – 14th March), and pledged £110,000 to NHS Charities Together.

During this period, 5p for every Mother’s Day card sold and £5 from every Rainbow bouquet bought was donated by thortful directly to NHSCT. thortful smashed their target on 15th March 2021 with the total figure now at £130,126.50.

Commenting on the initiative, a thortful spokesperson explained: “It’s great to see how generous and altruistic people have been during this time.

“We are so grateful to all our wonderful customers for helping us raise this huge amount of money. We wanted to show our support and gratitude for all of the NHS staff who have worked tirelessly during the pandemic.”

For the full thank you card range, go to: https://www.thortful.com/cards/thank-you

Invest in Scottish maternity to tackle deprivation, says RCM in message to next government

Tackling Scotland’s social deprivation and inequalities by investing in maternity services and staff must be at the heart of the next government’s policy. That’s the message from the Royal College of Midwives (RCM) in a Blueprint for maternity services published this week.

In five areas for action, it also calls for an end to Scotland’s midwife shortage, saying some areas of the country struggle to attract enough midwives. 

The pandemic has also exposed starkly existing inequalities hitting vulnerable women and those from Black, Asian and minority ethnic communities.  Maternity and other areas of healthcare have a key role to play in efforts to address these inequalities, says the RCM 

The RCM’s five areas for action for the next Scottish Government are: 

  • tackling social deprivation; 
  • delivering the best maternity care for all the people of Scotland; 
  • supporting NHS staff to recover from the pandemic; 
  • ensuring Scotland has birthplaces that are fit for the future; and 
  • ending Scotland’s midwife shortage for good. 

Pulling no punches, the Blueprint says the pandemic ‘has been brutal’ on maternity and other NHS staff, who have worked throughout to ensure safe and high-quality care for women. This has hit their mental and physical health and they must be given the time and support to recover from it. 

Jon Skewes, Executive Director for External Relations at the RCM, said: “There has been a monumental effort from midwives, maternity support workers, and maternity care assistants through the pandemic. It is time to step-up and really invest in them, in their pay and in their working conditions.

“Right now, we have a demoralised and exhausted workforce and women falling through the cracks and not getting the care they deserve. Staff are also often working in old, poorly designed buildings that are simply not fit for purpose. The pandemic has exposed the extent and the impact on care of this crumbling infrastructure.” 

Additional training places for student midwives are also needed in more of Scotland’s universities. When they qualify new midwives generally stay within the regions they trained in leaving the chances of recruiting staff stacked against other areas without midwifery courses.  

Jon Skewes added: “Tackling deprivation goes way beyond maternity and the wider NHS. Fixing it must be done through multiple channels including social care, education, and others.

“Maternity is a very good place to start improving the health of the nation, reduce inequalities and indeed, save lives that should not be lost. This has been a really tough year for the NHS and the people using it as it creaked under the weight of pandemic demands.

“It has also been a remarkable year because of how its staff and the service responded. Now is the time to invest to make it fit for the future.” 

Scottish Government pledges more say for communities in health and social care services

The public will have a greater say in how major decisions around health and social care services are delivered in Scotland.

New guidance will ensure NHS Boards, Integration Joint Boards and local authorities uphold their legal duty to consult and engage with local communities about major planning decisions.

This will guarantee people with real experience of using local services will be able to shape decision making at a local and national level, from building or rebuilding hospitals, to transferring health and social care services into the community.

This ‘forward thinking’ approach will ensure lessons are learned from the Coronavirus (COVID-19) pandemic by giving people with lived experience a say in the future of NHS Scotland and the reshaping of Adult Social Care. It will also help ensure services are effective, safe, value-for-money and meet individuals’ needs.

Health Secretary Jeane Freeman said: “Community engagement and participation is vital as we look to reform health and social care services, ensuring they are fit to meet the needs of the public as we deal with the long term impact of the pandemic.

“This guidance will help ensure people have a greater say in decisions which affect the care they receive.

“Our collective response to the pandemic has shown the strength of our public services and how we can come together to address challenges. Since the start of the pandemic we have been delivering services differently and have engaged with communities to ensure they are involved in decisions that affect them. This guidance captures that learning and seeks to ensure we all benefit from it.  

“The Scottish Government will continue to listen to the views of people who use health and social care services and actively involve them in re-shaping how we deliver care as we re-mobilise beyond the pandemic.”

COSLA Health and Social Care Spokesperson Cllr Stuart Currie said: “Planning with people promotes real collaboration between NHS Boards, Integration Joint Boards and Local Authorities.

“It sets out the responsibilities each organisation has to community engagement when services are being planned, or changes to services are being planned, and it supports them to involve people meaningfully.

“Fundamentally, good engagement means that services are developed which are effective, safe and value-for-money. And there is no doubt that greater participation brings better outcomes for communities all round.

“So, we encourage people in communities across Scotland to read this guidance and find out what they should expect when it comes to engagement about care planning. Ultimately, it is their experience that will be the real measure of what impact it is making.”

Care services – planning with people: guidance – gov.scot (www.gov.scot)

Nurses will earn £2,500 less in real terms than in 2010

  • New 1% NHS pay offer is “a real terms pay cut” and “hammer blow to morale”, says union body
  • All key workers deserve a decent pay rise, says TUC

The TUC has released new analysis which shows how major groups of NHS workers will be much worse off in real terms in 2021-22 than in 2010.

The analysis shows that following the government’s decision to offer NHS staff a pay rise of just 1% in 2021-22, nurses’ pay will be down as much as £2,500 in real terms compared to a decade ago.

The picture is bleak for many other NHS staff too:

  • Porters’ pay will be down by up to £850
  • Maternity care assistants’ pay will be down by up to £2,100
  • Paramedics’ pay will be down by up to £3,330

Real terms pay loss since 2010

OccupationPay 2010Pay 2010 in 20-21 prices  (CPI)Agenda for change 2020-21 payPay 2021-22 (1% proposed increase)Real terms pay loss 2010-2021
Porters£16,753£20,383£19,337£19,530-£852
Medical secretaries£18,577£22,602£21,142£21,353-£1,249
Nursery Nurse£21,798£26,521£24,157£24,399-£2,122
Maternity Care Assistants
Speech and Language Therapy Assistants
Team coordinators
Nurses£27,534£33,500£30,615£30,921-£2,579
Community nurses
Radiographer Specialist £34,189£41,597£37,890£38,269-£3,328
Paramedic

Source: TUC analysis of NHS Agenda for Change Pay scales

The TUC analysis also reveals that NHS workers across many occupations and pay bands will suffer a real-terms pay cut in 2021-22.

For example, an experienced nurse or midwife (NHS band 5) will a face an annual real-terms pay cut of up to £153 in 2021-22 as a result of the planned 1% increase.

Unions have described the latest pay offer to NHS workers as an insult to their hard work and dedication during the pandemic.

TUC General Secretary Frances O’Grady said: “Our brilliant NHS workers have put their lives on their line to get Britain through this pandemic.

“It’s time we cared for them the way they have cared for us.

“That means giving them the decent pay rise they deserve – not a pathetic 1% increase. After years of real-terms pay cuts the government’s latest offer is a hammer blow to staff morale.

“This boils down to political choices. Ministers have chosen to spend hundreds of millions on outsourcing our failed test and trace system and on dodgy PPE contracts. But they have chosen not to find the money to give nurses, paramedics and other NHS workers fair pay.

“Boosting pay for NHS key workers will help our local businesses and high streets recover faster – because their customers will have more cash to spend. And that will help other workers get a pay rise too.”

BACKLASH

Four major unions – the BMA, the Royal College of Nursing, the Royal College of Midwives and UNISON – have written an open letter to the Chancellor, expressing their dismay at the 1% pay offer made to health workers.

In the letter they ask him to reconsider the recommendation, made to the NHS pay review bodies yesterday, that NHS staff receive a 1% pay rise.

The letter goes on to say: “The proposal of a 1% pay offer, not announced from the despatch box but smuggled out quietly in the days afterwards, fails the test of both honesty and fails to provide staff who have been on the very frontline of the pandemic the fair pay deal they need.

“Our members are the doctors, nurses, midwives, porters, healthcare assistants and more, already exhausted and distressed,  who are also expected to go on caring for the millions of patients on waiting lists, coping with a huge backlog of treatment as well as caring for those with COVID-19.”

The unions make clear that the Government should demonstrate that it recognises the contribution of the hundreds of thousands of workers who have literally kept the country alive for the past year and call upon the Chancellor to, “make the right choice”.

Read the full letter

Letters: The Coming Attack

Dear Editor

THE COMING ATTACK

At the end of the War in 1945 the population including the armed forces were exhausted, having also lived throught the 1930s of unemployment and poor living conditions. The population were determined to change things after 6 years of war.

The main thing to tackle was the formation of a National Health Service. In 1948 this would tackle the poor state of the nation and provide an example of how the nation could be organised for the people.

Now 70 years on, the foresight of setting up the NHS has been experienced and it is paying off, particularly in the circumstances of the Covid19 epidemic.

Millions of people have expressed their gratitude for the NHS, for its originators and for all the people who work within it.

But now a danger looms over our NHS. The Conservatives, who voted AGAINST the formation of the NHS feel they are able to start ‘ Reorganising’ the service to allow the private sector a controlling role in it.

This infiltration is a first step by the Tories in a plan to kill off the NHS as a service for all.

Tony Delahoy

by email