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.”
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.
At the start of 2020 there was a gathering momentum to conversations about the role of kindness and compassion in health and social care in Scotland. When COVID-19 happened, the healthcare system entered a period of rapid transformation in which many of the previously insurmountable ‘barriers’ to kindness appeared to fall away. In this context, it felt important to capture what was happening.
The courage to be kind draws on a series of reflective conversations, conducted between April and September 2020 with five medics working in different parts of NHS Scotland.
The conversations reflected on what can be achieved when there is a common purpose, and when work is underpinned by relationships and collaboration. But alongside the opportunities presented by changes in practice and a renewed focus on wellbeing, there was concern that these may be lost amidst a focus on remobilising and ‘getting back to normal’.
The voices in this report offer a particular perspective. But the depth of reflection, and the clear message about the need to ease some of the pressure in the system in order to ensure the wellbeing of staff and patients is one that resonates with many other conversations and is relevant and urgent right across the health service.
At the end of a year that has demanded so much from our health service, we hope that this report adds to our collective understanding of the impact of COVID-19.
As we look to develop this work, we would really value your thoughts and reflections, which you can share withben.thurman@carnegieuk.org or by joining the debate on twitter @CarnegieUKTrust.
Survey reveals pride in service and achievements, despite challenges
Health and Social Care staff feel a strong sense of pride in their work, a new survey has found.
The survey found that despite concerns about challenges in both their work and personal lives, staff expressed satisfaction with their lives and the majority of health and care staff continue to say they would recommend their place of work to others.
The Everyone Matters Pulse Survey, which was carried out in September saw responses from across all of Scotland’s 22 Health Boards and 30 Health and Social Care Partnerships, with more than 83,000 staff members taking part.
The survey heard about the impact of the Covid-19 pandemic on staff and their loved ones, with one in four stating they were supporting a vulnerable relative while, prior to the schools going back, one in four had school aged children at home. One in six had a family member who had been furloughed.
The survey also heard accounts of a range of measures for wellbeing support put in place around the country and staff’s appreciation of this. Initiatives included comfort zones and wellbeing packs, e-cycles so staff could travel to work without using public transport and online huddles and blogs.
Cabinet Secretary for Health, Jeane Freeman said: “We all owe a huge debt of gratitude to our health and social care workers, which is why we announced a £500 ‘thank you’ payment for NHS and care staff.
“The challenges that have been faced in our emergency response have been substantial and Health and Social Care staff have continued to remain our biggest most valuable asset in delivering excellent care and quality services. As such, now more than ever, it has been vital that we hear from staff about their experiences of work during this period.
“I have been deeply affected by the stories of some of those who have experienced change and hardship in their role and personal life. Like many of us this year, NHS and care staff have had personal worries and difficulties, but they have continued to go above and beyond in the face of these challenges to ensure that fellow colleagues and the people that they care for feel supported, safe and recognised, throughout the pandemic period.
“The commitment and pride felt across the service is truly remarkable. I expect senior leaders and managers across health and social care to reflect seriously on this report, and show appreciation and value for the efforts made by staff and their achievements.”
The 2020 Everyone Matters Pulse Survey commenced on 1 September and closed on 23 September 2020. All 22 NHS Boards and 30 Health and Social Care Partnerships (HSCPs) took part and a total of 83,656 respondents participated in the survey, accounting for 43% of the Health and Social Care Partnership workforce.
The Everyone Matters Pulse Survey was carried out by Webropol Ltd, an independent company commissioned by the Scottish Government.
Many student midwives are struggling under the weight of financial concerns, poor mental health and an unpredictable job market, according to new findings by the Royal College of Midwives (RCM).
Student midwives in England, who must pay tuition fees and take out maintenance loans to cover living costs, will have, on average, a debt of £41,000 when they qualify. Even for those who receive a training bursary, the financial future is bleak.
A staggering 91 per cent of student midwives in Scotland, Wales and Northern Ireland said their training bursaries were not enough to live on.
Gill Walton, Chief Executive of the RCM, said: “Our student midwives should not be facing a triple threat of debt, worry and an unpredictable job market Unlike other students, the demanding nature of their course mean they have little opportunity to seek part-time work to supplement their income.
“They have a longer academic year, they work nights, weekends and bank holidays, and are often on-call to go in a at a minute’s notice. They show incredible dedication to their chosen career and there is an overwhelming case to give them better financial support, and to ensure they get jobs in our NHS when they qualify.”
The pandemic’s impact on student midwives cannot be underestimated. The RCM found that 96 per cent of student midwives reported having mild or moderate mental health problems since the pandemic began.
Our survey shows that by the end of July just 36 per cent of students in their final year of midwifery training had been offered a job in the NHS. At the same time, midwifery educator numbers are not keeping pace with the rise in student midwife numbers, potentially leaving students less supported throughout their training.
Gill Walton added: “Throughout the pandemic student midwives have made enormous efforts, working in our maternity services while also continuing their studies. At the same time the pandemic has disrupted midwifery education heavily.
“Some UK governments and institutions are doing better than others, but most are selling our student midwives short. They need to step up and ensure we continue to have the best educated, best prepared new midwives in the world. They are the future carers of mothers, babies, and families and we must invest in them.”
In the midst of the pandemic, nurse Lindsay Macdonald reassures little Hannah as she carries her to the operating theatre at the Royal Hospital for Children in Glasgow. This moment was captured by Lisa Miller, photographer with NHS Greater Glasgow and Clyde’s Medical Illustration team.
It has been selected as one of 100 photos to be displayed in the National Portrait Gallery’s new exhibit: Hold Still which captures a collective portrait of the UK during lockdown and the pandemic over the past six months. Lisa’s photo was chosen out of 31,000 submissions.
Lisa Miller, photographer NHS Greater Glasgow and Clyde’s Medical Illustration team, said: “I took this shot during the height of the pandemic and it shows that in the middle of what was and still is a scary time for everyone, the comfort of a nurse to a young patient.
“I’ve been working in our hospitals throughout the pandemic and have been able to capture moments no one else has been able to. We’ve had to wear full PPE which has made it hard to focus and frame the images through the viewfinder of the camera properly but I’ve been able to expand my skill range and take portraits alongside medical photographs.”
Lisa was only allowed to submit one photograph to the National Portrait Gallery and after much deliberation sought the opinion of her mum because she would look at the image from a mother’s perspective.
She added: “We’re always in sensitive situations, dealing with patients so it’s important to build up a rapport with them to make sure they feel safe and comfortable.”
Lisa has also been shortlisted for a Sky Arts TV photo competition, with another photo of Lindsay.
The National Portrait Gallery exhibit is available to view online: Hold Still.
Nurse Lindsay said: “The picture was taken during a time, right in the middle of lockdown and staff were all adjusting to new ways of working. At that time we were not using the anaesthetic rooms to put children under an anaesthetic and parents were not able to come with children into theatre. Because seeing staff wearing the full PPE could be quite scary for some children, especially young children who can’t see your face.
“That day I was going to meet the patient at reception and bring them to theatre. That way everyone who was already in all the PPE could stay in the theatre room and cause as much little distress for the child before she went to sleep.
“I still remember Hannah, she was such a lovely little girl. I was walking up the corridor to theatre with her in my arms, as she wanted to be there rather than on the trolley. Lisa was also there waiting to go into theatre when she took the photo.
“As a nurse I believe the patient feeling safe and happy is crucial to our role, as they are going into an unknown place with people that are complete strangers to them. I am a parent myself and I completely understand that when parents are handing over the most precious thing in the world to them, they have to believe and put their trust in us that we will absolutely take care of them and make sure that they are in safe hands.”
Lisa has also been shortlisted for a Sky Arts TV photo competition, with another photo of Lindsay.
The National Portrait Gallery exhibit is available to view online: Hold Still.
Early pay rise of at least £2,000 to every NHS worker is needed
Health staff across the UK – including nurses, paramedics, cleaners, domestics and porters – have embarked on two days of campaigning to urge the government to give an early, significant pay rise of at least £2,000 to every worker in the NHS.
Staff in UNISON branches based in NHS hospitals, ambulance stations and clinics will be using social media and taking part in socially distanced events to press home the message that health workers deserve much more than applause for their efforts during the pandemic.
Health workers know the public backs an early NHS pay rise, but now want to see the government show its appreciation for staff by bringing forward the pay rise due in April.
UNISON’s pay claim – delivered to Downing Street last month – would see every NHS employee receive an increase of at least £2,000 by the end of the year.
This early wage increase – equivalent to around £1 an hour extra for all staff – could give ailing local economies a much-needed boost as workers spend the extra money in their pockets on the high street, says UNISON.
With the arrival of autumn, and the increasing rates of infection, UNISON believes now is the perfect time for the government to show the high regard in which ministers say they hold NHS staff.
UNISON head of health Sara Gorton said: “Infection rates are rising in care homes and out in the wider community, and hospital admissions are on the up.
“The pressure on staff is beginning to build again, as the NHS tries to open services shut earlier in the year and deal with the backlog of cancelled appointments and operations.
“That’s why now would be the perfect time for the Prime Minister and Chancellor to show they can do more than clap for NHS staff, and demonstrate their appreciation in a much more practical way.
“Boris Johnson’s pie in the sky plans for any time, any place, anywhere ‘moonshot’ testing would cost a mindboggling £100bn. An early pay rise for NHS staff would be a tiny fraction of that and would make a huge difference to individuals and the services they help provide.
“Investing in the NHS and its incredible workforce is a must for the government. It would help the health service tackle the mounting staff shortages that were already causing huge problems even before the virus hit.
“An early pay rise would also be the country’s best way of saying a heartfelt thank you to every single member of the NHS team.”
The NHS, in all it’s forms, has been invaluable for people. This is understood: we would all be in deep trouble without it.
It is hard to believe organisations see the provision of health services as a means to make huge profits. One of the biggest dangers for the NHS is countries like the USA.
The importance of the people to own and control the NHS has been a tremendous lesson for all. It is now unthinkable to most that it should be otherwise.
This example of how to benefit society must now be extended to what is called the ‘care sector’. It, too, should be a publicly-owned extension of the NHS, not owned by private cmpanies or a business dependent on grants from local councils.
Every elderly person is exactly that, and must be treated with respect, not as an afterthought on some idea of ‘can we afford the cost?’ We can and must afford it!
The now elderly people need care and attention, love and respect for all they have done for us.
This weekend marks the 72nd anniversary of the NHS. Last night we lit up Scottish Government buildings in blue to mark the occasion. Join us in clapping to show our support for our staff across health and social care at 5pm today #NHSScot72
PM Boris Johnson said: This year has seen the NHS gallantly respond to the greatest challenge it has ever faced and rightly receive unprecedented support.
Week after week, we saw people take to their doorsteps, line the streets, lean precariously out of rainbow-bedecked windows to clap their hands and bang their saucepans to show their appreciation.
I am proud to be once again clapping for our heroic NHS staff, alongside Anne-Marie Plas who launched this inspirational initiative.
I am also celebrating today with staff from St Thomas’ Hospital who, quite simply, saved my life.
As we mark seventy-two years of the NHS, I want to say how thankful I am of this world leading institution.
As Prime Minister, I have given the NHS a £34 billion funding increase, the biggest in decades, and made sure it has every penny it needs to cope with coronavirus.
I’m immensely proud that the organisation built by Beveridge, Bevan, Willink, Godber, and so many others, has grown into the spritely seventy-two year old we see today.
And Royal approval:
Happy 72nd Bithday, NHS: you’ve never been more needed.
