George Cross for our NHS

Her Majesty The Queen has presented the George Cross to the NHS for 74 years of dedicated service.

The award for heroism was accepted by representatives of the NHS from Scotland, England, Wales and Northern Ireland in an audience at Windsor Castle.

It is only the third time in the award’s 82 year history that the honour has been presented to an organisation and follows the efforts of health and social care workers across the country during the COVID-19 pandemic.

Accepting the award on behalf of the health service in Scotland was NHS Scotland Chief Executive Caroline Lamb, and Eleanor Grant, a palliative care nurse specialist at University Hospital in Wishaw who was named Nurse of the Year at the Scottish Health Awards 2021.

Ms Lamb said: “We wouldn’t be where we are today without our health services. NHS and social care staff have cared for all of us on the frontline of the pandemic.

“Thanks to their dedication and duty our NHS has saved countless lives and the George Cross is a symbol of the country’s gratitude. I know that the rest of Scotland will join me in paying tribute and giving thanks for everything the NHS and wider social care has done for us not only during the pandemic, but since its formation in 1948.

“The NHS is only the third entity to receive the George Cross and I am truly honoured. This award goes beyond the commitment and personal sacrifices staff have made over the past two-and-a-half years. It reflects the wider admiration and gratitude we all have for the NHS.

“I’d like to take this opportunity to thank everyone working across the health and social care sector for everything they have done, and continue to do, to care for us all.”

Ms Grant has been a nurse for 35 years, working in St Andrew’s Hospice before re-joining the NHS to provide hospital patients with palliative and end-of-life care.

Ms Grant said: “I’m absolutely thrilled to accept this award on behalf of my colleagues across health and social care In Scotland. It’s an honour and a privilege.

“For me, COVID-19 has changed how I work. When patients were unable to have loved ones with them in their final moments, it was for me to be there. We all pulled together in the toughest of times and did what we had to do.

“The George Cross is sometimes awarded to individuals involved in the military and it feels quite fitting for this recognition to be given to the NHS as the early days of the pandemic did feel like a battle.”

National Care Service Bill published

This is the most ambitious reform of public services since the creation of the NHS” – Humza Yousaf

Legislation to establish a National Care Service for Scotland (NCS) will ensure the best possible outcomes for people accessing care and support and end the ‘postcode lottery’ of care, says the Scottish Government.

The National Care Service Bill will make Scottish Ministers accountable for adult social care in Scotland – a change strongly supported by those responding to the recent consultation on the plans.

The Bill provides the foundation for the NCS, and enables the fine detail of the new  service to be co-designed with people who have direct experience of social care services.

Plans have also been published to explain how that collaboration will work.

The aims are to:

  • support people in their own homes or among family, friends and community wherever possible, with seamless transitions between services;
  • create a charter of rights and responsibilities for social care, with a robust complaints and redress process;
  • introduce rights to breaks for unpaid carers
  • introduce visiting rights for residents living in adult care homes, giving legal force to Anne’s Law
  • ensure fair employment practices and national pay bargaining for the social care workforce;
  • focus on prevention and early intervention before people’s needs escalate;
  • create a new National Social Work Agency to promote training and development, provide national leadership and set and monitor standards in social work.

On a visit to Aberdeen-based charity VSA, which supports people with a wide range of social care needs, Cabinet Secretary for Health and Social Care Humza Yousaf said: “This is the most ambitious reform of public services since the creation of the NHS.

“People have told us they want a National Care Service, accountable to Scottish Ministers, with services designed and delivered locally. That’s exactly what we are going to deliver.

“The design of the NCS will have human rights embedded throughout, and the actual shape and detail of how the NCS works will be designed with those who have direct experience of accessing and providing social care.

“We are going to end the postcode lottery of care in Scotland. Through the National Care Service we’re going to ensure everyone has access to consistently high-quality care and support so they can live a full life. This is our ambitious goal and while it will not be easy to achieve it is vital that we do.”

Social Care Minister Kevin Stewart said: “One of the key benefits of a National Care Service will be to ensure our social care and social work workforce are valued, and that unpaid carers get the recognition they deserve.

“When this Bill passes we will be able to have the new National Care Service established by the end of this parliament. In the interim we will continue to take steps to improve outcomes for people accessing care – working with key partners, including local government, and investing in the people who deliver community health and social care and support.”

Chief Operating Officer of VSA Aberdeen John Booth, said: “We welcome the announcement that the National Care Service Bill has been published. With this being the biggest reform since the creation of the NHS we will now take the time to properly review the bill to understand the opportunities and challenges that lie ahead.

“We look forward to working with the Scottish Government to co-design the NCS to ensure the voices and needs of the vulnerable people who rely on our vital services are heard.”

Local government umbrella body COSLA has issued a statement:

A massive restructuring project, limited resources, local government opposition … Now, what could possibly go wrong?

National Care Service (Scotland) Bill

Tip of the Iceberg: New report exposes real number of A&E waits

Over 1,000 patients faced a 12-hour wait in A&E every day in 2021

A new report by The Royal College of Emergency Medicine Tip of the Iceberg: 12-Hour Stays in the Emergency Department reveals that on average 1,047 patients waited 12-hours or more from their time of arrival every day in a major Emergency Department in 2021 in England, equalling a total of 381,991 patients experiencing these 12-hour waits in 2021.

There is a total of 124 NHS Trusts in England. The College received responses from 74 NHS Trusts that were contacted. The figures above are only representative of 60% of NHS Trusts in England. The true total figure of 12-hour waits from time of arrival in major Emergency Departments in England in 2021 will be even higher.

These figures show the deep crisis facing the NHS and the Urgent and Emergency Care system. The alarming number of 12-hour waits are an indicator of the serious and dangerous levels of crowding occurring in Emergency Departments.

Crowding is unsafe, inhumane, and undignified for patients, our previous report Crowding and its Consequencesfound that patients can come to associated harm and even death.

The NHS in England currently measures 12-hour waits from decision to admit (DTA). The Decision to Admit is the decision to admit a patient to a hospital bed made by a clinician. Measuring from decision to admit is a gross underrepresentation of the reality of patient waits, as many patients will have already waited for a long period in a busy Emergency Department before this decision is made.

12-hour DTA waits have been increasing substantially, so much so that in the first four months of 2022 alone (January – April 2022) there were a total of 79,610 12-hour DTA waits; nearly as many as the cumulative total of the 11 years since data collection began (82,746 12-hour DTA waits between August 2010 – December 2021). It is evident that while the pandemic has contributed to the current situation somewhat, long waiting times have clearly been rising for over a decade.

Our recent report Beds in the NHS found that 25,000 staffed beds have been lost since 2010/11 and this has contributed to the steady increase in long waiting times in Emergency Departments since 2010/11 as detailed in Tip of the Iceberg.

Commenting on the FOI findings, Dr Adrian Boyle, Vice President of The Royal College of Emergency Medicine, said: “These figures are staggering and show the critical state of the Urgent and Emergency Care system.

“They also make clear that measuring 12-hour waits from decision to admit masks the reality facing patients and staff. Clearly, it is misleading to measure 12-hour waits in this way, and it is detrimental to staff efforts to improve A&E waiting times.

“NHS England have previously promised to make 12-hour data measured from time of arrival in the Emergency Department public and publish it alongside monthly NHS performance figures. We are still waiting for them to fulfil their promise.

“We recently wrote to Amanda Pritchard, Chief Executive of NHS England, about this, questioning why the data has not yet been published and when it will be. We have not received a response. Until it is published the NHS cannot hope to drive meaningful change and improvement in Emergency Care. Publishing this data will bring about greater accountability, and help all stakeholders understand the extent of crowding, long stays, and corridor care.

“NHS England must publish 12-hour data from time of arrival as a matter of urgency, this is the first step towards meaningfully tackling this crisis. At present, we fear that the full scale of this crisis is either being ignored or inadvertently misunderstood by the government.

“To truly tackle the problem, you must understand the scale of the task at hand. This data should facilitate better understanding of the challenges facing Urgent and Emergency Care and the wider health system and allow us to take the steps towards tackling it.

“In the short-term, the government must set out a meaningful plan for social care that includes recruitment and investment in the social care workforce and paying a wage that values and reflects significance of their role.

“In the medium-term, the government must finally commit to publishing a fully funded long-term workforce plan that recruits new staff into the health service and includes measures to retain existing staff who are burned out and questioning their careers. Then will it be possible to open the 13,000 staffed beds required to drive meaningful improvement within the health service.

“The health service is failing, and failure to act will take it deeper into crisis and inevitably lead to another ‘worst winter on record’ and further patient harm. The government can talk about phantom new hospitals all it likes, but political unwillingness to tackle the deepest health crisis in NHS history costs; the cost is both deteriorating patient health and patient lives, and an undervalued workforce struggling to deliver.”

Diagnostic test waiting times: cancer patients waiting too long, says charity

Cancer Research UK’s has responded to the latest diagnostic test waiting times statistics published by Public Health Scotland. Eight tests are considered in the report, including several that are relevant to the diagnosis of cancer. 

These latest figures show that more than 155,000 patients in Scotland were waiting for a key diagnostic test at the end of March 2022. This is a 10% increase compared with the previous quarter and a 74% increase compared with pre-pandemic levels. 

The report also tells us that, of those people waiting, 50% had been waiting more than six weeks for their test at the end of March 2022.

This is similar to the proportion waiting at the end of the previous quarter and more than three times the proportion pre-pandemic, which was 16% at the end of March 2019. The figures also show around 5,400 (3.5%) patients waiting for a test had been waiting over a year, with almost all of these patients waiting for an endoscopy test. 

The Scottish Government standard that no one should be waiting more than six weeks for a diagnostic test hasn’t been met since June 2010. 

David Ferguson, public affairs manager for Cancer Research UK in Scotland, said: “It is unacceptable that people in Scotland are waiting too long for a test to determine whether they have cancer. Early diagnosis followed by swift access to the most effective treatment can save lives.  

“Despite the best efforts of NHS staff, the delays are due to Scotland’s chronic staff shortages in the areas key to diagnosing and treating cancer. These shortages have hampered progress for years – well before the pandemic.

“The Scottish Government must set out long-term, properly funded plans to address workforce shortages and improve cancer services so patients get the care they need and deserve.”

Emergency Care ‘remains in extreme crisis’

More than one third of patients facing long waits in Scotland, as Emergency Care remains in severe crisis.
Responding to the latest weekly Emergency Department performance figures in Scotland Dr John Thomson, Vice President of The Royal College of Emergency Medicine Scotland, said: “We are continuing to see severely poor performance in the Emergency Care system. Staff are becoming more and more burnt out; the appalling crisis in Emergency Care is seriously distressing.

“The public are extremely worried about these long waiting times, and rightly so, because patients are coming to harm. Staff continue doing all they can to deliver care and keep patients safe, but it is incredibly challenging.

“It is a desperate situation, a result of widespread shortages of staff and beds throughout the system and a crisis in social care. Despite exiting winter and entering spring, the situation remains dire; we have never faced a crisis worse than this. The intense workload is breaking staff, and the distressing circumstances are breaking their morale.

“Patients continue to face seriously long waits, and we continue to state that this crisis is worse than ever, and that patients are coming to harm. The government cannot let this deteriorate further, staff and patients urgently need meaningful action now to tackle the desperate situation in Emergency Care and address the widespread staff shortages, the bed shortages, and the social care crisis.”

The latest weekly Emergency Department performance figures for Scotland show:

There were 22,774 attendances at Emergency Departments

Four-hour performance was 66.2%, the lowest ever on record-

7,705 patients waited more than four-hours in an Emergency Department

More than 3 in ten patients were waiting for more than four hours in an Emergency Department

2,373 patients waited more than eight-hours in an Emergency Department

Nearly one in six patients were waiting for more than eight-hours in an Emergency Department

944 patients waited more than 12-hours in an Emergency Department

One in twenty-five patients were waiting more than 12-hours in an Emergency Department

UK to donate fleet of ambulances to Ukraine

A fleet of NHS ambulances will provide urgent care for those injured by Russian attacks in Ukraine following a donation from the UK.

  • UK NHS trusts donating around 20 ambulances to the Government of Ukraine
  • donations will help replace Ukrainian ambulances lost to Russian bombardments and provide urgent care to injured
  • Ukraine’s health services stretched as Russian attacks hit civilian shelters and hospitals

The donation of around 20 NHS ambulances will help bring vital lifesaving care to Ukrainians remaining in towns and cities under attack from Russian bombardments.

This donation will help replace those Ukrainian ambulances lost to Russian attacks, bolstering the existing fleet’s resilience as the barbaric war goes on.

It is estimated more than 12 million people are currently in need of humanitarian assistance across Ukraine.

The conflict has stretched Ukraine’s health services, with Russia’s indiscriminate attacks targeting civilian shelters and even hospitals.

South Central Ambulance Service NHS Foundation Trust (SCAS) is leading the way, donating four of its ambulances, with further donations from NHS trusts across the country soon to follow.

The first ambulances will arrive in Ukraine this week, destined for Lviv in the west of the country, where they will be transported on to those areas most in need.

Foreign Secretary Liz Truss said: “We have sadly seen day after day the horrific impacts of Putin’s cruel war on the people of Ukraine, including evidence of appalling acts by Russian troops in towns such as Irpin and Bucha.

“The UK has been among the biggest aid donors, providing food, medicines and generators to help those affected. These world class NHS ambulances will now help bring lifesaving care directly to those injured in the conflict.”

Health and Social Care Secretary, Sajid Javid, said: “The UK government has stood shoulder to shoulder with Ukraine and provided them with the lifesaving medical equipment they need.

“The invasion has damaged key medical infrastructure and the generous donation of four ambulances by South Central Ambulance Service will ensure people in Ukraine can receive urgent care. It marks the first of many ambulances the UK government and the NHS is donating to Ukraine in the coming days.”

Paul Kempster, SCAS Chief Operating Officer said: “Ambulance Trusts around the country have been rallying to provide ambulances and we in SCAS are immensely humbled to also be able to support those in need in Ukraine.

“We hope that this small gesture goes some way to helping provide immediate frontline healthcare support to the many people who desperately need it.”

This latest funding and donation comes in addition to the nearly £400 million (£394 million) already pledged by the UK for the conflict in Ukraine, including £220 million of humanitarian aid.

To date, the UK has donated more than 5 million items of medical supplies to Ukraine to help the country cope with the medical emergency caused by the Russian invasion. 

Royal College: Urgent and Emergency Care ‘in dire crisis’

RCEM urges action to address failing A & E system

The latest monthly Emergency Department (Major EDs) performance figures for Scotland for February 2022 show:

  • There were 95,692 attendances
  • Four-hour performance was 71.7%, 1.9% lower than the previous month, January 2022, and the second lowest on record
  • 27,087 patients were delayed by four hours or more, this is means more than one in four patients were delayed by four hours or more
  • 6,248 patients were delayed by eight hours or more
  • 2,230 patients were delayed by 12 hours or more, this represents the highest proportion of attendances experiencing 12 hour waits since records began

Dr John Thomson, Vice President of the Royal College of Emergency Medicine Scotland, said: “The crisis in Urgent and Emergency Care is dire. The health system in Scotland is ceasing to function as it should. Patients are at risk of severe harm and staff are facing stress, distress, burnout and moral injury on a daily basis.

“This is unsustainable and dangerous. The first step to tackling this crisis is opening 1,000 beds that are desperately needed across the system and recruiting senior decision makers in Emergency Medicine. In addition, the crisis in social care, which is resulting in the most vulnerable patients residing in hospital for extremely long periods of time before being discharged means that the system is unable to cope.

“This patient safety crisis must be a priority for the Scottish Government, and they must take meaningful action now before more patients come to severe harm.”

SARCS: Rape and sexual assault support service launched

Improving healthcare choices and support

A marketing campaign has been launched to ensure people know about a dedicated national NHS service that offers choices in healthcare, forensic examination and support after a rape or sexual assault.

The national service, which is to be implemented across all health boards, will allow those aged 16 and over to self-refer for a forensic health examination at a Sexual Assault Response Coordination Service (SARCS), whether or not they wish to report to the police.

Funding of £11.7 million has been invested by the Scottish Government alongside the unanimous passing of Forensic Medical Services Act 2021 by Parliament. This money has gone towards creating healthcare facilities for examinations across all health boards, to recruit more specialist staff and set up a single point of contact for self-referral through NHS 24.

The campaign which will run across digital channels and outdoor advertising sites encourages people who have experienced a sexual crime to visit the NHS Inform website for information to help them decide the best next step for them.

Chief Medical Officer, Professor Sir Gregor Smith said: “It is very important that everyone knows about this service and while I hope that people will never need to use it, for those that do, knowing where to turn for support and information is a vital part of giving them back control.

“This legislation marks an important step in ensuring that those who have experienced a sexual assault have access to healthcare and support, even if they don’t feel ready to report it to the police.

“The campaign will be running over the next few months to raise awareness of the Sexual Assault Response Coordination Service (SARCS), to help improve the experience of those who have suffered a sexual crime.”

Jennifer Wilson, Nurse Director for NHS Ayrshire & Arran added: “Improving healthcare services for victims of sexual offences is a priority for NHS Ayrshire & Arran.

“We are committed to the Taskforce vision of consistent, person-centred, trauma-informed healthcare and forensic medical services and access to recovery, for anyone who has experienced rape or sexual assault in Scotland.

“With the launch of the FMS Act and the National Self-Referral Service we can now offer local services to victims of sexual assault who require a Forensic Medical Examination (FME) and who do not wish to, or are not yet ready to report this to the Police.

“This is a vital part of improving services for victims of sexual assault and making sure that timely healthcare support, including a forensic medical examination, is available to victims of rape and sexual assault in a way that is sensitive, compassionate and reduces the risk of any re-traumatisation.”

Sandy Brindley, Chief Executive of Rape Crisis Scotland said: “This is a huge step forward in improving responses to rape in Scotland. Immediately following rape or sexual assault can be a really difficult time to make a decision about whether to report what has happened to the police, but there are time limits involved in being able to capture forensic evidence.

“Self-referral means that if someone doesn’t feel ready to make the decision about reporting they can ensure all the evidence is captured and make the decision when they are ready.”

The Great Gamble: Johnson sets out plan for living with COVID in England

  • Prime Minister confirms next steps for living with Covid-19
  • Vaccines will remain first line of defence against the virus with further boosters this spring for the most vulnerable
  • All remaining domestic covid regulations restricting public freedoms to end this week as part of the Living with Covid Plan

Vaccines will remain the first line of defence against Covid-19 as the Prime Minister sets out the Government’s plans to live with and manage the virus.

The UK was the first country in the world to authorise the use of the Pfizer and Oxford-AstraZeneca vaccines, the first European country to vaccinate 50% of its population and has delivered the fastest booster programme in Europe.

Over 31 million boosters have been administered across England and almost 38 million UK wide helping break the link between infections and hospitalisations. In England, the number of cases, hospitalisations and deaths continue to decline and are far below the levels of previous waves, with boosters offering strong protection against severe illness and hospitalisation.

Thanks to our hugely successful vaccination programme, the immunity built up in the population and our new antiviral and therapeutics tools, the UK is in the strongest possible position to learn how to live with Covid and end government regulation.

To save lives and protect the NHS, unprecedented measures were taken on a global scale that interfered with people’s lives and livelihoods. Billions of pounds were spent on supporting a locked down economy as the public stayed at home.

The Prime Minister has been clear that restrictions would not stay in place a day longer than necessary. The British public have made extraordinary sacrifices during the 2020 lockdowns, the Roadmap, and recent Plan B measures in response to the Omicron variant.

The Plan, published yesterday, sets out how vaccines and other pharmaceutical interventions will continue to form our first line of defence. The UK Government has accepted the JCVI recommendation to offer an additional booster to all adults aged over 75, all residents in care homes for older adults, and all over 12s who are immunosuppressed.

An autumn annual booster programme is under consideration, subject to further advice. Further detail on deployment on the spring booster programme will be set out in due course. The Government will continue to be guided by the JCVI on future vaccine programmes.

The plan covers four main pillars:

  • Removing domestic restrictions while encouraging safer behaviours through public health advice, in common with longstanding ways of managing other infectious illnesses
  • Protecting the vulnerable through pharmaceutical interventions and testing, in line with other viruses
  • Maintaining resilience against future variants, including through ongoing surveillance, contingency planning and the ability to reintroduce key capabilities such as mass vaccination and testing in an emergency
  • Securing innovations and opportunities from the COVID-19 response, including investment in life sciences

The public are encouraged to continue to follow public health advice, as with all infectious diseases such as the flu, to minimise the chance of catching Covid and help protect family and friends. This includes by letting fresh air in when meeting indoors, wearing a face covering in crowded and enclosed spaces where you come into contact with people you don’t normally meet, and washing your hands.

The Prime Minister yesterday confirmed domestic legal restrictions (in England – Ed.) will end on 24 February as we begin to treat Covid as other infectious diseases such as flu. This means:

  • The remaining domestic restrictions in England will be removed. The legal requirement to self-isolate ends. Until 1 April, we still advise people who test positive to stay at home. Adults and children who test positive are advised to stay at home and avoid contact with other people for at least five full days and then continue to follow the guidance until they have received two negative test results on consecutive days.
  • From April, the Government will update guidance setting out the ongoing steps that people with COVID-19 should take to be careful and considerate of others, similar to advice on other infectious diseases. This will align with testing changes.
  • Self-isolation support payments, national funding for practical support and the medicine delivery service will no longer be available.
  • Routine contact tracing ends, including venue check-ins on the NHS COVID-19 app.
  • Fully vaccinated adults and those aged under 18 who are close contacts are no longer advised to test daily for seven days and the legal requirement for close contacts who are not fully vaccinated to self-isolate will be removed.

Our testing programme has been a crucial part of our response to the virus. Over 2 billion lateral flow tests have been provided across the UK since 2020 ensuring people could stay safe and meet family and friends knowing they were free of the virus.

As set out in the Autumn and Winter Plan, universal free provision of tests will end as our response to the virus changes.

From the start of April, the government will end free symptomatic and asymptomatic testing for the general public.

Limited symptomatic testing will be available for a small number of at-risk groups and we will set out further details on which groups will be eligible shortly. Free symptomatic testing will also remain available to social care staff. We are working with retailers to ensure that everyone who wants to can buy a test.

The Test & Trace programme cost £15.7 billion in 2021/22. With Omicron now the dominant variant and less severe, levels of high immunity across the country and a range of strategies in place including vaccines, treatments, and public health knowledge, the value for taxpayers’ money is now less clear. Free testing should rightly be focused on at-risk groups.

The Government remains ready to respond if a new variant emerges and places unsustainable pressure on the NHS, through surveillance systems and contingency measures such as increased testing capacity or vaccine programmes. Our world-leading ONS survey will allow us to continue to track the virus in granular detail to help us spot any surges in the virus.

Further changes being made include: * Today the guidance has been removed for staff and students in most education and childcare settings to undertake twice weekly asymptomatic testing. * On 24 February, removing additional local authority powers to tackle local COVID-19 outbreaks (No.3 regulations). Local Authorities will manage local outbreaks in high-risk settings as they do with other infectious diseases. * On 24 March, the Government will also remove the COVID-19 provisions within the Statutory Sick Pay and Employment and Support Allowance regulations.

From 1 April, the UK Government will:

  • Remove the current guidance on voluntary COVID-status certification in domestic settings and no longer recommend that certain venues use the NHS COVID Pass.
  • No longer provide free universal symptomatic and asymptomatic testing for the general public in England.
  • Remove the health and safety requirement for every employer to explicitly consider COVID-19 in their risk assessments.

PM statement on living with COVID

Prime Minister Boris Johnson made a statement in the House of Commons on the government’s strategy for living with COVID.

Mr Speaker, with permission I will make a statement on our strategy for living with Covid.

And before I begin, I know the whole House will join me in sending our best wishes to Her Majesty the Queen for a full and swift recovery.

It is a reminder that this virus has not gone away, but because of the efforts we have made as a country over the past two years we can now deal with it in a very different way, moving from government restrictions to personal responsibility.

So we protect ourselves without losing our liberties – and maintaining our contingency capabilities so we can respond rapidly to any new variant.

Mr Speaker, the UK was the first country in the world to administer an approved vaccine, and the first European nation to protect half our population with at least one dose.

And having made that decision to refocus our NHS this Winter on the campaign to Get Boosted Now, we were the first major European nation to boost half our population too.

And it is because of the extraordinary success of this vaccination programme, that we have been able to lift our restrictions earlier than other comparable countries, opening up last summer, while others remained closed, and keeping things open this winter, when others shut down again, making us one of the most open economies and societies in Europe, with the fastest growth anywhere in the G7 last year.

And while the pandemic is not over, we have now passed the peak of the Omicron wave, with cases falling, hospitalisations in England now fewer than 10,000 and still falling, and the link between infection and severe disease substantially weakened.

Over 71 per cent of all adults are now boosted in England, including 93 per cent of those 70 and over, and together with the treatments and scientific understanding of the virus we have built up, we now have sufficient levels of immunity to complete the transition from protecting people with government interventions to relying on vaccines and treatments as our first line of defence.

As we have throughout the past two years, we will continue to work closely with the Devolved Administrations as they decide how to take forward their own plans, and today’s strategy shows how we will structure our approach in England around four principles.

First, we will remove all remaining domestic restrictions in law.

From this Thursday, 24 February, we will end the legal requirement to self-isolate following a positive test, and so we will also end self-isolation support payments, although Covid provisions for Statutory Sick Pay can still be claimed for a further month.

We will end routine contact tracing, and no longer ask fully vaccinated close contacts and those under 18 to test daily for seven days.

And we will remove the legal requirement for close contacts who are not fully vaccinated to self-isolate.

Until 1 April, we will still advise people who test positive to stay at home. But after that, we will encourage people with Covid-19 symptoms to exercise personal responsibility, just as we encourage people who may have flu to be considerate to others.

Mr Speaker, it is only because levels of immunity are so high and deaths are now, if anything, below where you would normally expect for this time of year, that we can lift these restrictions.

And it is only because we know Omicron is less severe, that testing for Omicron on the colossal scale we have been doing is much less important, and much less valuable in preventing serious illness.

We should be proud that the UK established the biggest testing programme per person of any large country in the world.

But this came at a vast cost.

The Testing, Tracing and Isolation budget in 2020-21 exceeded the entire budget of the Home Office.

It cost a further £15.7 billion in this financial year, and £2 billion in January alone at the height of the Omicron wave.

We must now scale this back.

From today, we are removing the guidance for staff and students in most education and childcare settings to undertake twice weekly asymptomatic testing.

And from 1st April, when Winter is over and the virus will spread less easily, we will end free symptomatic and asymptomatic testing for the general public.

We will continue to provide free symptomatic tests to the oldest age groups and those most vulnerable to Covid.

And in line with the practice in many other countries, we are working with retailers to ensure that everyone who wants to can buy a test.

From April 1st, we will also no longer recommend the use of voluntary Covid-status certification, although the NHS app will continue to allow people to indicate their vaccination status for international travel.

And Mr Speaker, the government will also expire all temporary provisions of the Coronavirus Act.

Of the original 40, 20 have already expired, 16 will expire on 24 March, and the last 4 relating to innovations in public service will expire six months later, after we have made those improvements permanent via other means.

Second, we will continue to protect the most vulnerable with targeted vaccines and treatments.

The UK government has procured enough doses of vaccine to anticipate a wide range of possible JCVI recommendations. And today we are taking further action to guard against a possible resurgence of the virus, accepting JCVI advice for a new Spring booster offered to those aged 75 and over, older care home residents, and those over 12 who are immunosuppressed.

The UK is also leading the way on antivirals and therapeutics, with our AntiVirals Task Force securing a supply of almost 5 million – more per head than any other country in Europe.

Third, SAGE advise there is considerable uncertainty about the future path of the pandemic, and there may of course be significant resurgences.

They are certain there will be new variants and it’s very possible those will be worse than Omicron.

So we will maintain our resilience to manage and respond to these risks, including our world-leading ONS survey, which will allow us to continue tracking the virus in granular detail, with regional and age breakdowns helping us spot surges as and where they happen, and our laboratory networks will help us understand the evolution of the virus and identify any changes in characteristics.

We will prepare and maintain our capabilities to ramp up testing.

We will continue to support other countries in developing their own surveillance capabilities, because a new variant can emerge anywhere.

And we will meet our commitment to donate 100 million vaccine doses by June, as our part of the agreement at the UK’s G7 summit to provide a billion doses to vaccinate the world over the next year.

In all circumstances, our aim will be to manage and respond to future risks through more routine public health interventions, with pharmaceutical interventions as the first line of defence.

Fourth, we will build on the innovation that has defined the best of our response to the pandemic.

The Vaccines Task Force will continue to ensure the UK has access to effective vaccines as they become available, already securing contracts with manufacturers trialling bi-valent vaccines, which would provide protection against Covid variants.

The Therapeutics Task Force will continue to support seven national priority clinical trial platforms focused on prevention, novel treatments and treatment for long-Covid.

We are refreshing our biosecurity strategy to protect the UK against natural zoonosis and accidental laboratory leaks, as well as the potential for biological threats emanating from state and non-state actors.

And building on the Five Point Plan I set out at the United Nations and the agreements reached at the UK’s G7 last year, we are working with our international partners on future pandemic preparedness, including through a new pandemic treaty, an effective early warning system or Global Pandemic Radar, and a mission to make safe and effective diagnostics, therapeutics and vaccines available within the first 100 days of a future pandemic threat being identified.

And we will be hosting a global pandemic preparedness summit next month.

And Mr Speaker, Covid will not suddenly disappear.

So those who would wait for a total end to this war before lifting the remaining regulations, would be restricting the liberties of the British people for a long time to come.

This government does not believe that is right or necessary.

Restrictions pose a heavy toll on our economy, our society, our mental wellbeing, and the life chances of our children.

And we do not need to pay that cost any longer.

We have a population that is protected by the biggest vaccination programme in our history.

We have the antivirals, the treatments, and the scientific understanding of this virus, and we have the capabilities to respond rapidly to any resurgence or new variant.

And Mr Speaker it is time to get our confidence back.

We don’t need laws to compel people to be considerate of others.

We can rely on that sense of responsibility towards one another, providing practical advice in the knowledge that people will follow it to avoid infecting loved ones and others.

So let us learn to live with this virus and continue protecting ourselves without restricting our freedoms.

And in that spirit, I commend this Statement to the House.

PM statement at Covid press conference

The Prime Minister gave a press conference on the plan to live with COVID-19

Good evening, when the pandemic began, we had little knowledge of this virus and none about the vaccines and treatments we have today.

So there was no option but to use government regulations to protect our NHS and save lives.

But those restrictions on our liberties have brought grave costs to our economy, our society, and the chances of our children.

So from the outset, we were clear that we must chart a course back towards normality as rapidly as possible, by developing the vaccines and treatments that could gradually replace those restrictions.

And as a result of possibly the greatest national effort in our peacetime history, that is exactly what we have done.

Thanks to our brilliant scientists.

Thanks to the extraordinary men and women of our NHS and to every one of you who has come forwards to get jabbed and get boosted – the United Kingdom has become the first country in the world to administer an approved vaccine, and the fastest major European nation to roll out both the vaccines and the booster to half our population.

We have emerged from the teeth of the pandemic before many others, retaining one of the most open economies and societies in Europe and the fastest growth in the G7 last year.

And while the pandemic is not over, we have passed the peak of the Omicron wave, with cases falling, and hospitalisations in England now fewer than 10,000 and still falling, and so now we have the chance to complete that transition back towards normality, while maintaining the contingencies to respond to a resurgence or a new variant.

As we have done throughout the past two years, we will continue to work with the Devolved Administrations as they decide how to take forwards their own plans.

In England, we will remove all remaining domestic restrictions in law.

From this Thursday, it will no longer be law to self-isolate if you test positive, and so we will also end the provision of self-isolation support payments, although Statutory Sick Pay can still be claimed for a further month.

If you’re a fully vaccinated close contact or under 18 you will no longer be asked to test daily for seven days.

And if you are close contact who is not fully vaccinated you will no longer be required to self-isolate.

Until 1 April, we will still advise you to stay at home if you test positive.

But after that, we will encourage people with Covid symptoms to exercise personal responsibility, just as we encourage people who may have flu to be considerate towards others.

It is only because levels of immunity are so high and deaths are now, if anything, below where you would normally expect for this time of year that we can lift these restrictions.

And it is only because we know Omicron is less severe, that testing for Omicron on the colossal scale we have been doing is now much less valuable in preventing serious illness.

We should be proud that the UK established the biggest testing programme per person of any large country in the world.

But its budget in the last financial year was bigger than the Home Office – and it cost – the testing programme cost – £2 billion just last month alone.

So we must scale back and prioritise our resources for the most vulnerable.

From today, staff and students in most education and childcare settings will no longer be asked to undertake twice weekly asymptomatic testing.

And from 1st April, we will end free symptomatic and asymptomatic testing for the general public.

But we will continue providing free symptomatic tests to those at the highest risk from Covid.

And in line with the practice of many other countries, we are working with retailers to ensure you will always be able to buy a test.

We should be clear the pandemic is not over and there may be significant resurgences.

Our scientists are certain there will be new variants and it’s very possible that those will be worse than Omicron.

So we will continue to protect the most vulnerable with targeted vaccinations and treatments and we have bought enough doses of vaccine to anticipate a wide range of possible JCVI recommendations.

Today this includes a new Spring booster, which will be offered to those aged 75 and over, older care home residents, and those over 12 who are immunosuppressed.

We will also retain disease surveillance systems and contingency measures which can ensure our resilience in the face of future waves or new variants.

And we will build on the innovations that defined the very best of our response to the pandemic, including continuing the work of the Vaccines Task Force, which has already secured contracts with manufacturers trialling new vaccines which could provide protection against new variants.

Today is not the day we can declare victory over Covid, because this virus is not going away.

But it is the day when all the efforts of the last two years finally enabled us to protect ourselves while restoring our liberties in full.

And after two of the darkest grimmest years in our peacetime history, I do believe this is a moment of pride for our nation and a source of hope for all that we can achieve in the years to come.

Thank you very much.

REACTION:

Responding to the statement from the Prime Minster on the Government’s ‘Living with Covid’ strategy, which includes the removal of free Covid-19 tests for the public from 1 April in England, Dr Chaand Nagpaul, BMA council chair, said: “Today’s announcement fails to protect those at highest risk of harm from Covid-19, and neglects some of the most vulnerable people in society.

“We recognise the need, after two years of the pandemic, to begin thinking about how we adjust our lives to manage living alongside Covid-19, but as the BMA has persistently said the decision to bring forward the removal of all protective measures while cases, deaths and the number of people seriously ill remain so high is premature.

“Living with Covid-19 must not mean ignoring the virus all together – which in many respects the Government’s plan in England seems to do.

“On the one hand the Government says it will keep monitoring the spread of the virus, and asks individuals to take greater responsibility for their own decisions, but by removing free testing for the vast majority of the population on the other, ministers are taking away the central tool to allow both of these to happen.

“Far from giving people more freedom, today’s announcement is likely to cause more uncertainty and anxiety.

“Crucially, it will create a two-tier system, where those who can afford to pay for testing – and indeed to self-isolate – will do so, while others will be forced to gamble on the health of themselves and others.

“Covid-19 has already disproportionately impacted those on lower incomes, in insecure employment and from ethnic minorities. This move threatens to exacerbate these health inequalities.

“People will want to do the right thing, and not knowingly put others at risk if they are infected, but how can they make such a judgement if they have no way of knowing if they’re carrying the virus or not? This is especially important for those who come into contact with people who are at much greater risk of becoming ill with Covid-19, such as elderly relatives or those who are clinically vulnerable.

“Providing free tests to clinically vulnerable people – and only once they develop symptoms and are potentially very unwell – but not providing any free tests to friends or family who come into contact with them is completely illogical, as the priority should be protecting them from infection in the first place. The same goes for care home staff, who will only be tested if they have symptoms, by which time they could have passed on the virus to vulnerable residents.

“There must also be urgent clarity around testing provision for NHS workers. People visit hospitals and surgeries to get better, and not to be exposed to deadly viruses, and the continuation of testing for healthcare workers is invaluable in protecting both staff and patients.

“That plans are underway for a new booster programme is sensible but we must not – as we have continued to state – rely solely on vaccination to protect the nation. The necessity for further boosters underlines that Covid-19 will continue to present a challenge for healthcare services and wider society for potentially many years to come. And while the Prime Minister talks about Omicron resulting in a mild illness for most, others will still become very unwell with Covid-19, and an estimated more than one million people continue to live with long-Covid – themselves needing ongoing care.

“As part of ‘learning to live with Covid’, protections must be maintained for the most vulnerable, including the provision of enhanced face masks, and clear guidance for both patients and clinicians.

“Meanwhile, all people must be financially supported to do the right thing, and the removal of self-isolation payments, and then access to statutory sick pay in a months’ time, is incredibly concerning, as it will mean people cannot afford to stay at home if they are unwell. In healthcare settings, enhanced infection prevention measures – including mask-wearing for patients and enhanced PPE for staff – must remain, while in the longer-term premises are in desperate need of improvements, such as higher standards of ventilation, to limit the spread of infections.

“And with such a planned scale back of free testing, it is imperative that the Government keeps its commitment to continue other surveillance methods, including the ONS infection survey1, and to not hesitate to act on worrying surges of infections or new dangerous variants.”

Responding to today’s ending of Covid restrictions, Morgan Vine, Head of Policy and Influencing at older people’s charity Independent Age, said: “We know that many people aged 65 and over are worried about the upcoming relaxation of Covid restrictions, particularly the ending of self-isolation.

“We are concerned that this sudden change in direction of public safety is likely to increase anxiety among older people, and even cause some to shield themselves and limit daily activities.

“Our research revealed that the challenges faced by those in later life due to the pandemic have worsened many people’s mental health with many people we spoke to expressing fear at catching the virus in public settings. If the requirement to isolate is removed at the same time free lateral flow tests for most age groups stop, this fear is likely to increase as is the likelihood of coming into contact with someone who has Covid.

“Recent polling showed that a majority (56%) of older people thought isolating should always be a requirement for somebody who has tested positive for Covid, and a further 27% said it should at least be a requirement for the next few months.

“It’s essential that older people are able to live their daily lives safely. Now the government has announced the relaxation, it must clarify how it plans to protect those in later life from the virus.”

First Minister Nicola Sturgeon will lay out Scotland’s response when she addresses the Holyrood parliament this afternoon.

So Boris Johson urges ‘personal responsibility’? Yes, Boris ‘Partygate’ Johnson – the great leader who would not even follow the rules he wrote himself? Oh, the irony! It really would be funny it it wasn’t quite so serious. #covid #gieyetheboak

They think it’s all over: Boris Johnson set to sweep away Covid regulations in England

Living with Covid doesn’t mean ignoring it, says BMA ahead of PM announcement

Prime Minister Boris Johnson says his latest “living with Covid” recovery plan will return people’s freedom as he prepares to scrap the legal duty to self-isolate in England.

The prime minister will meet the Cabinet later this morning before updating parliament on his plans this afternoon.

Mr Johnson said the end to restrictions would “mark a moment of pride as we begin to learn to live with Covid” – despite serious concerns being expressed by health professionals.

Health organisations have warned that Johnson’s determination to sweep away Covid regulations are premature.

WHATEVER HAPPENED TO ‘FOLLOWING THE SCIENCE’?

Responding to calls from NHS leaders for free Covid tests and self-isolation rules to continue ahead of the UK Government’s Living With Covid Strategy announcement today, Dr Chaand Nagpaul, BMA council chair, said: “It’s clear that we will have to learn to adjust to the reality of Covid-19.

“However, the BMA agrees with NHS leaders that living with Covid doesn’t mean ignoring its continued harm to many, and must not result in removing protections to some of the most vulnerable in our society. 

Scrapping all restrictions and allowing the infection to spread in an unmonitored and unfettered manner would be damaging to the health of millions, including for those who go on to suffer Long Covid symptoms.

“Without access to free testing for the public or a legal requirement for the sick to self-isolate, protecting others from illness and surveillance of the disease and its prevalence vanishes; we won’t know where outbreaks are happening, whether they are circulating among more vulnerable populations, and this means local public health teams will be lacking key information to be able to respond effectively to Covid outbreaks in their local areas.

“Charging for tests  will only discourage people from checking if they have Covid, especially if their symptoms are mild enough for them to continue socialising and mixing with others.  

“Currently, case rates remain exceptionally high. When Plan B measures were introduced in December, there were 7,373 patients in hospital in the UK. While rates are now falling, the latest figure sits at 11,721. The ONS also estimates that around 1 in 20 people in England were infected last week, and there continues to be significant work absence due to Covid. 

“The decision to remove all restrictions is not based on current evidence and is premature. It clearly hasn’t been guided by data or done in consultation with the healthcare profession. 

As the BMA has previously warned, Covid poses a serious risk to public health as well as NHS capacity if cases are allowed to spread rapidly again. Living with Covid-19 doesn’t mean ignoring it. As well as keeping free testing and self-isolation measures, it’s vital that the ONS infection survey carries on, and that local authorities are supported to contain outbreaks with necessary restrictions. 

“This is particularly important for protecting the vulnerable, and Government must ensure that these groups are allowed to live as normal a life as possible as the pandemic subsides. This means giving them access to free FFP2/3 masks where required so they can protect themselves, and providing healthcare professionals with clear, clinical guidance to advise them and other patients in the community.

“Healthcare settings are places which people attend to get better not to get sick, so it would be totally wrong to remove the protections in healthcare settings that currently exist, such as mask wearing, without discussion with healthcare workers and without evidence to support it.

“Only yesterday, the World Health Organisation released updated guidance for contact tracing and quarantine, saying in its report that any interruption or shortening of these measures will increase the risk of onward transmission.

“Of course, we all want to see a time when measures are no longer needed. However, relaxing them must be done sensibly, based on data, and gradually, in consultation with the profession, and not at the cost of public health or our already-stretched NHS.”

Leaving it up to individuals and employers to decide on isolation periods will place health care staff and patients at risk, the Royal College of Nursing has warned.

the government is expected to confirm plans to end the legal requirement to self-isolate following a positive COVID-19 test, in a move described as signalling the end of the pandemic.

But the pandemic is far from over for health care staff, and the lack of clarity and guidance on isolation rules going forwards could put our members and their patients at risk.

By “passing the buck” to nursing staff and employers to decide when to work if staff fall sick with COVID-19, the government is leaving the way open to increased infection rates and yet more pressure on an already overworked NHS.

The RCN is calling for the government to produce a specific plan for nursing staff working in health and social care which supports them when unwell.

RCN General Secretary & Chief Executive, Pat Cullen, said: “Ending the legal requirement to self-isolate following a positive test is a big leap in the dark. The government has yet to present any scientific evidence to support its plan.

“The public messaging around this is very mixed and unclear: with any other highly infectious disease you would be expected – and supported – to stay away from work if you caught it, yet with COVID-19 we’re being told you should learn to live with it. This doesn’t add up.

“Health and social care isn’t like other sectors – staff treat some of the most vulnerable in society whose wellbeing, and their own, mustn’t be put at risk.”

The RCN also stresses that nursing staff must continue to have access to free lateral flow tests for their and their patients’ sake amid reports they could be scrapped.

Despite advice and warnings from a range of health professionals the Prime Minister seems determined to take the gamble and sweep away Covid regulations, however, and whatever is decided in England will have an impact on public health in the other nations of the UK.

First Minister Nicola Sturgeon is expected to announce the Scottish Government’s response tomorrow.