The Week in 10 | Danny Mortimer

The Week In 10 newsletter

Our Week in 10 blog provides the latest intelligence and insight from our members across the health system. As the only membership organisation that brings together, supports and speaks on behalf of all healthcare organisations in England, Wales and Northern Ireland, we are uniquely placed to ensure the views of healthcare leaders across the system influence the government and its national bodies.

This blog, from NHS Confederation chief executive Danny Mortimer, captures what we are hearing from our members and how we are using your insights to influence on your behalf.

01 Speaking on your behalf  

The public profile of our work on your behalf is much higher during the pandemic. We, of course, continue to speak candidly and privately with national politicians, officials and arm's-length bodies, as well as colleagues in other sectors and healthcare representatives. Some of the issues raised are described below, but other important issues we have raised include: the coordination challenges and duplication in many areas of national and regional interaction with you; the need for national organisations to recalibrate their non-COVID-19 priorities and requests in light of the present pressures you are under (as they did in the spring); and the need for direct reporting of the impact of the virus on the NHS. 

02 Countering COVID-19 deniers 

We are now in the highest COVID-19 alert level and we know there is a material risk of some services being overwhelmed. Despite this, there is a growing number of commentators who believe the threat from COVID-19 is overplayed. We know this is an issue of concern to you, given it is damaging staff morale and the impact it could have on public behaviour. That’s why I and my senior team have been touring the news channels and talk shows to counter these myths. This will continue to be a high priority for us in the weeks to come. 

  • This week, I issued a statement saying the latest figures need to be a wake-up call to the stark impact the pandemic is having on our friends, neighbours and loved ones, and the daily battle being played out across all health and care services. 
  • I also spoke to Sky News, LBC and TalkRadio, among others, about the pressures you are facing.

03 Vaccine rollout

Our members will be instrumental in rolling out the vaccine. But you have raised concerns about a range of operational issues, including last-minute cancellations or postponements of deliveries, that need to be put right. We are making NHSEI and DHSC aware on a daily basis. Working with our PCN members, we went public with their concerns about a last-minute JCVI change to when the second dose should be administered. We are clear these last-minute changes damage staff morale and their ability to deliver the vaccine.

04 Workforce capacity and wellbeing 

We are hearing widespread concerns about staff absence levels, with pockets of absence in some local areas at extreme levels. This is being compounded by some members reporting that their staff are being abused by the public. We continue to speak out publicly for greater public understanding about the pressures that your staff are under. We are exploring whether there is more coordinated action we can take with the unions and other professional bodies to counter this.

05 Non-COVID-19 service delivery

Members are telling us that they are close to the limit with their capacity, with more units being closed due to COVID-19 outbreaks. Some trusts in London are days away from being overwhelmed. We continue to make clear that all parts of the NHS will do all they can to maintain non-COVID-19 services, despite the inevitable disruption to services. We are also exploring ways to give a more public platform to what other parts of the NHS are facing in these very challenging times.

06 Ambulance pressures 

Our ambulance sector members are reporting a spike in the operational pressure they are under. Staff absences are causing delays in answering 999 calls, while maintaining social distancing for staff in 111/ 999 call centres is proving a real challenge. Ambulance services are experiencing turnaround delays at some sites and there are challenges in supporting acute trusts to achieve effective discharge and flow out of hospitals. We will continue to give a public platform to these pressures so that public awareness is raised.

07 Test and Trace

We remain very concerned at the lack of progress with Test and Trace. Only a third of results for in-person COVID-19 tests were received within 24 hours – this isn’t enough to stem the rising tide of infections. We’re also concerned the true figure for close contacts reached and asked to self-isolate is masked by the fact that under-18s and other adults in the same household are no longer included. We are raising concerns with DHSC that if we do not have the full picture, then we cannot know how effective the system is.

08 Integration and system working

Following months of events, surveys and other engagement with our provider, CCG, PCN and ICS members, we have today responded to the NHSEI integrated care legislative options paper. There is consensus across our membership that now is the right time to further embed collaboration and integration into the NHS architecture through legislation. But there are several issues that require further development and we have raised these in our response. Our paper outlines the range of views of our members across the system, including where there is clear consensus.

09 Elective backlog 

The news this week that a number of trusts are struggling with the cancellation of P1/2 procedures highlights the long-term issue with elective care that we now face. 

10 Brexit

As you know, a trade and cooperation agreement was concluded between the UK and EU on Christmas Eve. This has been a key focus of the Confederation’s work through our NHS European Office. The deal addresses many of the issues that we – on your behalf – have asked of the government over the last four years. We have produced a briefing which explains the key implications for the NHS and our international director, Dr Layla McCay, has written this blog.

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