DAUK is part of SOS NHS Coalition of health organisations and unions which has written to the prospective prime minister urging him to secure the long-term future of the NHS.

The letter, which has been featured in the Guardian, also asks Burnham to meet members of the coalition to listen to their experiences of the NHS and social care.

Meanwhile, DAUK GP co-lead Dr Steve Taylor has contributed to an article exploring ‘a surge in portfolio working’ among GPs.

Underemployed and unemployed GPs

GP Online has reported that two-thirds of UK doctors have portfolio careers, which combine clinical work with work in other areas such as teaching and research.

Dr Taylor said: “There’s the element of underemployed and unemployed GPs – many have been forced to look for alternatives.

“It’s also the case that the intensity of working five days a week in NHS general practice is too high.”

Dr Taylor also provided comment to GP Online on its report that half of GP workforce growth in the last financial year came from jobs created through the additional roles reimbursement scheme (ARRS).

Workforce rebalancing

He said: “There needs to be a rebalancing of the workforce, because we’ve been under-employing GPs for some time.”

Elsewhere, Dr Taylor welcomed new NHS England guidance for planned patient care which sets out what patients and carers should expect when patients are referred for non-urgent NHS care as ‘a step in the right direction’ but said it ‘doesn’t go far enough’.

Speaking to Pulse, he said: “Patients are currently left in the dark about the referral process and where they are on the journey to seeing a specialist or waiting for an investigation. This should save some time for GP practices.”

Picture credit: Andy Burnham/Facebook

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NHS staff treating Covid patients should be given much more protective facewear than thin surgical masks to help them avoid getting infected during the Omicron rise, doctors say.

The British Medical Association (BMA), Hospital Consultants and Specialists Association (HCSA) and Doctors’ Association UK are calling for frontline personnel to be given FFP3 masks.

Read the full article here

My day today started at 6am, faced with a roster of e-consults, alongside breastfeeding breaks and nappy changes, occasionally interrupted by a vocal toddler running in when he tires of daddy daycare. I am a part-time GP, and mother to a two-year-old and a six-month-old. It’s not how I envisioned my medical career – but it works for me, for now. In our brave new world of telemedicine and remote consulting, I was able to return to work for the NHS when my baby was only a month old, while arranging face-to-face appointments with colleagues judged on what I feel my patient needs.

Today’s plans from Sajid Javid to “ramp up” in-person consultations, are no more than a political soundbite; his offer of £250m a soggy sticking plaster which cannot buy non-existing GPs or extra consulting rooms. So am I the problem? If you want to play the government’s blame game then I’m an easy target – part-time, a remote worker. Javid announced plans to list surgeries on league tables, exposing those failing to offer appropriate “access” to patients – essentially naming and shaming practices. However, viewed another way, I could be part of the solution. Flexible working needs to be welcomed within the NHS in an attempt to hold on to an ever-dwindling, increasingly burnt-out workforce. I can be a mum, provide for my family and continue to contribute to the NHS.Advertisementhttps://4800587f1a4e419d18e917774cd01981.safeframe.googlesyndication.com/safeframe/1-0-38/html/container.html

“Call-centre doctor” is no one’s dream job, but this new way of working must be incorporated. Our practice gets emails every day from patients expecting e-consults. We’ll never be able to go fully back to the old system. That doesn’t seem to have got through to the government yet. I believe politicians should leave to healthcare professionals the decision on returning to face-to-face consultations. The health secretary has provided no evidence or modelling on the current supply and demand in primary care to warrant a return to “blanket face to face”. Nor has he given the public realistic expectations on how long they might wait to see a GP face to face, as opposed to undergoing a telephone triage – it might be a month’s wait, instead of two hours. Much of what I deal with remotely doesn’t need to be seen in person: fitness notes, contraceptive pill checks, follow-up of blood tests and discussions about mental health problems. With e-consults, patients can submit their queries via email and have a response within 48 hours, without the risk of picking up Covid from a crowded waiting room – if they now request a face to face appointment as “their right”, that’s fine, but they will be waiting a lot longer for a response.Javid’s GP rescue plan will fail to ‘turn the tide’, says former Tory health secretary Jeremy Hunt – as it happenedRead more

Things haven’t all been great with work-from-home: the notion of set working hours has gone out of the window, for one. But GPs and their teams need to be trusted to deliver care in the most appropriate way for their local populations. Face-to-face care in general practice never stopped when needed. Remote consulting was mandated during the pandemic to protect patients and, according to NHS England’s patient survey in July, they are happy with the care they received. The benefits of telemedicine have been embraced for years by private companies such as Babylon and GP at Hand, and the NHS is only just catching up, ensuring the limited resources provided by the government get to the people who need them most.

We have a crisis in general practice which goes way beyond money. Despite government promises in 2019 to deliver 6,000 more doctors, GP numbers have fallen – through burnout, early retirement and emigration. Most GPs are working 12 hours or more a day, and “part-time” GPs clock up the same number of hours as most 9-5 workers. Abuse has become endemic. Last month, four practice staff in Manchester were hospitalised – one with a skull fracture – from a disgruntled patient. I’ve been screamed and shouted at down the phone on more occasions than I can count. Much of this abuse has been legitimised by some sections of the media with their clickbait anti-GP campaign. Politicians have not been blameless, with Boris Johnson, Sajid Javid and Jacob Rees-Mogg all making it clear in recent weeks that they expect GPs to go back to pre-Covid working conditions. But we’re still battling a pandemic. With winter approaching, I fear for our vulnerable patients. Is it right to encourage them to sit in doctors’ waiting rooms? Yet another example of our leaders being out of touch with general practice.Advertisement

This needs to stop. Blaming GPs deflects attention from this week’s damning Commons inquiry which exposes the failures of the UK government in the handling of the pandemic. The NHS was underfunded before this crisis hit, and the pandemic has only made the cracks in the system more visible. We need an independent investigation into the real problems around GP access, with GPs involved in the plan. It is worth remembering that GPs want nothing more than to provide good standards of care for patients.

If general practice fails, the NHS fails. There are solutions to this crisis, but the health secretary’s gestures today are sadly adding to the problems rather than solving them.

Read the original Guardian piece here

Dr. Jenny Vaughan, chair of the Doctors’ Association states that the review into this case should have been released as soon as possible, in order to learn lessons.

The chief executive at Matt Hancock’s local hospital is to step down before the publication of a delayed review into bullying allegations involving an unprecedented demand for fingerprints from senior clinicians first revealed by the Guardian.

In January 2020, a “rapid review” was ordered into claims of a “witch-hunt” at West Suffolk hospital trust, from which the former health secretary had to recuse himself because of his friendship with the trust’s chief executive, Stephen Dunn.

On Tuesday, Dunn announced he was resigning after what he acknowledged were “operational, structural and cultural challenges within the trust”. The trust’s deputy chief executive, Craig Black, will be taking over as interim chief executive while a replacement is found.

Dunn’s exit, after seven years in charge at the Bury St Edmunds-based trust, follows the departure of the trust’s medical director, Nick Jenkins, who stepped down to support his family. Its chief operating officer, Helen Beck, is due to retire in November.

The NHS has been criticised for taking its time to publish a review that had initially been promised in April 2020, but was delayed ostensibly because of the pandemic. In December, the Doctors’ Association UK said it suspected the conclusions were being sat on because they were likely to make embarrassing reading for Dunn, who was once described by Hancock as a “brilliant leader”.

Dunn was urged by the Royal College of Anaesthetists to end the “toxic management culture” after the Guardian revealed the trust had demanded fingerprint samples of senior clinicians in the hunt for a whistleblower who had tipped off a family about a potentially botched operation.

John Warby, whose wife, Susan, died after an operation in August 2018, was sent an anonymous letter highlighting errors in her procedure. A coroner concluded that errors in her care had contributed to her death. This led to a search for the whistleblower, which health unions described as a “witch-hunt”.

The incident, and other failings in patient safety, contributed to the hospital in January becoming the first to be relegated by Care Quality Commission (CQC) inspectors from “outstanding” to “requires improvement”.

Weeks before Warby’s operation, Patricia Mills, a consultant anaesthetist at the trust, had, along with a number of other colleagues, formally raised the alarm internally about patient safety over a doctor who had been seen injecting himself with drugs.

Dozens of staff had accessed Warby’s hospital records, but it was those who had expressed concern about the drug-taking doctor who were asked to provide fingerprint and handwriting samples, insiders claim.

As the same doctor was involved in Warby’s care, Mills, along with other colleagues who had complained, was immediately suspected by those investigating the leak of alerting her family to the errors.

Mills has consistently denied this. But managers demanded that she and other senior staff provide fingerprint and handwriting samples to prove it.

In an email seen by the Guardian, Beck had warned Mills that any failure to provide fingerprints “could be considered as evidence which implicates you as being involved in the writing of the letter”. Despite the email, Dunn claimed staff had not been threatened to provide fingerprints, and that the request was only voluntary.

In his resignation statement, Dunn said: “The last 18 months has presented operational, structural, and cultural challenges within the trust, with a challenging Care Quality Commission inspection locally and the overwhelming impact of the pandemic taking a toll on us all. I have been thinking about my position for some time but felt it was my duty to our amazing staff to lead the trust through one of the most difficult times it has ever faced.

“Now is the right time to step down, as we emerge from the brutal pandemic and refresh our strategy for the future.”

The trust’s chair, Sheila Childerhouse, said Dunn had led the trust with “passion and dedication”. She added: “We thank him for his commitment and leadership over the last seven years.”

Dr Jenny Vaughan of the Doctors’ Association said: “Our concern is that the report of the review into bullying allegations should have been published as soon as possible so that vital lessons could have been learned in a timely fashion. It has still not seen the light of day despite recent changes in the leadership of the hospital.

“Figures show that less than 60% of West Suffolk staff feel they are treated fairly when they raise patient safety concerns. We hope, despite this, that the report will be totally rigorous when it comes to examining the actions of the executive. An open safety culture is always better for patient care.”

Read the full article here.

Dr Kaveri Jalundhwala, co-chair of DAUK, urges youths to get a jab saying Covid patients are ‘getting younger and younger’, as well as highlighting the risk of long Covid, having experienced the condition herself.

Increasing numbers of young people with coronavirus are being admitted to hospital – including to intensive care wards – doctors have said, begging them not to “suffer unnecessarily” and to get the vaccine.

During the first weekend after the majority of Covid restrictions were lifted in England there were pictures of crowded nightclubs, filled with revellers not wearing masks or social distancing. Medics raised the alarm that unvaccinated young people urgently needed to protect themselves against infection to avoid serious illness.

The warning came as scientists gave a cautious welcome to the fifth day in a row of falling Covid case rates – the first time that cases have seen a sustained fall without a national lockdown. These figures, however, do not include the impact of 19 July’s easing of restrictions.

The UK recorded 29,173 new cases on Sunday, down from 48,161 the week before. But NHS England said one-third of 18- to 29-year-olds had still not had at least one dose of the vaccine – a figure that falls to one in 10 for the whole adult population.

While young people are generally at a much lower risk of dying from Covid, doctors say they are increasingly witnessing them become severely unwell. Dr Samantha Batt-Rawden, senior intensive care registrar, said the patients they were seeing were “getting younger and younger”.

“The vast majority of those requiring intensive care are unvaccinated: some of them will die. It is heartbreaking for us as NHS staff to watch people suffer unnecessarily knowing that this almost certainly could have been prevented by the vaccine,” she said.

“We are seeing patients in their 30s, or even in their 20s, who are fit and have no other medical problems on ICUs [intensive care units]. As an ICU doctor I am begging you to have the vaccine. Please don’t let not having the jab become the biggest mistake of your life.”

Prof Adam Finn, a member of the Joint Committee on Vaccination and Immunisation and from the University of Bristol, said there had been close to 200 admissions, with a mean age of 40, in the city during the Delta variant wave.

Speaking on LBC on Sunday, he said: “We have had people under 30 on our intensive care unit and also requiring high-level oxygen therapy. This is not always trivial in young adults. There are younger people really getting seriously ill at the moment, so that’s one good reason to think about having the vaccine.

“But the other one is, these vaccines now – it’s clear – do reduce the risk of not only getting the infection but passing it on to other people.”

The latest data from the Office for National Statistics shows that coronavirus in England is now largely an infection among young adults, with cases in 16- to 24-year-olds almost six times more common than in 50- to 69-year-olds.

Many experts had urged the government to postpone the easing of restrictions to allow more adults to get both Covid doses. On Friday, Prof Robert West, a health psychologist at University College London and scientific adviser to the government, accused ministers of allowing infections to rip through the younger population in an effort to bolster levels of immunity before the NHS faces winter pressures.

Dr Adrian Boyle, vice-president of the Royal College of Emergency Medicine, said it was critical young people got vaccinated. He said that while young people getting ill with coronavirus was rare, “suddenly there’s quite a lot of them just because there’s so much Covid around”.

Saffron Cordery, the deputy chief executive of NHS Providers, which represents hospital trusts, said members were reporting “a much higher proportion of younger patients, under 40”.

Cordery also warned of the risk of long Covid. Government data published last month suggested more than 2 million adults in England have experienced coronavirus symptoms lasting more than 12 weeks, although the risk was found to rise with age. “It is important that everyone – whatever their age – understands the risks of remaining unvaccinated,” she said.

Dr Kaveri Jalundhwala, co-chair of Doctors’ Association UK, a campaigning and lobbying group, also highlighted the risk of long Covid, having experienced the condition herself. “Even if only 5% of people are getting long Covid, that’s going to be a huge number of people having a very debilitating condition that might last for a year or longer,” she said.

“It’s more debilitating than people realise. People can’t do their normal jobs any more, they can’t do normal activities, people struggle to walk or do any kind of exercise. We absolutely recommend everybody to get both vaccines as soon as possible, especially with the Delta variant just everywhere at the moment.”

The shadow health secretary, Jonathan Ashworth, described levels of infection among young people as alarming, saying: “Ministers must do more to promote vaccination, ensure young people have time off to get jabbed and open more pop-up vaccination clinics targeted at young people.”

The impact of Covid, and particularly the Delta variant, on young people is also of increasing concern in other countries. In the Netherlands, curbs on bars, restaurants and nightclubs were reimposed after new cases rose sevenfold.

In Australia, the Nobel prize-winning immunologist, Peter Doherty, said on Sunday: “Young people are at considerable risk and at higher risk than with the earlier variants of Covid. Young people shouldn’t think they’re at no risk or even minimal risks. Because it’s going to kill.”

The government’s proposed introduction of vaccine passports has caused significant backlash among Conservative MPs and it is unclear whether the government will be able to assemble a majority behind it.

Ministers are currently considering whether to make them mandatory for Premier League football matches and other events with more than 20,0000 attenders, having already announced their introduction for nightclub entry and “other venues where large crowds gather”.

Finn suggested the move could backfire and a more gentle approach was needed.

“If people begin to feel they are being kind of forced against their will to do something, then in a sense that’s quite a damaging thing to do because it gives people the impression [that] vaccination is something being imposed on them from outside,” he said.

A Department of Health and Social Care spokesperson said:“We have one of the highest Covid-19 vaccine uptake rates in the world. The latest ONS (Office for National Statistics) data shows 90% of adults under 30 have said they would come forward for a vaccine and three in five adults aged 18-24 have already received one dose in England.

“We have worked closely with the NHS to provide information at every opportunity on how to get a vaccine and its benefits – including partnerships with high-profile celebrities, social media platforms, and dating apps to encourage uptake among younger age groups.

“We are continuing to do everything we can to boost uptake for younger people and urge all those who have yet to book their appointment to do so as quickly as possible to help protect themselves and their loved ones.”

Read the full article here.

“The fact that politicians stood on the doorsteps of No 10 clapping while treating NHS staff with such contempt has angered even the most mild-mannered of my colleagues.
And it is this deep, impassible feeling of betrayal which has made people feel they have no option but to leave. A mass exodus from the NHS is no longer a case of if, it’s a case of when.
Staff morale will probably never recover fully. But there is a small window of opportunity now that, if lost, will never be regained. If we don’t start caring about our staff now, there will be no one left to care for our patients.”

– Dr Samantha Batt-Rawden, DAUK founder

Read the full article in The Guardian

Two directors at Matt Hancock’s local hospital are to step down, it has been announced ahead of the publication of a delayed review into a “witch-hunt” for a whistleblower involving an unprecedented demand for fingerprints from senior clinicians.

In January 2020 a “rapid review” was ordered into claims of managing bullying at West Suffolk hospital trust which the health secretary had to recuse himself from because of his friendship with the trust’s chief executive, Steve Dunn.

Days before the review is expected to be published, Dunn emailed staff to announce that two of his colleagues on the board were due to stand down early.

Dr Jenny Vaughan, chair of the Doctors’ Association UK, said: “Doctors that approached DAUK said they felt persecuted. The concern is that this long awaited report has still not seen the light of day and less than 60% of West Suffolk staff feel they are treated fairly when they raise patient safety concerns.

“We note recent events but we agree that family should come first for the medical director. The report we hope will be totally rigorous when it comes to examining the actions of the executive. We look forward to seeing the report as soon as possible.”

Dr Jenny Vaughan

Read the full article here

It’s 4am and resus looks like a bomb has hit it. We have had to open almost every piece of kit available to keep the patient in front of us alive. Wearily, I register there’s blood spattered across my shoes.

It’s been a long night, and there’s still another five hours to go.

“What will you do after this?” the nurse asks. I’d love to say I’ll go for a run before crawling into bed. But on night shifts it’s all I can do to eat, sleep, work, repeat.

“No, I mean after intensive care,” they say. “I think I’m going to retrain.”

It’s a conversation I am having more and more. Some days, it seems like all of my colleagues are making exit plans. I can’t blame them, really.

How did things get this bad? In truth, it was years of neglect of both the NHS and its staff. Decisions made under the previous health secretary came home to roost as the pandemic hit. Cost-cutting was a gamble, and ultimately the NHS paid the price. Months later, the UK would end up with one of the worst death rates in the entire world.

The psychological harm of this is barely talked about, but it is palpable every day in the ICU. While some people are suffering from post-traumatic stress disorder, almost everyone is experiencing some form of moral injury, our own epidemic among healthcare professionals.

There is no doubt that our jobs are hard, but they are made so much harder by things that really should have been fixed a long time ago. These are called the “legacy issues”, well known secondary stressors that exacerbate moral distress.

The fact that politicians stood on the doorsteps of No 10 clapping while treating NHS staff with such contempt has angered even the most mild-mannered of my colleagues.

And it is this deep, impassible feeling of betrayal which has made people feel they have no option but to leave. A mass exodus from the NHS is no longer a case of if, it’s a case of when.

Staff morale will probably never recover fully. But there is a small window of opportunity now that, if lost, will never be regained. If we don’t start caring about our staff now, there will be no one left to care for our patients.

The NHS has been urged to rethink safety for thousands of frontline staff after new research suggested that Covid patients’ coughing is putting them at far greater risk of catching the virus than previously thought.

The study found that coughing generated at least 10 times more infectious “aerosol” particles than speaking or breathing – which could explain why so many NHS staff have fallen ill during the pandemic.

The research has led to fresh demands that anyone caring for someone with Covid-19, or suspected Covid-19, should be provided with the most protective equipment – including FFP3 respirator masks – and that hospital ventilation should be improved.

Health workers are up to four times more likely to contract coronavirus than the general population, with infection rates among those on general hospital wards approximately double those of intensive care unit (ICU) staff – who do have access to the most protective PPE.

This access to higher-level PPE was based on the assumption thatICU wards are more dangerous because treatments such as continuous positive airway pressure (CPAP), used to support patients’ breathing, generated large amounts of aerosols – which linger in the air and can be breathed into the lungs.

Staff working in other hospital areas, GP surgeries and care homes are issued with looser-fitting surgical masks, which afford little protection against these tiny particles, but block larger virus-carrying droplets.

The new research, which has not yet been peer-reviewed, turns these assumptions on their head.

The research may also boost efforts to force a public inquiry into Covid-19 deaths among NHS staff and care workers. In December, Doctors’ Association UK (DAUK), which represents frontline medics, escalated its threat of judicial review against the government. “Inquiries must be initiated to investigate any factors that may have led to healthcare workers’ deaths,” a spokesperson said.

“We feel that there would be fewer infections among healthcare workers, and fewer deaths, if people had proper masks,” said Dr Katie Sanderson, a junior doctor and committee member of DAUK. “Acute medical wards and A&E, which is where most Covid patients are being cared for, have much lower standards of ventilation than intensive care units, and generally people are coughing all the time.

“This issue affects GPs as well, because most GP commissioners have refused to let GPs have access to proper masks.”

Read the article in full here: https://www.theguardian.com/world/2021/feb/03/covid-coughing-study-suggests-nhs-staff-at-far-greater-risk-than-thought

Matt Hancock has been criticised for a “disgustingly disrespectful” claim that there was never a national shortage of personal protective equipment during the pandemic.

Doctors and MPs condemned the UK health secretary as “deeply insulting” on Tuesday after he insisted that his team had delivered protective equipment for frontline NHS staff in the “teeth of a pandemic”.

Doctors groups said they had helped deliver 45,000 masks to hospitals that lacked adequate supply at the start of the crisis and that the families of healthcare workers who lost their lives to Covid had raised concerns about the protection they received.

Amid the first wave of coronavirus, NHS staff were photographed with poorly fitting PPE, with some having to make gowns themselves from bin bags.

Hancock said that while there were “individual challenges in access to PPE”, they “never had a national shortage, because of my team”.

He was addressing a high court ruling over failings in publishing details of coronavirus-related contracts. He told BBC Radio 4’s Today programme: “This has all been looked into in great detail. It’s only because of the transparency that I support that we can ask questions about these contracts.

“And what’s more, it’s easy to ask these questions, but what is hard is to deliver PPE in the teeth of a pandemic.”

Dolin Bhagawati, from the medical campaign group Doctors’ Association UK (DAUK), said Hancock’s comment that the NHS did not face a national shortage of PPE during the first wave of the pandemic “is disgustingly disrespectful to the memory of frontline colleagues who died from Covid-19 while raising concerns about inadequate PPE”.

He said frontline staff did not imagine having to provide their own makeshift protective equipment, “raising our concerns for weeks only for them to be ignored”.

DAUK delivered 45,000 masks to hospitals that lacked adequate supply. “We are not imagining mourning the colleagues that treated Covid-19 patients with inadequate PPE,” Bhagawati said.

He added: “This callous disregard for the experience of shell-shocked NHS staff in order to save political face is beneath contemptible.”

Read the full article here: https://www.theguardian.com/world/2021/feb/23/hancock-criticised-for-claim-there-was-no-national-covid-ppe-shortage