Are we in danger of repeating the same catastrophic mistakes Cathy Gardner is challenging?

Does no-one learn lessons? – Owl

Extract from: Hospitals ‘will be overwhelmed’ by middle of January, Kat Lay, Health Editor ww.thetimes.co.uk [also been discussed on BBC radio]

“…Hospitals are seeking to move patients into care and nursing homes as their beds fill up, prompting fears among residents’ families that the move might seed coronavirus in those settings.

Chris Hopson, chief executive of NHS Providers, said: “It’s literally leaving no stone unturned to maximise every single piece of capacity we’ve got in those areas under real pressure.”

However, Diane Mayhew, co-founder of Rights for Residents, said: “The irony is that the reason care and nursing homes have so many ‘empty beds’ is mainly due to the fact that they were wiped out in the first wave with Covid during which many residents lost their lives. It was well reported at the time that patients were being discharged from hospitals without tests.” She said that sending patients from hospitals to care homes was “a disaster waiting to happen”.

Homes are understood to be reluctant to take hospital patients because of increased insurance premiums. A Department of Health and Social Care spokesman said: “No care home should be forced to admit an existing or new resident if they do not feel they can provide the appropriate care.”

Must men wear long trousers at work? The short answer is ‘No’

Councillors will have to get used to the new normal when “normality” returns post Covid – Owl

“There are moments, Jeeves, when one asks oneself, ‘Do trousers matter?’ ” Bertie Wooster ponders in PG Wodehouse’s The Code of the Woosters as he struggles to dress for the day. “The mood will pass, sir,” his thoughtful valet assures him.

Jonathan Ames, Legal Editor  www.thetimes.co.uk [extract]

…..In the latest disagreement a judge at an employment tribunal has given a ruling on whether trousers, or the length of them, matter for men.

In a ruling that would send shivers down the spine of Johnny Rose, the patriarch in Schitt’s Creek who cannot abide his son’s three-quarter length trousers — or “colostomy pants” — the judge decided that if female employees did not have to wear a full-length pair then neither should the men.

Judge Alan Johnson ruled that Boots, the high street retailer, discriminated against a male staff member when he was told that he could not wear three-quarter-length trousers in summer…….

Judicial Review – New Year message from Dr Cathy Gardner

Update on Help me hold the government to account for Covid-19 care home deaths

Thank you for your support this year. If it wasn’t for your donations, the case would not now be awaiting a trial date. I could not have pushed this case forward without sufficient funds and also the moral support. The comments left on this page show that some donors have also lost loved ones to COVID-19 and I know that Christmas will have been difficult. 

I’m determined to hold this government to account for some of its failings and we should know the court date soon. It’s likely to be in June, although earlier would of course be better.

Too many people have already died and many more are likely to lose their lives before this pandemic ends. Please stay safe and look out for an update soon.

Cathy

Just a refresher on what happens next, following the permission to proceed to a full Judicial Review:

The government and NHS have to file their detailed evidence by 22ndJanuary 2021 and we then have an opportunity to file evidence in reply. For the first time we will see what the Government’s reasoning was in making some of the disastrous decisions they took – for example the requirement to urgently discharge patients from hospital without COVID-19 tests in March this year.

We expect the trial to take place around April/May next year.

Covid-19: Under 30’s fall victim in increasing numbers

People aged under 30 are contracting coronavirus in the greatest numbers in parts of the Westcountry, the latest statistics show.

[From yesterday’s Western Morning News]

As the new variant of the disease spreads rapidly, figures have confirmed that the young are now falling victim to the disease.

Cornwall’s current overall infection rate is 301.7 people per hundred thousand – but the infection rate for 20 to 24-year-olds is 806.8, while for those aged 25 to 29 it’s 710.3 per hundred thousand.

Two more deaths of patients in the Westcountry, one in Devon and one in Cornwall were reported yesterday.

But weekly figures reveal better news for the two counties.

The number of deaths registered across Devon and Cornwall where Covid-19 was mentioned on the death certificate has fallen to the lowest level for six weeks.

The figures from the Office of National Statistics (ONS) out yesterday relate to the week of December 19 to December 25, but registered up to January 2. They show that 27 of the 285 deaths registered in the two counties had Covid-19 mentioned on the death certificate.

The previous week saw 43 of the 402 deaths registered in the two counties had Covid-19 mentioned on the death certificate.

However experts caution that the reduction in the number of deaths may relate to a combination of factors as a result of the second lockdown, due to the time lag between infection and death, but also could be a result of registration delays over the Christmas holiday period.

And from Today’s paper:

…Meanwhile in the Westcountry, Plymouth’s director of public health Ruth Harrell has told councillors that the city appears to have so far avoided an outbreak of the new highly transmissible variant of Covid-19. 

‘We’re being impoverished’: how English councils have cut care during the pandemic

Lee Mangar’s voice trembles with exhaustion and indignation. She has been looking after her increasingly frail father throughout the pandemic without any payments to cover her caring responsibilities.

Tom Wall www.theguardian.com 

“I am going to cry now … I just need everyone to know the absolute shoddy position Suffolk is putting vulnerable people like my dad in,” she says from her home in Ipswich. “I’m just lucky that I’ve got the determination to keep fighting, because there are a lot of people out there who can’t stand up for themselves.”

Her father, Harold, sold his house to fund a move into a specially adapted extension on Mangar’s house. But Suffolk county council stopped paying Mangar £844 a month to care for her father, who has Lewy body dementia, following the move.

Under the Care Act, people in need of care can use direct payments from their local authority to pay carers, including family members, to help them carry out everyday tasks. Mangar was being paid to help Harold with his personal care and meals – now she has to do it without any financial support.

“They deemed him to be a self-payer. But there is no money,” says Mangar, who gave up her job in a nursery to look after her dad. “We are living off my dad’s pension and borrowing from my mum, who’s in sheltered accommodation. We’re being impoverished.”

Mangar can barely afford to buy the essentials she needs to clean him – let alone treats such as his favourite takeaway meals or new clothes for herself. She says her father needs specialist wipes which cost £4.75 a pack. “I’ve run out and at the moment I haven’t got enough money to go and buy them. So today I had to use kitchen roll, which is no good.”

Their plight is far from unique. Freedom of information requests by the Guardian to 19 English councils facing a high demand for social care, reveal that more than 3,700 working-age adults with physical or learning disabilities and almost 8,500 people aged over 65 have had the monetary value of their care package reduced since March.

The responses also show that just over 1,200 working-age adults with disabilities and nearly 3,500 over-65s have had the number of hours of support provided by local authority-funded carers reduced. And among new applicants for support, less than half of the 255,000 requests for social care were accepted, with only 41% given funded care packages in the 19 authorities between March and September.

“The pandemic seems to be making a bad situation worse,” says Caroline Abrahams, charity director at Age UK. “There’s no reason to suppose that these people’s needs have diminished during this health emergency, rather the reverse if anything, so in most cases they are being left to manage without all the care they require.”

The largest cuts were in bigger, more rural local authorities. Devon county council reduced the monetary value of 655 care packages for working-age adults and nearly 2,000 care packages for over-65s between March and September, more than any other council. Suffolk county council cut support for 571 working-age adults and 1,779 older people.

Staffordshire county council turned down the highest proportion of social care requests, with just under two-thirds of 16,443 people approaching the council for care assessments during the pandemic initially offered only advice, occupational therapy or directed to community groups. Northamptonshire county council – which declared itself effectively bankrupt in 2018 – had the next highest rate of rejection, with more than one-third of families and individuals refused long-term care packages, which can cover help with everyday tasks such as washing and cooking to trips to day centres.

Metropolitan authorities also rejected a large proportion of care requests and cut back on support throughout the pandemic. Liverpool turned down 31% of the near 3,500 requests for social care, while reducing the hours carers spend with 194 working-age adults and 223 elderly people in the city. Birmingham turned down a quarter of its 18,500 requests for social care and Solihull rejected 27%.

The pandemic has increased demands on already overloaded local social care services, which have been struggling to meet the growing needs of ageing populations. Requests for care have soared by over 100,000 since 2015. But austerity since 2010 has shrunk social care budgets by 10% and total real terms spending on social care is below 2009 levels.

Edel Harris, Mencap’s chief executive, says cash-strapped local authorities are clawing back vulnerable people’s support packages at a time when they need it most. “Many people with a learning disability have spent the pandemic trapped at home, losing vital life skills and suffering from increasing mental health problems,” she says. “Unpaid family carers have been left to pick up the pieces, but they are exhausted, stressed and in some cases completely broken.”

A survey in November by the Association of Directors of Adult Social Services (Adass) found that nearly a quarter of English adult social care directors have no confidence in their budgets being sufficient to meet all of their statutory duties, with several councils warning that they could follow Northamptonshire’s footsteps without more government support. Stoke-on-Trent city council this month proposed cuts of £412,000 to disabled and older people’s day services as well as more than £1m worth of savings from adult social care services.

Covid-19 is accelerating these cuts. Minha Chaudhary (not her real name) was told in December that her council was reviewing the care package for her 25-year-old disabled daughter, Zahra, who needs round-the-clock support.

Until now, the funding enabled Zahra to take part in activities such as swimming, cycling and reflexology. Chaudhary, who lives in north-west England, fears the council’s review of Zahra’s care package will lead to cuts to her daughter’s support. “[The support planner] was really antagonistic,” says Chaudhary. “She was recommending that she would take some of the package away from us because we’ve not used it all. But we are in a pandemic and everywhere is shut.”

Chaudhary, who works part-time while her husband looks after their daughter, is taking legal advice. “I’m worried sick,” she says.

Belinda Schwehr, chief executive of specialist legal advice service CASCAIDr, which is supporting Chaudhary, says “This is the endgame for social care. We are getting to the point where anyone able to feed themselves will not get social care.”

In November, the chancellor Rishi Sunak announced new funding for the beleaguered social care sector, including an additional grant of £300m. Sunak also allowed councils to levy a 3% adult social care precept, which could, along with the grant, generate up to £1bn. But this still falls short of what many experts and charities say is needed to keep up with demand next year, let alone the additional costs generated by the pandemic.

“Once again, local authorities are faced with trying to meet the care needs of their populations with inadequate government funding, but it’s older and disabled people who are ultimately paying the price, as these FoI responses demonstrate,” says Abrahams.

Suffolk county council says it has increased the value of more packages than it has reduced since March. “Every authority has continued to adjust the number of care packages it provides to eligible residents throughout 2020, as we continue to react to a range of social changes including the effects of the coronavirus on our communities,” says Beccy Hopfensperger, Suffolk’s cabinet member for adult care.

Devon county council says care packages had been changed rather than cut, with the high numbers reflecting the size of the authority: “Between March and September, there have been changes to people’s care packages in response to coronavirus, and many have sought alternative ways to meet their care needs. The fall in value then is a reflection of such changes,” says a spokesperson. Solihull council says it responds to all requests but some people may not accept social care services, or may not be eligible.

Staffordshire county council insists a range of support is available in communities, with the council funding those most in need. It adds it carries out care assessments at first contact when support is less likely to be needed. Northamptonshire county council says it had not turned down anyone who is eligible for social care support. Liverpool city council says people are assessed for services according to need rather than budget. While Birmingham city council says it is not turning down requests and points out there are many reasons referrals do not result in social care provision.

The Department of Health says it has made £4.6bn available to councils to address pressures on local services, including social care: “We are committed to sustainable improvement of the adult social care system and will bring forward proposals this year.”

This cannot come soon enough for dedicated but burned-out carers like Mangar. She has little to look forward to this year: “There is no money for me to plan anything. I can’t have a break. My life is just getting up in the morning and caring for my dad … we have been treated very, very unjustly.”

Coronavirus: Devon care hotel opens to help ease hospital pressure

A new facility has opened in Plymouth for people needing extra care before they return home from hospital during the pandemic.

BBC News www.bbc.co.uk 

The care hotel, which opened on Monday, aims to ease pressures on the city’s Derriford Hospital.

It is being run by Plymouth City Council and health provider, Livewell Southwest.

A similar set-up was used during the first lockdown last April.

The Hearts Together Hospital Hotel, which normally provides accommodation for patients, carers, relatives and healthcare workers, is being used for the care facility.

Geoff Baines, director of safety and quality at Livewell Southwest, said the service was proud to work with the council to “ensure we can support people during the second wave of the Covid-19 pandemic”.

He added the hotel will help “to relieve some of the pressure on our hospitals by providing somewhere safe for people to move to from hospital when they are well enough but when they are not quite ready to go home without support”.

Two more life-saving Covid drugs discovered

Two more life-saving drugs have been found that can cut deaths by a quarter in patients who are sickest with Covid.

Michelle Roberts www.bbc.co.uk

The anti-inflammatory medications, given via a drip, save an extra life for every 12 treated, say researchers who have carried out a trial in NHS intensive care units.

Supplies are already available across the UK so they can be used immediately to save hundreds of lives, say experts.

There are over 30,000 Covid patients in UK hospitals – 39% more than in April.

The UK government is working closely with the manufacturer, to ensure the drugs – tocilizumab and sarilumab – continue to be available to UK patients.

As well as saving more lives, the treatments speed up patients’ recovery and reduce the length of time that critically-ill patients need to spend in intensive care by about a week.

Both appear to work equally well and add to the benefit already found with a cheap steroid drug called dexamethasone.

Although the drugs are not cheap, costing around £750 to £1,000 per patient, on top of the £5 course of dexamethasone, the advantage of using them is clear – and less than the cost per day of an intensive care bed of around £2,000, say experts.

Lead researcher Prof Anthony Gordon, from Imperial College London, said: “For every 12 patients you treat with these drugs you would expect to save a life. It’s a big effect.”

In the REMAP-CAP trial carried out in six different countries, including the UK, with around 800 intensive care patients:

  • Nearly 36% of intensive care Covid patients receiving standard care died
  • The new drugs reduced that by a quarter, to 27%, when given to patients within 24 hours of them entering intensive care

Prof Stephen Powis, NHS national medical director, said: “The fact there is now another drug that can help to reduce mortality for patients with Covid-19 is hugely welcome news and another positive development in the continued fight against the virus.”

Health and Social Care Secretary Matt Hancock said: “The UK has proven time and time again it is at the very forefront of identifying and providing the most promising, innovative treatments for its patients.

“Today’s results are yet another landmark development in finding a way out of this pandemic and, when added to the armoury of vaccines and treatments already being rolled out, will play a significant role in defeating this virus.”

The drugs dampen down inflammation, which can go into overdrive in Covid patients and cause damage to the lungs and other organs.

Doctors are being advised to give them to any Covid patient who, despite receiving dexamethasone, is deteriorating and needs intensive care.

Tocilizumab and sarilumab have already been added to the government’s export restriction list, which bans companies from buying medicines meant for UK patients and selling them on for a higher price in another country.

The research findings have not yet been peer reviewed or published in a medical journal.