PPE: Ministers pay consultants to find procured kit

The government is not sure where billions of pounds worth of personal protective equipment (PPE) is located, the head of the National Audit Office has disclosed.

Rajeev Syal www.theguardian.com

Gareth Davies, the comptroller and auditor general, said outside consultants had been brought into Whitehall to find all equipment, which is stored at different sites around the country, or is in transit from abroad.

The task had been undertaken so that the Department of Health and Social Care knew when stocks would become too old to use and could complete its own accounts, he said.

Under questioning from the public accounts committee, Davies said: “We have been working closely with the DoH. It has commissioned consultants to advise it on first of all understanding where all the PPE that has been bought actually is. It sounds like a strange question but it is a really big issue because it is not all standing neatly in an NHS store somewhere.

“We have amounts in containers, in storage around the country, there’s some on the docks and there is some en route somewhere from China.”

Concern over shortages of PPE was a marked feature of the early phase of the pandemic last year as countries around the world scrambled for scarce supplies as the disease spread across the globe.

Frontline staff in both health and social care experienced shortages of PPE, with some forced to reuse single-use items as stocks ran low.

In July, Rishi Sunak allocated £15bn to procure masks, gowns and gloves – a sum that dwarfs the entire spending of other Whitehall departments.

Davies said the task of evaluating how much the stock was worth would also mean assessing when the equipment went beyond its “use by” date.

“Evaluating that [PPE] accurately for the 31 March for the accounts is a really difficult proposition – it is not one that can be avoided because it is a very material sum this year. Fifteen billion pounds has been budgeted to spend on it in the year.

“We have been working with the department and their consultants to understand how they are getting a handle of where the material is and then how it is being valued, including the issue that I know the committee has been interested in, the age of the stock and at what stage does it become unusable and therefore valueless.”

The government has been criticised for an over-reliance upon outside consultants during the pandemic.

A Department of Health and Social Care spokesperson confirmed that it has outside consultants working on its accounts, but said it was incorrect to suggest they are working on locating and accounting for PPE. The department did not reply to questions asking which outside consultants are being employed or how much they are being paid.

“These claims are false. We are working to ensure that our accounting records are accurate and up to date and the National Audit Office is performing its annual audit. As is standard practice in any industry, a stock take is done before the end of the financial year, so that records are up to date. The Department of Health and Social Care is no different,” the spokesperson said.

NHS: What reforms does the government want to make?

Joined-up care and less bureaucracy are among the proposals by the government in a bid to reform the health and social care system in England.

ITV News www.itv.com 

A plan to build on work done during the coronavirus pandemic to create a “more integrated, more innovative and responsive” NHS has been set out by Health Secretary Matt Hancock.

However, many have questioned why these changes are being suggested while the NHS battles the Covid-19 crisis.

So, what exactly is being suggested?

What do the plans hope to achieve?

The Department of Health and Social Care (DHSC) said the proposals include improving care and tackling health inequalities through measures to address obesity, oral health and patient choice, the Department of Health said.

The measures effectively sweep away some of the bureaucracy and organisational changes introduced by then health secretary Andrew Lansley in the heavily criticised 2012 Health and Social Care Act which increased competition in the NHS.

The DHSC acknowledged that under the current system NHS staff waste a significant amount of time on unnecessary tendering processes for healthcare services.

The new proposals mean the NHS will only need to tender services when it has the potential to lead to better outcomes for patients.

What about social care?

The White Paper (the way the government sets out planned changes) promises better integration between the NHS and social care, which is usually funded privately or by local authorities.

Making it easier to treat people outside hospitals and making it safer and easier for medics to discharge patients into the community could ease pressure on the NHS while also improving care.

The government’s plans would allow the NHS and local government to come together legally as part of integrated care systems to plan services around their patients’ needs, including a greater focus on preventative healthcare outside hospitals.

Will ministers have a greater role?

Ministers will assume greater responsibility, although Mr Hancock has insisted the clinical and day-to-day operational independence of the NHS will be protected.

The reforms will give the health secretary “the right levers to ensure accountability back to Parliament and taxpayers”, DHSC officials said.

Anything else?

The coronavirus pandemic has starkly illustrated the dangers of an obese population and the White Paper includes new requirements about calorie labelling on food and drink packaging and the advertising of junk food before the 9pm watershed.

The White Paper also calls for the Healthcare Safety Investigations Branch to be made a statutory body and so able to enforce laws, and to reduce risk and improve safety.

What did the government say?

The proposed social care reform will “make the system work for those who work in the system”, Mr Hancock told the Commons.

“At its heart, this White Paper enables greater integration, reduces bureaucracy and supports the way that the NHS and social care work when they work at their best together,” the health secretary said.

“It strengthens accountability to this House and, crucially, it takes the lessons we have learnt in this pandemic of how the system can rise to meet huge challenges and frames a legislative basis to support that effort.”

Mr Hancock continued that “there is no better time than now” to carry out social care reform.

Answering critics who have asked “why now?” Mr Hancock told the Commons: “The response to Covid-19 has, in my view, accelerated the pace of collaboration across health and social care, showing what we can do when we work together flexibly, adopting new technology focused on the needs of the patient and setting aside bureaucratic rules…

“The pandemic has made the changes in this White Paper more not less urgent, and it is our role in Parliament to make the legislative changes that are needed.”

Shadow health secretary Jonathan Ashworth questioned plans to reform the health service during the ongoing pandemic Credit: UK Parliament/Jessica Taylor/PA

What has Labour said?

Labour also questioned the timing of the suggestions, with shadow Health Secretary Jonathan Ashworth saying” “Staff on the front line are exhausted, underpaid. The Royal College of Nurses says the NHS is on its knees.

“Primary care and CCG staff are vaccinating and will be doing so for months ahead, including possibly delivering booster jabs in the autumn. And today we learn that 224,000 people are waiting over 12 months for treatment.

“And this secretary of State thinks this is the right moment for a structural reorganisation of the NHS.

“Now we will study the legislation carefully when published but the test of his reorganisation will be whether it brings waiting lists and times down, widens access, especially for mental health care, drives up cancer survival rates and improves population health.”

He added: “Fundamentally, how will this reorganisation and power grab improve patient care?

“He didn’t mention waiting times in his statement, it’s only mentioned once in the leaked White Paper.”

What have experts said?

Richard Murray, of the King’s Fund health think tank, said there was “much to welcome in the ambition of the White Paper, but the history of the NHS is littered with reform plans that overestimated benefits and underestimated disruption”.

He also questioned the timing of the proposed shake-up, with the health and care sectors still battling Covid-19.

Sir Simon Stevens, chief executive of the NHS, said: “Our legislative proposals go with the grain of what patients and staff across the health service all want to see – more joined-up care, less legal bureaucracy and a sharper focus on prevention, inequality and social care.”

Professor Helen Stokes-Lampard, chair of the Academy of Medical Royal Colleges welcomed the proposals “to drive integration and support greater collaboration through integrated care systems (ICS)”.

She said while legislation will not make collaboration happen, it can “remove barriers and facilitate the changes that the NHS really needs as we move into the post-pandemic recovery stage”.

NHS Providers chief executive Chris Hopson said there is “widespread agreement” across the NHS on many of the proposals in the White Paper based on a set of agreed legislative proposals in 2019.

He said: “These proposals provide an important opportunity to speed up the move to integrate health and care at a local level, replace competition with collaboration and reform an unnecessarily rigid NHS approach to procurement.”

But he said the organisation is “keen to understand the government’s intentions on some of the new proposals it has added such as the new powers for the Secretary of State to direct NHS England, transfer powers between arms length bodies and intervene in local reconfigurations”.

Dr Jennifer Dixon, chief executive of the Health Foundation, gave only a partial welcome.

She said: “One half of the proposals, to help local services collaborate better, could help improve care for patients and follows the direction NHS leaders are already taking.

“The other half, giving the Secretary of State more power over the NHS, is concerning, has no clear rationale and could take health care backwards.”

Ian Hudspeth, chairman of the Local Government Association’s community wellbeing board, said the paper “provides a promising base on which to build stronger working relationships between local government and the NHS”.

The British Medical Association’s council chair Dr Chaand Nagpaul warned against rushing reform when doctors are “now both physically and emotionally exhausted”.

He said: “Proposals for sweeping reorganisation on such a scale will need greater time for consideration and must not be rushed through while doctors are still tackling the winter surge in infections, hospitalisations and tragically, deaths.”

Harvard researchers have calculated how many unnecessary deaths the Trump administration left behind

A novel way to audit an administration’s impact on the health of a nation. Owl has totted up the figures which appear to exceed 2 million over Trump’s four year term.

Wonder how Boris is doing? What are the “costs” of his delayed decision making?

Arianne Cohen www.fastcompany.com 

The Trump administration leaves a devastating health legacy far beyond COVID-19, according to a new study in The Lancet by 33 researchers, led by professors at Harvard Medical School and the University of California at San Francisco.

The report finds that the Trump administration’s health policies resulted in 461,000 unnecessary U.S. deaths annually—in addition to 40% of America’s COVID-19 deaths thus far, plus 22,000 avoidable deaths annually from environmental policies.

The authors paint a damning picture of Trump politics, concluding that he purposely sought struggling white voters, and then backed policies that threatened their health: He earned his largest 2016 electoral margins in counties with the county’s worst mortality statistics, with life expectancies averaging 2 years shorter than in counties where he lost. His policies overwhelmingly favored corporations and wealthy Americans.

The paper presents a horrifying quantification of how and why the pandemic has cost so many American lives. Though the report points many fingers at the Trump administration, it also highlights the previous four decades of weakened social and health safety nets, including the 50,000 frontline workers that public health agencies lost from 2008 to 2016 due to budget cuts; over 10% of Americans faced hunger, which correlates with a high risk of obesity and diabetes, both common factors in severe COVID-19.

The researchers compared the U.S. figures to those of G7 nations. “This unprecedented decoupling of health from national wealth signals that our society is sick,” says coauthor Steffie Woolhandler, a lecturer (and former professor) at Harvard Medical School. “While the wealthy have thrived, most Americans have lost ground, both economically and medically. The Biden administration must reboot democracy and implement the progressive social and health policies needed to put the country on the road to better health.”

This is the first comprehensive look at the health impacts of the Trump administration.

Devon and Cornwall are closed to tourists this half term

Tourism bosses in Devon and Cornwall are backing the police message to holidaymakers not to travel to the region during next week’s traditional half-term school holiday.

[Matt Hancock admits he’s booked a summer break in Cornwall after Transport Secretary Grant Shapps declared: ‘People shouldn’t be booking holidays right now – not domestically or internationally.’ www.dailymail.co.uk]

Colleen Smith www.devonlive.com

Despite the disastrous impact that Covid-19 has had on the holiday sector, industry leaders across the South West all joined the police and emphasised that lockdown still means lockdown: “Please, please do not come.”

The director of Visit Devon, Sally Everton, said: “Saying ‘Don’t come’ goes against the grain because my role in life is to promote Devon’s tourism industry – so for me it is really difficult. But we 100 per cent support the police message. We are still in lockdown. It is illegal to travel outside of your local area.”

It comes despite new figures which show that the region lost over half of its visitor economy in 2020, with 166,000 South West people currently on furlough – most of those in hospitality.

Devon and Cornwall Police issued their message earlier today urging people to stay local in order to prevent the spread of coronavirus. It called on people to “stay local this half term”, saying the region “will welcome you back again soon”.

In March 2020 CornwallLive, DevonLive and Plymouth Live joined forces with the region’s MPs, tourism leaders and the emergency services to issue one simple message – please come back later.

The campaign continues with its three main objectives, calling on visitors to pledge to:

Help stop the spread of corona and save people’s lives

Protect our NHS from further pressure

Support our tourism industry by pledging to come back later in the year and not now

Alistair Handyside, South West Tourism Alliance chairman, said: “We are in lockdown. We are closed. Please, please do not come.

“And then, when we do eventually get the announcement that we can open the message is very simple: Don’t come unless you have booked somewhere to stay because we will have less capacity.

“We have lost a lot of business and some are not operating. For example 15 per cent of holiday cottages will not open because they are not confident about dealing with the Covid cleaning and all the other issues around this terrible pandemic.

“Hotels will be operating at less than normal capacity, as will guest houses.

“Although people are predicting a boom what they don’t realise is that we are full because we have less capacity and more demand. This means people have to book before they come.”

Ms Everton, the director of Visit Devon, added: “Our message to tourists is very clear: Welcome back – but not until it’s safe. We are very much in the government’s hands and as things stand people have to stay away. It’s illegal to travel out of your local area. We 100 per cent support the police message.”

Malcolm Bell, chief executive of Visit Cornwall, agreed that that the tourism board’s message is very much in line with that of Devon and Cornwall Police.

Mr Bell added: “There is no reason for anybody to come because we are in lockdown.

“It’s stating the obvious to be honest but that does probably have to be restated and it’s always good to remind everybody.

“I think a lot of people might say that they knew that and of course, they are aware that they can’t come, but it doesn’t hurt to remind people of that.”

He continued: “As always public health comes first and that goes without saying. We did have two-and-a-half-million people down last year with no impact so it has proved that the tourism industry can operate in a Covid safe manner when safe to do so”.

North Devon MP Selaine Saxby yesterday called on the Health Secretary to give reassurances that efforts to get coronavirus infection rates in the region to among the lowest in England will not be eradicated by the return of tourists.

Ms Saxby asked Matt Hancock after he unveiled tough new measures for travel in England whether the Government is working on making sure the infection does not increase when tourists are allowed back.

The Conservative MP also asked about whether consideration is being given to easing lockdown measures in areas were infection rates are low.

Transport Secretary Grant Shapps raised fears that Britons might not be able to enjoy a holiday either in the UK or abroad this summer.

Mr Shapps told Sky News that border measures were now targeted against newer variants of the virus, rather than a means of restricting travel to areas with higher infection rates as under the now-scrapped “travel corridors” system.

“It’s not about the prevalence of the virus elsewhere now, it’s about the variants,” he said.

Ms Everton added: “Last year there was very clear evidence that tourists did not cause a spike when they were here during July and August.

“But now we have all these variants which are far more transmissible. In Devon and Cornwall we have done a great job and the figures for the virus are coming down and down. It proves that lockdown works.

“Many of our holiday businesses have spent thousands of pounds to ensure they are Covid safe and have the correct personal protective equipment. Now when we are allowed to reopen it’s up to the public to play their part – act like responsible adults and stay away from crowded places. The problem is that when people come away on holiday they tend to breathe a sigh of relief and think ‘Ah – thank God for that’ and forget the Hands, Face, Space rules still apply.”

More than a quarter of Devon has now had jab

Nearly 300,000 people in Devon – more than a quarter of the population – have had their first Covid-19 vaccine, latest NHS England figures show.

Daniel Clark www.devonlive.com 

The statistics, which provide the position as of February 7, show that there have been 284,342 vaccinations in the county, with 271,603 of them being the first dose. Just under 70,000 vaccinations were carried out in that seven day period.

The figures for Devon, which will have risen in the most recent days, are by far the highest number of vaccinations for any of the regions within the South West – double that of Cornwall – and they show that 27.1 per cent of the population had received their first jab. This is up on the 20.5 per cent as of January 31.

With estimated adult population of the Devon STP area being 999,049, the 271,603 who had received their first dose, means that as of Sunday, 27.1 per cent of Devon’s residents had received at least one dose of the vaccine. Those numbers will have risen since, with Thursday morning’s Team Devon Local Outbreak Engagement Board meeting hearing the number was now just under 300,000.

The statistics show that as of Sunday, of the 79,525 estimated population of over 80s within Devon, 76,193 had received their first vaccine – a total of 95.8 per cent, with 10,897 – 13.7 per cent – having also had the second dose, with Devon’s population of over 80s is significantly higher than every other region – more than double in some instances

Of those aged 75-79, 54,074 people have received the first dose of the vaccine – an estimated 98.2 per cent of the cohort – while 42,785 of those aged 70-74, an estimated 53.8 per cent of the cohort – had as of Sunday had at least one dose.

And 98,551 under 70s, primarily those employed in health and social care settings, although some in the next cohorts from the priority list, had received the first dose of the vaccination as of Sunday – 12.5 per cent of the total under 70s.

Health chiefs say that the remain confident that all of those in the top four priority groups – all those in care homes, health and social care staff, and those over 70, will have at least been offered a vaccine by Monday, and that so far, 84 per cent of them had received their first vaccination.

Dr Paul Johnson, clinical chair of the Devon CCG, told Thursday’s morning Team Devon Local Outbreak Engagement Board meeting that close to 300,000 first doses in Devon had now been issued.

He said that all but eight care homes where Covid-19 outbreak had been in progress had now been vaccinated, and that they were ready to start on cohort 5 – the over 65s next week.

Dr Johnson said: “Given the high proportion of older people in the county, it is testament to good work to keep up with other areas who don’t have so many old people.”

He showed figures that prior to the start of the vaccine rollout from a survey that they carried out that suggested that 74 per cent of the population were happy to take the vaccine, 19 per cent were hesitant, two per cent were resistant, while less than two per cent were going to reject the vaccine.

He said: “It looks like we will get at least 90 per cent of the population having the vaccine, so a significant number who were hesitant have been persuaded.”

The Team Devon meeting also were presented with findings from Living Options, who had been asked jointly by Devon County Council and Devon Clinical Commissioning Group, to contact a wide range of partners to gather their perspectives on how their often vulnerable and hard to reach service users were understanding the new Covid-19 vaccination programme

The report said: “A positive majority of respondents will not reject having the vaccine and feel that prevention is better than a cure. They feel that, though there may be risks attached to it, as nothing is free of side effects, healthy people are dying and they would rather give the vaccine a go.

“The biggest concern was about possible side effects as the testing is seen to be for a much shorter amount of time than normal. There is confusion for many on the practicalities of when they might get the vaccine and difficulties in knowing where best to look for accurate information. It feels for some like there are inconsistencies in provision across localities and this can be hard to understand / accept.

“Many communities, including BAME and Learning Disability, are identified already as being disproportionately affected by Covid-19 and this inequality is further compounded by a lack of translated resources about both Covid rules in lockdown and information about the vaccine.

“Accessible information including alternative languages, Easy Read, BSL and for those who are hearing and / or visually impaired is essential.

“Other communities that might be more vulnerable to Covid are homeless people, refugees / asylum seekers, those in custody, and Gypsy / Romany Travellers, so it will be vital that strategies are in place to vaccinate these as soon as possible.

A member of staff prepares a dose of the Oxford/Astrazeneca coronavirus vaccine at a coronavirus vaccination clinic at the NHS Nightingale Hospital North East in Sunderland. Picture date: Tuesday January 26, 2021. (Image: PA Wire/PA Images)

“Alongside making the vaccines manageable to all communities the actual vaccination centres must also be as accessible as possible. Many people live without anyone else to offer practical support to help them so this must always be understood, and provision made to ensure that they are equally able to access information / the actual vaccine.

“Poor mental health is an increasing concern, and the vaccination programme offers hope that the pandemic may start to get a little easier to live through and there is good understanding of why certain groups have been prioritised.

“However, those who are vulnerable, but not in a priority group, may feel they have to ‘shield’ until they receive the vaccination to remain safe. This is likely to increase feelings of loneliness and isolation. There is also an increased reporting of those who have serious agoraphobia / OCD, amongst other conditions, because of the key messaging about how Covid-19 is transmitted. This can stop people being able to leave their houses so provision needs to be made for people in this situation to enable them to access the vaccine.”

There are now five methods by which the vaccine is being rolled out across Devon.

All four of the county’s main hospitals – in Plymouth, Exeter, Torquay and Barnstaple – are giving the vaccination to priority groups in line with national guidance, while GP practices are working together in groups to set up local vaccination centres, and across the county, 20 centres are now in operation, serving all of Devon practices.

GP-led facilities are delivering the vaccine to residents and staff in care homes, while pharmacies have started to deliver the vaccine, and the mass vaccination sites at Home Park in Plymouth, and Westpoint Arena just outside Exeter became operational with thousands of vaccines a day to be delivered.

Every Devon care home has been vaccinated as well, except for those where there were active outbreaks.

East Devon Watch – the first million hits Part 2

Old Owl continues..

Part 2The scandals …

So, here we are … Claire Wright, a new, young, very feisty INDEPENDENT district councillor, looking for answers (a novelty in itself) and prepared to do whatever it took to find them … and a restive community pining for change.

Scandal 1 – the “Local Development Framework Forum”

This was a closed group, meeting in secret, with no agendas or minutes published (which is why it was created as a “Forum” and not a full committee).  Its job was to scope out future development sites to include in the forthcoming Local Plan, which every council was being forced to produce by central government to very narrow guidelines.

It was hard at first for her (and others) to penetrate this secrecy – but to cut a long story short – eventually through Freedom of Information requests and publicity, EDDC reluctantly had to publish the agendas and minutes.

And what a scandal that was!  It seemed that this Forum spent most of its time discussing and visiting sites of close associates and businesses to assess their suitability for developments large and medium.  This was NOT the idea of such a group.  It was supposed to assess ALL sites brought forward by ALL interested parties against criteria that ought to have included such things as sustainability and landscape protection.  Again, to cut a very long story short, this was found to be the wrong way to be going about things (duh) and the whole procedure, Forum and all, had to be scrapped and started again – this time as a formal committee – with the beady eyes of the public (and Claire Wright) watching … at least two years wasted (though it would undoubtedly not have been wasted had it been allowed to remain secret and led to a Local Plan that would have been very, very local).

Scandal 2 – the East Devon Business Forum

Some bright sparks in the ruling group then had a stunner of a brainwave.  Given that councillors and officers were now having to be in the open, why not create another group of local councillors and landowners and get them to be the major force for the new Local Plan – genius!

The great and the “good” were therefore assembled and – yet again – met in secret under the redoubtable chairmanship of one Councillor Graham Brown, who had also played one of the leading roles in Scandal 1 above.  But this time local and national developers had seats (by invitation only) at the table.

All the usual … er I was going to say suspects but let’s say local and national house builders and wannabe housebuilders … were members.  And, to add insult to injury, the Forum was allowed to meet in an EDDC-owned building, bankrolled and given senior administrative support by … East Devon District Council – at this point under the iron hands of Karim Hassan and Mark Williams aided by their senior officer Nigel Harrison, who gave this Forum all the help it needed.

Once again, much fighting by locals meant that this “Forum” eventually had to publish its work, which, once again, concentrated on giving its members the best possible opportunities to be developers large and even larger …

Once people heard about this new group, there was outrage and a growing number of local people decided that something radical needed to be done.  This led to the creation of a new local pressure group “East Devon Alliance”.  This group had no interest in political affiliations – it simply wanted what was best for East Devon, not for developers’ pockets.

East Devon Alliance eventually had no choice but to register as a political party if it wanted to fight locally (and even nationally) in elections, which it duly did.  It had some success at the local elections 2015, returning several councillors, but not enough to encroach on the established Conservative majority.  Still it was making inroads.

Scandal 3 – I can get you planning but I don’t do it for peanuts

What can one say – a sting by the Daily Telegraph no less and it even made its front page!  A couple of delightful young women were sent to talk to Councillor Graham Brown about how to get planning permission in East Devon, covertly recording their meeting.  Bear in mind, he was Chair of East Devon Business Forum AND ran his own planning consultancy while being a Conservative councillor at this time.

Owl can report no better than this:

https://www.bbc.co.uk/news/uk-england-devon-21768520

It must be noted that Councillor Brown was not suspended immediately and resigned rather than being expelled from the Conservative Party.

Tempers were now running high, and there was even a report published on planning scandals which devoted a whole chapter to East Devon!  It was called “Scaring the Living Daylights out of People” by Anna Minton:

https://spinwatch.org/index.php/component/k2/item/5458-the-local-lobby-and-the-failure-of-democracy

Partly on the back of this and partly because of a real desire for change in the district, the East Devon Alliance went from strength to strength and fielded more candidates at the next local election in 2019 and successfully got some of those candidates elected to the district council.  It seemed like EDA was in the ascendance but then a major setback occurred. Its then Leader, Ben Ingham (formerly a Conservative Councillor, then an Independent councillor, then an East Devon Alliance councillor) turned once again to become an “Independent” Councillor claiming to be the leader of all independents in the council.

At the May 2019 elections the Conservatives lost their overall majority but “Independent” Ben Ingham turned his back on the East Devon Alliance, he once led, and took a miscellaneous group of independent councillors into a loose coalition with the Conservatives, following very similar policies to those of the defeated Tory administration…. All that hard work had now come to nothing!

Next … part 3 concluding – successes, the future and East Devon Watch’s place in that future …