Good afternoon and welcome to my latest patient safety update in which we look at Sajid Javid’s big reform speech, delays to the Ockenden final report, a fascinating Select Committee session on body image and whether I (and others) spoke too soon on Covid. Plus a crucial victory in the House of Lords on my favourite whinge –the NHS and care workforce crisis.

LORDS WORKFORCE RESULT Let’s start with some genuinely good news. Thanks to tireless work from Julia Cumberlege, Simon Stevens and Dido Harding (amongst others) the House of Lords has amended the Health and Care Bill to insert the requirement for independent workforce projections to be published every couple of years. As many of you will know I have long believed this is the only long-term solution to the massive workforce problem we have - a necessary but not a sufficient solution because of course then the government has to commit to increasing the numbers we train appropriately. Because this requirement will now come back to the Commons in what is known as ‘ping pong’ the government will have to decide whether to vote it down a second time (after they voted down my identical amendment before). It will not be easy to get Rishi to change his mind (it is the Treasury blocking it) but at least the government will now have to make an active decision on the issue. We now have a couple of weeks in which I and many others will be pushing them hard on this - and making the point that it is the only way to reduce the eye watering £6.2 bn we spend on locums/agency staff every year.

PROGRESS ON NURSE NUMBERS In resisting this amendment the government will no doubt cite the fact that they are now more than halfway to achieving their goal of recruiting 50,000 additional nurses. This is obviously welcome news as these extra nurses will help to tackle the backlog but what no one in the NHS or government has ever been able to say is whether the 50,000 figure is the right one or just plucked out of the air - another reason for those independent projections.

OCKENDEN DELAY A frustrating parliamentary procedure means that the final report from the Ockenden Review has been delayed. The DHSC laid the required minute to provide indemnity to the review team yesterday and that now means we have to wait 14 days that Parliament is sitting to see if any MP objects to it. As I understand it the report won’t be published until that has happened which means things are tight in terms of it being published before the Easter Recess starting on 31st March.  What matters to me most is whether we get the Secretary of State himself responding to it in parliament - if David Cameron found time to respond to the Francis Report into Mid Staffs surely it is not asking too much for the Health Secretary to respond to what is likely to be an equally pivotal report.

TALKING OF WHICH Sajid Javid gave a wide-ranging speech at the Royal College of Physicians yesterday where he made a familiar case for reforming the way we deliver healthcare. He argued that changing demographics, raising expectations and unsustainable finances all mean we need to reform the NHS rather than simply put more money in. He also said that without reform taxes and waiting lists would rise. There was nothing to disagree with but few concrete policies to deliver his ‘four Ps’ (Prevention, Personalisation, Performance, People) - and those of us worried about workforce were disappointed money for workforce reforms will have to be found out of existing budgets which sounds very much like no additional doctors or nurses are going to be trained.

PREPARING FOR FUTURE PANDEMICS In an earlier speech at the CEPI Global Pandemic Preparedness Summit 2022 the Health Secretary also announced the 100 Day Mission, a partnership designed to make “diagnostics, and therapeutics and vaccines more available more effective more affordable within the first 100 days of any new pandemic being identified.” This was originally outlined by Matt Hancock at the G7 Health Ministers meeting last summer and would make a massive difference…provided of course DHSC is not too distracted by the backlog to deliver it.

COVID RESURGING? I may have spoken too soon last week when I said we might be getting back to normal as there was “so little fuss about” covid. News on Monday that cases and hospitalisations have rebounded significantly are a cause for concern and worth keeping an eye on. In the last 7 days cases have gone up 39.2%, hospitalisations up 11.1% and deaths down 1.6%. Interestingly the ONS, which is a couple of weeks behind the dashboard, still found cases were going down at the end of February finding that 1 in 30 in England had the virus.  So there appears to have been a significant shift in the first week or so of this month. More oomph on fourth jabs please.

BODY IMAGE On Tuesday the Select Committee kicked off its inquiry into the impact of body image on mental and physical health. We heard some incredible stories from young people who had suffered from poor body image including James Brittain-McVey from the Vamps (yes I hadn’t heard of them and was relieved to hear their fan base is the under 30s). He explained very powerfully how body image struggles aren’t rooted in vanity, contrary to some misconceptions. Model Nyome Nicholas-Williams told us of how bullying at school caused her to stop eating and campaigner Alex Light spoke powerfully about how societal pressures around being thin led to her struggles with disordered eating. We also heard from academics on how widespread these issues were and how best to strike a balance between tackling public health issues such as obesity without descending into fat-shaming. Not a totally easy balance to get right in my experience.

EATING DISORDERS As Dr Georgina Krebs told the Select Committee those with high levels of body dissatisfaction are four times as likely to have eating disorders. So it is a real concern that  more young people than ever before are being treated for eating disorders according to the latest figures from the NHS. A staggering 10,000 young people started treatment between April and December of last year. Extra funding is being provided for children’s mental health services in general and eating disorders in particular but as the Select Committee warned this increase in capacity may not be happening fast enough. 

THE ADMIN As ever you can sign up to receive this update via our website here and please tell any friends you think might enjoy it. I enjoy writing it!

Jeremy Hunt