GOOD AFTERNOON and welcome to my weekly patient safety update. This week the Select Committee examined the future of general practice, the government published its plan for digital health and social care as well as the draft Mental Health Bill, and the NHS announced progress on tackling two year waiting lists.

IS CONTINUITY OF CARE THE ANSWER TO GP WOES? The Select Committee continued its investigation into the future of general practice yesterday with a strong consensus that the partnership model should be backed rather than scrapped with the NHS Confederation, NHS Providers and Dr Claire Fuller all supporting them. More depressing though was the NHS resistance to reintroducing individual patient lists for GPs because of an apparent lack of capacity to do so. But as earlier evidence we heard shows a well organised system in which patients are offered the chance to see their regular GP if they are willing to wait longer actually reduces the intensity of work for GPs. It is far less stressful seeing 40 patients in one day if you know two thirds of them - and your chance of fixing a problem quickly is much higher if you know a patient’s context. 

DIGITAL DELIGHT The government has today published its plans for digital health and social care which will see significant changes to the NHS App, an acceleration in the use of technology to improve efficiency and tackle the covid backlogs, and the roll out of electronic patient records. This is all backed up by £2bn that was allocated in the spending review last autumn. The number of patients benefitting from remote monitoring with be increased by 500,000 by March next year and £25m will be spent to support the digitisation of social care records. All good stuff which we will look at closely in our forthcoming Select Committee inquiry into the NHS use of technology.

THANK YOU SIR SIMON After Sir Simon Wessley’s magnum opus into reform of mental health legislation, originally commissioned ahead of the 2016 election (remember that one?) the government has finally published its draft Mental Health Bill for pre-legislative scrutiny. The Secretary of State told the House of Commons that the Bill will make detention a last resort, give patients greater control over the treatment, address disparities in how the Mental Health Act is used, and limit the scope for detaining people with learning disabilities and autistic people for treatment. This is all really welcome but as I said in the debate it will be a wasted opportunity if we don’t do something to get the 2,000 people with autism or learning disabilities who are currently incarcerated out and into the community. This remains in my view the biggest human rights scandal in the country today and it is a golden opportunity to sort it.

HSIB ON NURSING SHORTAGES On a similar topic HSIB has published a report highlighting the shortage of learning disability nurses. In an investigation into medication omissions to patients in learning disability secure units it concluded that a shortage of specialist nurses together with poor ward design increased the risk of such omissions. HSIB reports are starting to get much better in my view.

TWO YEAR WAITS ARE OVER?  NHS England has announced it is making decent progress towards eliminating the waiting list of those waiting two years or more for treatment by the end of July. They state that the number waiting two years or more in acute hospitals has fallen from a peak of 22,500 in January to 6,700. Those remaining on the list are being asked if they would be prepared to travel further in order to get treatment quicker. It is a welcome ‘quick win’ for ministers but the bigger question of course is what substantive progress we make towards the extraordinary 6.5m English patients overall who are currently waiting for treatment. The Health Foundation says it will need 4,000 more doctors to eliminate the backlog, but without a workforce plan there is precious little chance of that.

COVID LATEST Covid cases continue to rise with the ONS reporting that 1 in 40 people in England in the week ending 18th June had the virus, up from 1 in 50 in the previous week. The dashboard is also flashing red showing that in the last 7 days cases have increased 36%, hospitalisations up 38% and deaths up 25%. Separately the pandemic Public Inquiry has now properly got underway as the Terms of Reference have been agreed by the Prime Minister. All of the recommendations made by Baroness Hallett to the terms have been accepted which is good news.

THE PLUG Why not forward this email to a friend and get them to sign up here? You will be helping patient safety messages reach the parts other emails do not…

Jeremy Hunt